Aloe vera for hemorrhoids: what the research says

Aloe vera is one of the most searched natural remedies for hemorrhoids, mostly because the gel feels cool on sore skin. The research behind it is real and narrow. It comes from people healing after hemorrhoid surgery, where aloe cream reduced pain in small trials. Nobody has tested aloe on the everyday flare that most people are trying to treat.

This page covers the trials, what they do and do not show, how to use aloe gel on the outside skin without irritating it, why aloe juice is a bad idea for hemorrhoids, and the remedies with stronger data. For a side-by-side look at every option, see natural remedies for hemorrhoids, graded by evidence.

Does aloe vera help hemorrhoids?

It may ease pain on healing skin. In surgery patients, aloe cream beat a placebo cream on pain, pain during bowel movements, and wound healing ¹. A large analysis of creams and ointments used after surgery ranked aloe near the top for pain in the first two days ².

What it does not show is a smaller hemorrhoid, less bleeding, or faster relief from a flare at home. The American Gastroenterological Association’s review of hemorrhoid care says the topical products people buy have little data that they work ⁵. Aloe fits that description for flare-ups.

The trial behind the claim

The main study is a randomized, placebo-controlled trial of aloe cream after hemorrhoid surgery ¹. Forty-nine people who had open hemorrhoidectomy, the operation that cuts hemorrhoids out, used aloe cream or a placebo cream three times a day for 4 weeks.

The aloe group had less pain at 12, 24 and 48 hours and at 2 weeks ¹. Bowel movements hurt less at 24 and 48 hours, wounds looked better healed at 2 weeks, and the aloe group needed fewer extra pain pills ¹. That is a good result for a cheap cream. It is also 49 people, at one center, using a cream made for the study.

What a 26-trial analysis added

A 2023 network meta-analysis of ointments after hemorrhoid surgery compared every cream and ointment that had been tested in 26 randomized trials with 2,132 patients ². A network analysis ranks treatments against each other even when two were never tested head to head.

Aloe vera cream ranked first for pain at 24 hours, and first for pain during bowel movements at 24 and 48 hours ². A numbing cream ranked first at 12 hours, and an antibiotic ointment did best at 7 and 14 days ². The authors called the results inconclusive and asked for more trials ². So aloe looks good in this setting, from a small number of studies.

Aloe on wounds in general

A Cochrane review of aloe vera for acute and chronic wounds found 7 trials with 347 people ³. Healing after hemorrhoid surgery was faster with aloe. Burns did not heal faster than with standard treatment, and in a trial of open surgical wounds left to heal on their own, aloe slowed healing by about 30 days ³. The authors said the trials had a high risk of bias and that there is no high-quality evidence for aloe on wounds ³.

That mixed record is a reason to ask your surgeon before you put aloe, or anything else, on a fresh surgical wound. What recovery normally looks like is in hemorrhoidectomy recovery, week by week.

How to use aloe vera gel on hemorrhoids

If you want to try aloe on a flare, keep it simple and keep it outside.

1. Choose a plain aloe gel with as short a label as you can find. The trial used a cream, not fresh leaf.
2. Test a small patch on the inside of your arm first and wait a day.
3. Clean gently with water after a bowel movement and pat dry.
4. Smooth a thin layer over the sore outside skin, up to three times a day.
5. Stop if it stings, itches or a rash appears. The NIH center for complementary health lists burning, itching, rash and eczema as occasional reactions to aloe gel ⁴.
6. Give it about a week. If you are no better, see a clinician ¹⁰.

Do not put aloe inside the anal canal. There is no research on that use.

Do not drink aloe for hemorrhoids

Aloe sold to drink is a different product from the gel on your skin. The gel comes from the inner leaf, and the latex comes from the leaf’s outer layer ⁴. The latex is a laxative. NIH’s complementary health center says oral aloe latex can cause abdominal pain, cramps and diarrhea, and that the FDA had it removed from over-the-counter laxatives in 2002 because of a lack of safety data ⁴. Oral aloe leaf extracts have been linked to cases of acute hepatitis, and a whole-leaf extract that has not been treated to remove its irritant compounds is classed as a possible human carcinogen ⁴.

Diarrhea and frequent wiping make sore anal skin worse. If constipation is behind your flares, fiber is the treatment with trials: in seven of them, fiber cut the risk of bleeding by half ⁶. How to build up fiber without bloating is in the hemorrhoid diet.

Aloe in pregnancy and after birth

NIH’s guidance is that aloe taken by mouth may be unsafe during pregnancy and breastfeeding ⁴. It does not give the same warning for gel on the skin. No trial has tested aloe on pregnancy or postpartum hemorrhoids, so check with your obstetric provider first. The home care steps that are considered safe are in hemorrhoids during pregnancy and postpartum hemorrhoids.

What works better than aloe for a flare

Aloe is a comfort step at best. These steps have more support behind them:

• Fiber, every day. It has the strongest trial record of any home remedy ⁶.
• Warm sitz baths. Warm water at 40°C relaxed the anal sphincter in a lab study, which eases spasm pain ⁷. NIDDK suggests sitting in warm water several times a day ⁹.
• A wrapped cold pack. After surgery, ice packing reduced pain and swelling more than warm soaks in 166 people ⁸.
• A short course of a medicated cream if itching or pain is the main problem. The options are compared on the best hemorrhoid ointments.

Other plant remedies that people put on the skin, such as witch hazel and coconut oil, are graded in witch hazel vs aloe vera for hemorrhoids and coconut oil for hemorrhoids. The full list of evidence-graded steps is in hemorrhoid home remedies that work.

When to stop and see a doctor

MedlinePlus advises a check if symptoms are no better after a week of home care, and says rectal bleeding should be looked at because hemorrhoids are not the only cause ¹⁰. Colon cancer screening is recommended from age 45 for adults at average risk ¹¹. If a lump suddenly turned hard and purple, read thrombosed hemorrhoid, because the first 72 hours matter.