Rationale:This study aimed to evaluate the efficacy of topical application of Aloe vera gel in preventing chemotherapy-induced hyperpigmentation (CIH). CIH is a common side effect of chemotherapy that causes skin irritation, redness, and itching. Aloe vera has been studied for its potential use in treating radiation-induced dermatitis, which may help alleviate some of the symptoms associated with this condition.Patient concerns:In this study, 4 children requiring curative chemotherapy were prospectively enrolled and treated with Aloe vera gel.Diagnosis:Acute skin reactions were monitored and classified according to the Common Terminology Criteria for Adverse Events Grading Scale.Interventions:Patients were asked to use the gel on one-half of the body field twice daily from the beginning of treatment until 4 weeks after the completion of chemotherapy, with no medication to be used on the other half.Outcomes:The results indicate that applying Aloe vera gel may reduce the visibility of hyperpigmentation at subsequent time points. The most important observation was that the continued application of Aloe vera gel 4 weeks after the completion of chemotherapy was effective in reducing the grading of CIH.Lessons:These effects highlight the potential of Aloe vera gel as a topical onconutraceutical treatment for CIH.