Aloe vera with lidocaine: should you use it?

What is the difference between plain aloe and aloe with lidocaine?

Plain aloe gel is used to cool, moisturize and soothe skin, which leaves little work for a dramatic product name. Aloe with lidocaine combines aloe with a topical analgesic, meaning a medicine applied to the skin for pain relief. The exact ingredients and directions depend on the bottle, so do not treat every aloe pain relieving gel as the same product.23

Why does the bottle say it treats sunburn?

Some US aloe pain relieving gels list sunburn among their uses. For example, Duane Reade Aloe Vera Pain Relieving Gel contains lidocaine 0.50% and menthol 0.10% as active ingredients. Its listed uses include temporary relief of pain and itching from sunburn, minor burns, cuts, scrapes, skin irritation and insect bites. That is different from choosing the best home care for sunburn: avoid numbing medication and use cool water, gentle moisturizing care and plain aloe instead.26

Does aloe help the burn heal?

Aloe can make sunburned skin feel more comfortable, but it does not reverse ultraviolet damage or make sunburn disappear overnight. A soothing sensation is useful, but it is not an undo button for an afternoon in the sun, however attractive that button would look on the bottle. Research suggests topical aloe gel may speed healing and reduce pain in some burns; for sunburn specifically, its useful role is comfort rather than a cure. Aloe is also not an established treatment for acute or chronic wounds.347

Sunburn can take several hours to become visible, and its full effect can take 24 hours or longer to appear. Pain is often worst between 6 and 48 hours after sun exposure, while peeling can develop several days later. Feeling better after applying gel does not mean the underlying damage has gone away.1

How to use plain aloe for mild sunburn

1. 1Get out of the sun, preferably indoors. Keep burned areas covered against further sun exposure.
2. 2Cool the skin with a cool shower, bath or damp compress. Avoid very cold water and harsh soap.
3. 3Gently pat the skin dry. If using an aloe or soy moisturizer, apply it while the skin is still damp.
4. 4If using plain aloe gel, gently spread a layer over the affected skin without rubbing hard. Chilling the gel in the fridge can make it feel more soothing.
5. 5Reapply plain aloe as needed for discomfort. These directions are for plain aloe, not a medicated gel with its own daily application limit.
6. 6Drink extra water to help prevent dehydration. For pain, ibuprofen or acetaminophen can help when taken as directed; do not give aspirin to children.

Which aloe should you choose?

For mild sunburn, look for plain aloe gel with a simple formula, ideally 100% aloe vera gel. Avoid added fragrance, dyes and alcohol, which can irritate already sensitive skin. Fresh clear gel from inside an aloe leaf is another option. Aloe lotions can suit daily moisturizing, but added ingredients can dry out or sting sunburned skin. The shelf beside the sunscreen is convenient retail geography, which gives shelf placement rather more authority than it deserves.4

What if you are using a lidocaine gel for another minor irritation?

Follow the directions on your exact product. Duane Reade's gel directs adults and children aged 2 years and older to apply it to the affected area no more than 3 to 4 times daily. For children under 2, its label says not to use it and to ask a doctor. Keep it away from eyes, use it externally only, and do not use large quantities, particularly over raw surfaces or blistered areas. Do not carry these directions over to a different formula.2

Who should be careful?

Topical aloe is generally well tolerated, but it can cause burning, itching, rash or eczema. Allergic contact dermatitis, an allergic skin reaction, and hives are also possible. Avoid aloe if you have reacted to it before, and read the full ingredients if you have allergies or sensitive skin. Stop applying a product that causes new burning, itching or a rash.347

If you are pregnant or breastfeeding, ask your healthcare professional before using aloe products. Aloe taken by mouth may be unsafe during pregnancy and breastfeeding; a topical pain relieving gel is not something to swallow. If you take prescription medicines, discuss aloe use with your healthcare professional because some herbal products interact with medicines.7

When should you stop home treatment?

Get immediate medical attention for blistering or extremely painful sunburn, facial swelling, fever, severe chills, nausea, confusion, faintness, or painful eyes that are sensitive to light. Dehydration signs such as extreme thirst and no urine output also need urgent attention. Increasing redness, warmth, swelling, pain or pus can signal infection. Do not pop or peel blisters. A baby younger than 1 year with sunburn needs medical advice rather than aloe alone.146

For Duane Reade's medicated gel, stop use and ask a doctor if the condition worsens, symptoms last more than 7 days, or symptoms clear and return within a few days. Do not wait for that deadline if the sunburn already has any of the urgent signs above. If the gel is swallowed, get medical help or contact a Poison Control Center right away.2