What is Aloe?

Aloe is a thick, spiky succulent plant grown across warm parts of the world. Yoruba speakers in West Africa call it eti erin. One leaf gives two very different products.

The inner part is a clear gel. It is used on skin and also sold as juice, capsules and creams. Just under the leaf skin sits a bitter yellow sap called latex, rich in aloin.

Aloe latex is a harsh laxative and the risky part of the plant. Swallowed whole-leaf extracts carry the same concern. Most of the safety warnings on this page are about those products, not about gel on skin.

Aloe has a long record of use in West African home care and in many other traditions. Long use is not proof that something works. It is not proof that it is safe either.

Here is the short verdict. Gel on minor burns and small skin problems has modest human support. Taken by mouth, the evidence is thin, and the latex is a real hazard.

How does Aloe work?

The two parts of the leaf seem to act in different ways.

Aloe latex holds anthraquinones (plant laxative compounds) such as aloin. In the gut these pull water into the bowel. They also speed up the squeezing that moves stool along.

That laxative effect is well described in people. It is also what causes the cramping, the fluid loss and the drop in potassium.

The gel is mostly water. It also holds long sugar chains called polysaccharides, plus plant sterols and enzymes.

In cell and animal studies, these gel compounds appear to hold water in the skin. They also appear to calm inflammation (swelling, heat and redness). Small human trials on burns and mouth ulcers point the same way.

What aloe gel does when you swallow it is much less clear. Small trials in type 2 diabetes suggest a modest drop in fasting blood sugar. The trials are few, small and weakly designed, so this is not settled.

What forms does Aloe come in?

Aloe is sold in several forms. Risk depends heavily on which one you pick.

Put on the skin or in the mouth:

- Fresh leaf cut open at home, with the gel scooped out and the yellow sap drained away. - Gel, creams and after-sun lotions for skin. - Mouthwashes and gels for the inside of the mouth.

Swallowed:

- Drinking juice, usually filtered so that aloin is removed. - Capsules and tablets of dried gel or whole leaf. - Dried latex, sold as a laxative and restricted in several countries.

Labels are often vague. If a product does not say it is aloin-free, assume it is not.

Where it comes from:

Aloe has been grown and used in West Africa for centuries. Yoruba speakers know it as eti erin, meaning elephant's ear, after the broad leaves.

Healers in the region applied the fresh gel to burns, cuts, boils and rashes. The bitter sap was used as a purge for the bowels and in cleansing mixes. It also appeared in hair and scalp preparations.

Aloe travelled widely and shows up in Egyptian, Arab, Indian and European records. Caribbean and African American home care kept the same two uses: gel on skin, sap for the bowels.

These records tell you what people did. They do not tell you that it helped, and they do not tell you what dose was safe.

What does Aloe help with?

• Minor burns and sunburn: This is aloe's best supported use. Several small trials suggest gel helps first and second degree burns close faster than plain dressings. The trials are small and hard to blind, so the quality is only fair. Tradition in West Africa used fresh gel the same way. Deep, large or blistered burns need medical care, not gel.
• Small cuts, grazes and dry skin: Aloe gel is soothing and holds water in the skin. Trials here are few and mixed. Some wound studies found no benefit, and one found slower healing after surgery. Treat it as a comfort measure for intact or lightly broken skin.
• Mouth ulcers and sore mouth: Small trials of aloe mouth gel report less pain and faster healing of mouth ulcers. Some studies in oral lichen planus (a long-term mouth rash) also showed benefit. The studies are small and from a few centres. The result is promising, not proven.
• Psoriasis plaques: Trial results are mixed. One study found aloe cream better than placebo for scaly patches. A later one found it no better. Tradition did not single out psoriasis. Evidence does not support aloe in place of prescribed treatment.
• Constipation (latex, and a hazardous use): Aloe latex does produce a bowel movement. That effect is real and is the oldest recorded use. It is also the reason regulators acted. Repeated use can lower potassium, cause cramping and make the bowel lazy. EU and US bodies have restricted aloe laxatives over safety and cancer concerns. This page does not support that use. Gentler laxatives with better safety records exist.
• Blood sugar in type 2 diabetes: Small trials of oral aloe gel report modest drops in fasting blood sugar and HbA1c (a three-month blood sugar average). The trials are small, short and of low quality. This is an early signal only. If you take diabetes medicine, aloe may add to its effect. Speak to your doctor before trying it.
• Mild ulcerative colitis: One small trial of oral aloe gel found more people improved than on placebo. It has not been convincingly repeated. Bowel disease needs proper medical care. Aloe latex can make any inflamed bowel worse.

Which foods are rich in Aloe?

Aloe is not a nutrient found in everyday foods. Filtered aloe gel is added to some drinks and desserts. In the EU, aloin and aloe-emodin are not permitted in food.

What are the side effects of Aloe?

• Stomach cramps and griping pain
• Diarrhoea and loose stools
• Low potassium, which can cause muscle weakness
• Dehydration with heavy or repeated use
• Red-brown urine after latex use
• Skin rash, itching or stinging where it is applied
• Rare reports of liver injury after oral use

Good to know:

Gel on intact skin causes few problems. A rash or sting happens in a minority of people, and a patch test on a small area is sensible.

Swallowed aloe is the bigger risk. Cramping and diarrhoea are common with latex products. Potassium loss and dehydration follow repeated use and can affect the heart.

Liver injury has been reported, but it is rare. Stop at once and seek care if your eyes or skin turn yellow.

How much Aloe should you take?

• Recommended daily: This is what labels carry. It is not advice for you. Skin gels and creams are usually applied thinly to clean, unbroken skin, up to a few times a day. Drinking juices made from filtered, aloin-free gel often give 50 to 100 mL a day. Capsules of dried gel vary widely between brands. No amount is given here for aloe latex or whole-leaf laxative products. Regulators have restricted them over cramping, potassium loss and a possible cancer risk. Your doctor or pharmacist is the right person to set any oral amount.
• Best time of day: Timing does not matter much for skin gel. Many people use it in the evening and after sun exposure. Oral juice is usually taken in the morning. If a product loosens your stools, the time of day will not fix that.
• With or without food: Oral aloe juice or capsules are usually taken with or just before food. Food may soften any stomach upset. Keep aloe well apart from your other tablets if it loosens your stools. Loose stools can carry medicines through before they are absorbed.
• Time to effect: On skin, cooling and comfort are often felt within minutes. Healing of a minor burn is judged over several days. Mouth ulcer gels are studied over about one to two weeks. Blood sugar trials ran four to twelve weeks before any change showed. It may also do nothing for you. That is a real possible outcome, and the evidence is too thin to promise otherwise.
• How long to take it: Skin gel is normally used for a few days, until the sunburn or graze settles. If a burn, rash or wound is not improving in a week, stop and get it looked at. Oral use has no agreed safe length. Most trials ran four to twelve weeks. Long daily use of any aloe laxative is the pattern most strongly linked to harm.