Ingestion of Aloe vera is associated with diarrhea, electrolyte imbalance, kidney dysfunction, and episodes of contact dermatitis, erythema, and phototoxicity have been reported from topical applications .
The anthraquinones aloe-emodin, emodin and rhein were found to be phototoxic in vitro. The probable mechanism may be through the involvement of singlet oxygen and stable photoproducts . Aloe emodin was also found to generate singlet oxygen when irradiated with UV light and this photochemical mechanism is the most likely pathway responsible for the phototoxicity of Aloe emodin .
The use of A.vera on surgical wounds has been reported to slow healing and, in one case, to cause redness and burning after aloe juice was applied to the face after a skin-peeling procedure (dermabrasion).
Application of A.vera prior to sun exposure may lead to rash in sun-exposed areas .
The use of Aloe or Aloe latex by mouth for laxative effects can cause cramping or diarrhea. Use for over seven days may cause dependency or worsening of constipation after the aloe is stopped. Ingestion of aloe for over one year has been reported to increase the risk of colorectal cancer. Individuals with severe abdominal pain, appendicitis, ileus (temporary paralysis of the bowel), or a prolonged period without bowel movements should not take aloe. There is a report of hepatitis (liver inflammation) with the use of oral aloe .
Electrolyte imbalances in the blood, including low potassium levels, may be caused by the laxative effect of aloe. This effect may be greater in people with diabetes or kidney disease. Low potassium levels can lead to abnormal heart rhythms or muscle weakness. People with heart disease, kidney disease, or electrolyte abnormalities should not take aloe by mouth. Healthcare professionals should monitor for changes in potassium and other electrolytes in individuals who take aloe by mouth for more than a few days.
Based on a small number of human studies, aloe taken by mouth may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Serum glucose levels may need to be monitored by a healthcare professional, and medication adjustments may be necessary.
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