Sábila

What is Sábila?

Sábila is the Latin American name for Aloe vera, a thick-leaved succulent plant. It is used mainly on the skin for burns, sunburn and small wounds. Some people also drink the juice for the gut or for blood sugar.

One leaf holds two very different substances. The clear inner gel is bland and watery. The yellow latex, found just under the leaf skin, is bitter and acts as a harsh laxative.

That split matters for safety. Gel and latex are not the same product, and the latex carries most of the risk. Drinking juices should be made from decolourised or purified inner leaf, with the latex removed.

The short evidence verdict: aloe gel on skin has modest support for minor burns, and the latex clearly purges the bowel. Most other claims rest on tradition and small, weak studies. Long traditional use is not proof that a remedy works, and it is not proof that it is safe.

How does Sábila work?

No single mechanism is proven in people for the gel.

The gel is almost all water. It holds moisture and forms a thin film on skin. That is probably why it feels cooling on sunburn.

In cell and animal studies, sugars in the gel appear to speed wound repair. They also seem to damp down inflammation in those models. Whether the same thing happens on human skin is not settled.

In laboratory tests, aloe compounds slow the growth of some bacteria and fungi. That does not make aloe a treatment for infection.

The latex works by a different and well-understood route. Compounds called anthraquinones, mainly aloin, irritate the bowel lining. They also pull water into the bowel, which brings on a strong bowel movement.

For blood sugar, the idea is that gel polysaccharides slow sugar uptake. Small human trials hint at a modest drop in fasting blood sugar. The studies are low in quality, so treat this as unproven.

What forms does Sábila come in?

Sábila is sold and used in many forms.

- Fresh leaf, cut open, with the gel scraped out at home - Clear gels and after-sun products for skin - Creams, lotions and ointments - Bottled drinking juice, usually inner leaf and decolourised - Capsules and tablets of dried gel or dried latex - Mouth rinses and gels for the mouth - Shampoos and scalp products - Soaps and cosmetics

Quality varies a lot between brands. Some "aloe" gels hold very little actual aloe. Fresh home-cut leaf gives you gel, but it is easy to carry latex across with it if the leaf is not drained and rinsed.

Where it comes from:

Aloe vera is not native to the Americas. It came from the Arabian Peninsula and spread through the Mediterranean and Africa. Spanish and Portuguese ships carried it to the Caribbean and Mexico in the 1500s.

It settled into home life quickly. Across Mexico, Central America, the Caribbean and South America, a potted sábila by the kitchen door became ordinary. People cut a leaf and smoothed the gel onto burns, scrapes and sun-damaged skin.

Healers also used it inside the body. The bitter latex was taken as a purge for constipation. Juice and gel were given for stomach complaints and, later, for diabetes.

Sábila also carried meaning beyond the body. In many households a hanging leaf was believed to guard the home and bring luck. This was a folk custom, not a medical one.

What does Sábila help with?

• Minor burns and scalds: This is the best-supported skin use, and the support is still modest. A review of several small trials found that burns treated with aloe gel healed faster. The trials were small and not well blinded, so the result is weak. This applies to small, shallow burns only. Deep, large or blistered burns need medical care, not a plant.
• Sunburn: Tradition across Latin America used fresh gel for sun-scorched skin. Many people say it feels cooling and less tight afterwards. Trials testing aloe for sunburn are few and small. Any relief is likely from moisture and the cooling film, not from healing the burn faster.
• Minor cuts and grazes: Here the human evidence is disappointing. A Cochrane review of aloe for acute and chronic wounds found no clear benefit. The authors judged the evidence to be low quality. Aloe should not be put into deep or surgical wounds. One small study linked it to slower healing after surgery.
• Dry or irritated skin: Aloe gel works as a light moisturiser, and this is uncontroversial. It adds water and leaves a film that slows water loss. That is a cosmetic effect rather than a medical one. It does not treat the cause of eczema or any skin disease.
• Mouth ulcers and sore mouth: Small trials point in a helpful direction. Aloe mouth gels and rinses reduced pain in oral lichen planus and mouth ulcers in several small studies. The trials were short and few in number. Sore patches in the mouth that last over three weeks need a dental or medical check.
• Psoriasis patches: Results are mixed and not convincing. Some small trials found aloe cream cleared patches better than a dummy cream. Others found no difference, or found the dummy cream did better. There is not enough good evidence to call it a treatment.
• Constipation (latex only): The latex does cause bowel movements, and that part is not in doubt. Anthraquinones such as aloin irritate the bowel and pull in water. The problem is safety, not effect. US regulators removed aloe from over-the-counter laxatives in 2002 because safety data were missing. Repeated use can drain potassium. Gentler options exist, and a pharmacist can point you to them.
• Blood sugar in type 2 diabetes: This use is common in Latin America, and the evidence is early. Several small trials of aloe gel or juice reported modest drops in fasting blood sugar. The studies were small, short and of low quality. Aloe is not a replacement for diabetes medicine. If you take insulin or tablets, aloe may push blood sugar too low.
• Heartburn and reflux: One small trial of aloe syrup reported fewer reflux symptoms. It was a single study with few people. That is a hint, not an answer. Reflux that keeps coming back, or comes with trouble swallowing, should be checked by a doctor.

Which foods are rich in Sábila?

Aloe is not a nutrient found in everyday foods. The inner gel is eaten as a food in some places, in drinks and desserts. That is culinary use, not a source of anything your diet needs.

What are the side effects of Sábila?

• Itching, stinging or rash where the gel is applied
• Allergic skin reaction, more likely if you react to onion, garlic or tulips
• Stomach cramps and griping pain after swallowing latex
• Diarrhoea, sometimes severe
• Dehydration with repeated laxative use
• Low potassium (hypokalaemia) with repeated laxative use
• Red or brown urine, which is harmless but alarming
• Rare liver injury reported after oral aloe products
• Flare-up of bowel disease such as Crohn's or colitis

Good to know:

Aloe gel on skin is generally well tolerated. Allergic rashes happen, but they are uncommon.

The serious problems almost all come from swallowing latex or whole-leaf products. Cramping and diarrhoea are common with those. Potassium loss and dehydration follow repeated use.

Liver injury after oral aloe has been reported, and is rare. Yellowing of the skin or eyes, dark urine or deep tiredness means stop and seek care the same day.

How much Sábila should you take?

• Recommended daily: This page gives no personal dose. What follows is only what labels tend to carry. Skin gels are usually labelled for use on small areas of clean, unbroken skin, a few times a day. Bottled inner-leaf juices often list a serving of a few tablespoons. Latex-based laxative products are a different matter. They are no longer sold over the counter in the United States, and the European Union restricts aloe extracts containing aloin in supplements. Strength varies widely between brands. If you take any regular medicine, ask a pharmacist before drinking aloe juice.
• Best time of day: Time of day does not matter much for the gel on skin. Many people use it after sun exposure or at night. For drinking juice, there is no evidence that timing changes the result. Spreading it across the day is simply what most labels suggest.
• With or without food: Aloe gel on skin is unaffected by food. Drinking juice with or without food makes little known difference. Taking it with food may ease stomach upset. Latex products on an empty stomach tend to cause worse cramps.
• Time to effect: It depends on what you are using it for, and it may do nothing at all. - Cooling on sunburn: within minutes, and it fades - Minor burns and grazes: days to a couple of weeks - Mouth soreness: usually one to four weeks in trials - Blood sugar in trials: four to eight weeks - Latex laxative effect: about six to twelve hours If a skin problem is no better after two weeks, stop and get it looked at.
• How long to take it: On skin, aloe is normally used for a few days to a few weeks, until the skin settles. By mouth, long runs are the problem. Stimulant laxatives are not meant for more than about a week, and regulators warn against habitual use. Long-term use of latex or whole-leaf products is linked to potassium loss and bowel damage. In rat studies, whole-leaf extract containing aloin caused bowel tumours. What that means for people is not known.