Efficacy of Aloe vera/olive oil cream versus betamethasone cream for chronic skin lesions following sulfur mustard exposure: a randomized double-blind clinical trial

Background: Chronic pruritic skin lesions are among the common late complications of sulfur mustard intoxication. In the present randomized double-blind clinical trial, therapeutic efficacy of Aloe vera/olive oil combination cream in the alleviation of these lesions was evaluated and compared to that of betamethasone 0.1% cream. Methods: Sixty-seven Iranian chemical warfare-injured veterans were randomized to apply A. vera/olive oil (n = 34, completers = 31) or betamethasone 0.1% (n = 33, completers = 32) cream twice daily for 6 weeks. Evaluation of pruritus severity was performed using a pruritic score questionnaire and visual analogue scale (VAS). Results: Both treatments were associated with significant reductions in the frequency of pruritus (p < 0.05), burning sensation (p < 0.01 and p < 0.001 in A. vera/olive oil and betamethasone group, respectively), scaling (p < 0.01 and p < 0.05) and dry skin (p < 0.001) at the end of trial. Fissure and excoriation were only reduced in the A. vera group (p < 0.05). The change in the frequency of hyper- and hypopigmentation lesions, blisters, erythema and lichenification did not reach statistical significance in any of the groups (p > 0.05). Mean pruritus (p < 0.05) and VAS scores (p < 0.01 and p < 0.05) were significantly decreased by the end of trial in both groups. The rate of improvement in the pruritus severity [defined as being classified in a less severe category (mild, moderate and severe)] was found to be comparable between the groups (p > 0.05). Conclusion: A. vera/olive oil cream was at least as effective as betamethasone 0.1% in the treatment of sulfur mustard-induced chronic skin complications and might serve as a promising therapeutic option for the alleviation of symptoms in mustard gas-exposed patients.