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Activated charcoal (or activated carbon) is a form of carbon processed to include large amounts of micro-pores, thus increasing the surface area available for adsorption or chemical reactions. The substance has one of the highest adsorbing porosity characteristics of all known materials. 3g of activated carbon has the equivalent surface area of a football field.
Because of this ability to rapidly "soak up" substances, activated charcoal has a long established role in the medical profession as a treatment for ingesting toxins (e.g., many, but not all, oral poisonings). Unfortunately, the same ability has also found currency among the alternative medicine crowd for what woo-meisters consider "toxins".
In the late-18th century, the sugar-refining industry was looking for ways to improve the process to remove colored sugar impurities, which at that time involved passing sugar extract through beds of standard charcoal. Research focusing on this goal resulted in the development of activated charcoal around the early 1800s. By processing charcoal using heat and/or chemicals, the adsorptive capabilities of the substance were dramatically increased due to the formation of large amounts of small, low-volume pores. Thus, activated charcoal is very useful for its abilities to filter out impurities (a role that activated charcoal fulfills to this day).
People quickly realized that the super-adsorptive properties of activated charcoal had applications in emergency rooms: in case of suspected drug overdose or poisoning, activated charcoal is administered orally to bind the toxins before they have a chance to be absorbed into the bloodstream. It is considered a "fairly invasive" way to manage acute poisoning, but the medication is on the World Health Organization's List of Essential Medicines.
Although activated charcoal has occasionally sprung up in alternative medical circles in the past, popular interest in activated charcoal picked up in 2014 when Gwyneth Paltrow (of Goop.com infamy) started mentioning various activated charcoal drinks on her website. Interest then really took off when celebrity Kim Kardashian revealed in a blog post in 2016 that she regularly drank "Charcoal Lemonade" to "feel cleansed and energized throughout the day." Since then, activated charcoal has become a staple ingredient in websites promoting the more bullshit side of "wellness".
As a detox supplement
"It is wonderful for cleansing the intestines. It is great at binding to toxic gases, Candida, parasites and other physical impurities and at rendering them harmless. Bloating, flatulence and constipation are relieved... It is estimated that daily use of activated charcoal reduces the toxic load in the human body by over 60%."
"Activated charcoal can be used to treat skin ailments, diarrhoea, bad breath, constipation and body odour. It can be used as a poultice to treat insect stings, mushroom poisoning, poison ivy, cholera, dysentery, bites and inflammation. It can also be used to treat snake bites in an emergency. Babies born with jaundice have been known to be treated with activated charcoal as well."
There are a couple of studies that suggest activated charcoal can possibly treat such symptoms as irritable bowel syndrome and gas or bloating (though other studies fail to even find benefits for this claim.) In some countries, a treatment that combines activated charcoal, simeticone, and magnesium oxide is marketed under the name of Carbosymag for the treatment of gas and bloating. (However, even this treatment is poorly studied, and was not recommended in a 2017 consensus survey on dyspepsia treatments due to lack of evidence.) There is not enough data presently to make a sound judgement about activated charcoal's ability to help with these symptoms.
In the 1980s, there were a few studies concerning the effects of activated charcoal on hypercholesterolemia and hyperlipidaemia. While some trial results showed encouraging results, other studies showed no effects. The few studies so far were done with only a small, preliminary trial size; the data is not sufficient to draw any conclusions at this time.
Activated charcoal, particularly silver impregnated activated charcoal, is sometimes used in wound management, primarily for odor absorption[note 1] (with the anti-bacterial properties of silver helping to prevent reinfection.) There is no evidence that activated charcoal would be useful for any topical treatments of poison ivy or insect or snake bites.
A small study looked at using activated charcoal for the treatment of neonatal hyperbilirubinemia, however (even after considering the fact that this is preliminary data only) this was evaluated using activated charcoal as a supplement to the accepted medical treatment for neonatal jaundice, phototherapy.
All other health claims lack any solid evidence at all for any benefits. Furthermore, the problem with activated charcoal is that it doesn't exactly distinguish between what is "toxic", and what is not. Thus, activated charcoal can prevent your body from digesting food and absorbing beneficial nutrients, and can make medications and supplements much less effective. It can also cause nausea, diarrhea or constipation, black tongue, and black stools.  While probably not terribly toxic in most cases, there are no studies to date looking at the effects of long-term use at the levels likely to be present in "detox" products. There is one case recorded where a man who hoped to detoxify his body with an activated charcoal supplement actually ended up activating a case of colitis -— he recovered by simply no longer taking the supplement.
Activated charcoal doesn't absorb all orally ingested toxins. One of the toxin categories activated charcoal performs poorly with is organic solvents… a category that happens to include ethanol. Ethanol simply absorbs too rapidly in the stomach for activated charcoal to be effective. Studies also indicate that activated charcoal performs poorly as a hangover prevention "pre-treatment". So while it is indeed possible to buy a purported "hangover cure" in your supplements store with activated charcoal and "Electrolytes for Faster Recovery!", don't expect any benefit other than placebo.
As a toothpaste
Activated charcoal toothpaste is being sold by several brands as a "naturally formulated" way to whiten teeth, with ingredients that are both "clinically proven by real geeks to safely whiten and polish teeth" and are "hipster approved, vegan, and certified natural by Europeans".
Activated charcoal is an abrasive substance, so it does actually remove stains on teeth. However, in a study comparing multiple abrasive materials commonly used in tooth-whitening toothpastes, activated charcoal achieved only mid-grade performance compared to microbeads, hydrogen peroxide, and blue covarine.
Asides from efficiency, the problem here is that activated charcoal (given the lack of testing) potentially fares poorly compared to other tooth whiteners when it comes to product safety. There are concerns that activated charcoal might be too abrasive to your teeth's enamel, due to a lack of standardization and studies that would give some guidance on the optimal activated charcoal source and particle size for whitening purposes. One study expressed concern, for instance, that the fine charcoal powder "may become embedded in defects such as margins or cracks present on older dentition."
Furthermore (speaking of ingredients "approved by geeks"), fluoride — considered the gold-standard ingredient when it comes to cavity prevention — is often not present in many of these formulas… probably in part due to various fluoride conspiracy theories that often are present in movements aligned with "natural" wellness.
As charcoal is (as noted above) excellent at absorbing odors, one area that has been postulated where charcoal might show some effectiveness, is in controlling bad breath. However, this notion is only speculative at this point.[note 2]
As a beauty treatment
Although at least in this case it "looks cool, (is) inexpensive, and (is) not harmful", there just isn't a lot of studies on whether the beneficial claims skin care companies using activated charcoal are making are accurate. Many beauty products with activated charcoal use it simply as a supplement (and a marketable selling point) to already-proven ingredients (such as bentonite for facial masks).
Carbon-ated food and drinks
Not content with simply being a "detoxifying" dietary supplement, activated charcoal for a time became Instagram-chic to add to foods, due to its ability to color foods mixed with it in a trendy, "suitably Goth" black color.  Trendy hip restaurants gained notice for mixing activated charcoal in everything from lattes to burger buns to ice cream to pizza. Mixologists in some urban locations rushed to create their own activated charcoal-infused cocktails.
The Food and Drug Administration (FDA) does not recognize activated charcoal as an approved color additive, and thus considers any food colored by activated charcoal as adulterated. (The FDA recognizes activated charcoal as "generally recognized as safe (GRAS)" in its role in purifying water, wine, and various foods). Concerns with its role as a food colorant include the difficulty of determining if the source of carbon is safe (e.g., if there are known toxic impurities in the original source material), the unknown effects of chronic consumption, and the potential for the presence of polycyclic aromatic hydrocarbons (which are known to be carcinogenic).
DIY Activated Charcoal
Several sites, particularly in the "prepper" community, contain documentation of making "activated charcoal" at home using a source of carbon, heat, and chemicals such as calcium chloride.. Surprisingly, these recipes are not entirely bullshit: in 2012, researchers at Santa Clara University, seeking to produce a low-tech, inexpensive version of activated carbon (for water filtration purposes in low-income nations) explored using various chemical activation methods (with easily obtainable, low-cost chemicals ranging from calcium chloride to table salt) on burnt coconut shells. The results were encouraging; however, the research paper noted that the activated charcoal produced by this process has only 1/6 the adsorption capability of commercially-produced activated charcoal.
- As a side note here, activated carbon pads for purportedly controlling the odor of flatulence actually exist. They don't work very well, unfortunately. But they inspire some hilarious Amazon reviews.
- As the activated charcoal anti-fart pads prove, you can't just throw a bunch of activated carbon at an odor and expect it to just magically work without some thought on design…
- "Producing Activated Carbon",Thomasnet.com
- Activated Carbon product page, Chemviron
- Charcoal, Activated, AHFS Monographs, archived on 2016 Dec 21 from drugs.com
- Activated Carbon Fiber and Textiles Edited By Jonathan Y. Chen, Woodhead Publishing, Aug 5, 2016
- "Activated Charcoal", Drugbank entry
- "Charcoal is one of the most important substances ever discovered" by Joe Schwarcz, PhD, McGill Office for Science and Society, 2017 Mar 20
- "Activated charcoal is an actual detox product, which is why you should avoid it" by Angela Lashbrook, TheOutline, 2018 Aug 06
- "Benefit from the detoxification power of charcoal" by David Jockers (2011 March 18) Natural News (archived from June 7, 2011).
- "The many uses of activated charcoal as a dietary supplement" by Michelle Simmons (2018 November 24) Natural News (archived from November 27, 2018).
- "The Treatment of Patients With Irritable Bowel Syndrome" by Mark Pimental, MD, Gastroenterology and Hepatology, 2010 Jul
- "Does Activated Charcoal Help with Gas and Bloating?" by UCLAHealth, October 22, 2018
- "Failure of activated charcoal to reduce the release of gases produced by the colonic flora." by Suarez FL, Furne J, Springfield J, and Levitt MD, American Journal of Gastroenterology, 1999 Jan
- Package Leaflet, Carbosymag
- "Mexican consensus on dyspepsia", Revista de Gastroenterología de México, Vol. 82 Issue 4 October-December 2017
- "Activated charcoal in the treatment of hypercholesterolaemia: dose-response relationships and comparison with cholestyramine." by P. J. Neuvonen, P. Kuusisto, H. Vapaatalo & V. Manninen, European Journal of Clinical Pharmacology, 37,225-230 (1989)
- "No effect of activated charcoal on hyperlipidaemia. A double-blind prospective trial." by Hoekstra JB, Erkelens DW, Netherlands Journal of Medicine, 1988 December
- Subtle Butt: disposable gas neutralizers (5 saving graces) Amazon.com (archived from November 4, 2019).
- ACTISORB™ Silver 220 Activated Charcoal Dressing with Silver, product page, KCI
- "Wound Odor Management: Charcoal Wound Dressings" by Laurie Swezey, Wound Source, 2016 February 5
- "Treatment of neonatal hyperbilirubinemia with repetitive oral activated charcoal as an adjunct to phototherapy." by Amitai Y1, Regev M, Arad I, Peleg O, Boehnert M., Journal of Perinatal Medicine, 1993
- "Activated Charcoal: The Powerful Detox Ingredient You Don’t Want in Your Regular Diet" by Katie Mui, Goodrx.com, 2019 February 7
- "Is It Safe to Take Charcoal Pills for Gas and Bloating?", Seth Podolsky, MD, MS, Cleveland Clinic Health Essentials
- "What is activated charcoal and is it safe?" by Kerry Torrens, BBC Good Food
- "Beware Claims That Activated Charcoal Can Cure Gut Troubles" by Randy Dotinga, Healthday News, 2014 October 23
- "Does alcohol absorb to activated charcoal?" by Hultén BA, Heath A, Mellstrand T, Hedner T., Human Toxicology, 1986 May
- "Activated charcoal in oral ethanol absorption: lack of effect in humans" by Anil Minocha, David A. Herold, Jeffrey T. Barth, Deborah A. Gideon & Daniel A. Spyker Journal of Toxicology: Clinical Toxocology, Volume 24 Issue 3, 1986
- Hangover Prevention and Relief Pills, Amazon.com (archived from February 19, 2020).
- "My Magic Mud - Activated Charcoal Toothpaste, Natural, Whitening, Detoxifying, Peppermint, 4 Ounce (Pack of 1)" Amazon.com (archived from February 19, 2020).
- "Whitening toothpaste containing activated charcoal, blue covarine, hydrogen peroxide or microbeads: which one is the most effective?" by Vanessa Torraca Peraro Vaz, 1 Dandara Proba Jubilato, 1 Morgana Regina Mendonça de Oliveira, 1 Janaina Freitas Bortolatto, 2 Michael Christopher Floros, 3 Andrea Abi Rached Dantas, 1 and Osmir Batista de Oliveira, Journal of Applied Oral science, 2019 January 14
- "What does activated charcoal do — and does it really work?" by Melissa Pandika, Mic.com, 2019 November 21
- "Activated Charcoal as a Whitening Dentifrice" by Brantley McCarty, Nicholas Letteri, Jim Singletary, Carolyn Primus, Academy of General Dentistry 2015 Annual Meeting
- "Study: Fluoride Crucial To Prevent Cavities" by Kathleen Doheny, Webmd.com, 2018 Aug 15
- "Why the charcoal toothpaste trend needs to die" by Nicole Karlis, Salon, 2020 February 10
- "What's The Deal With Charcoal?", Into The Gloss
- "Activated Charcoal Works Like A Magnet To Thoroughly Cleanse And Enhance The Skin" by Melissa Scott, 2020 January 31, Divine Bounty press release
- "This Is Why People Are Obsessed With Charcoal Beauty Products", MarthaStewart.com, 2018 December 03
- "The truth about activated charcoal in beauty products" by Kat Eschner, Popular Science, 2019 December 13
- "Bad news for Instagram foodies, because activated charcoal is now banned in New York", Irish Examiner, 2018 June 25
- "The Activated Charcoal Food Trend Is Pretty, but You Should Definitely Avoid It" by Lindsey Lanquist, Self, 2017 May 18
- "The 5 Activated Charcoal Cocktais to Try Now in NYC" by Casey Brennan, Thirsty, 2016 November 15
- "Activated Charcoal in Food" by Ellen Anderson, Consumer Safety Officer, US Food and Drug Administration, Center for Food Safety and Applied Nutrition, Office of Food Additive Safety, 2019 May 9
- "How to Make DIY Activated Charcoal for Prepping and Survival" by Samantha Biggers, 2020 January 23
- "Low-Tech Coconut Shell Activated Charcoal Production" by Ami Cobb, Edwin P. Maurer, Mikell Warms, and Steven Chiesa, Santa Clara University Civil Engineering