Aloe ferox, Agathosma betulina, and Bulbine frutescens Extracts Show Antifungal Activity at Concentrations Favourable to the Proliferation of Epidermal Cells

The increasing prevalence of antifungal resistance presents an enormous challenge to healthcare professionals. The adverse effects and resistance of current antifungal drugs have prompted the need for alternate antifungal therapy in the form of natural products. Although anecdotal reports have suggested that Aloe ferox , Agathosma betulina, and Bulbine frutescens have been used to successfully treat fungal skin infections, little scientific evidence is available to validate these claims. Therefore, this study aimed to determine whether the concentrations of A ferox , A betulina, and B frutescens hydroethanolic extracts showing antifungal activity against skin-related Candida species are cytotoxic to normal human epidermal cells. Crystal violet and lactate dehydrogenase assays were employed to determine cell viability and cytotoxicity on the human epidermal cells. Broth microdilutions were performed to evaluate the susceptibility of Candida species to plant extracts. Candida spp. inhibition was observed at a concentration of 200 µg/ml, while optimum extract concentrations for cell proliferation ranged between 200 and 400 µg/ml for B frutescens and 200 µg/ml for A ferox and A betulina . This suggests that these plants could prove to be effective as antifungal agents at a dosage of 200 µg/ml while still supporting the growth of epidermal cells at the same concentration, which is an important process in maintaining healthy skin. These findings from this study lay a foundation for further studies confirming the applicability of these medicinal plants as safe alternative antifungal treatments that promote skin cell proliferation, regeneration, and enhance tissue repair. ● Aloe ferox , Bulbine frutescens and Agathosma betulina extracts demonstrated antifungal activity against various Candida species while having non-cytotoxic effects on normal skin cells, particularly at concentrations between 200–400 µg/ml. ● Lower concentrations (200–400 µg/ml) of the extracts promoted HaCaT skin cell proliferation, with cytotoxicity only evident at higher doses. ● These extracts offer dual benefits, supporting healthy skin cell growth and combating fungal infections, making them promising candidates for developing natural therapies for cutaneous candidiasis.