Acemannan, a major polysaccharide component derived from Aloe vera gel, has been studied for its wound healing and ulceration-support properties, particularly in external applications. Several in vitro and in vivo studies have indicated that Acemannan may accelerate wound healing by promoting fibroblast proliferation, collagen deposition, and angiogenesis. It is thought to stimulate macrophage activity, leading to the release of growth factors that facilitate tissue repair. Some animal studies and a limited number of small-scale clinical trials have shown that topical application of Acemannan-containing gels or dressings can reduce healing time and improve outcomes in the treatment of skin ulcers and burns.

Despite these findings, the body of evidence remains limited, with most studies being preclinical or involving small patient groups. Systematic reviews note the potential of Acemannan but also highlight the need for larger, well-controlled human trials to establish its efficacy and safety profile for external ulcerations. Regulatory bodies have not universally approved Acemannan for this indication, and its use is often adjunctive rather than primary. Thus, while there is some scientific basis for its use in supporting the treatment of external ulcerations, the evidence is not yet robust or comprehensive enough to warrant a higher rating.