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Patients poorly informed of the risks of self-administered escharotics

Researchers from the University of Utah have found that patients who self-administer strong escharotics—often referred to as ‘black salve’—for skin lesions, are unaware of the potentially severe side effects of these products. They also rarely consult with a dermatologist before trying to self-treat their lesions.

Published in the Journal of the American Academy of Dermatology (May 2016; 74(5):Suppl 1), the paper notes that black salve containing zinc chloride or blood root is used by some patients to self-treat benign and cancerous skin lesions, but there are many case reports that document detrimental side effects from the practice.

The authors interviewed patients who had previously used black salve products to try and understand the perspective of these individuals, their information sources and decision-making processes regarding use of the salves.

Some 74% of interviewed black salve users were unaware of the potential side effects before their first use of the escharotic. Side effects include infection, extensive scarring and disfigurement. As well, this type of self-treatment can obscure cancerous lesions and delay professional diagnosis and treatment, according to the authors.

“There is a misperception that black salve ‘draws the cancer out,’ when, in fact, it just indiscriminately damages anything it touches,” study co-author Dr. Mark Eliason, a dermatologist at the University of Utah, said in a news release from the American Academy of Dermatology. “One of the reasons black salve treatment is so dangerous is that many users have no idea how harmful it can be.”

Investigators found that most of the interviewed participants who had used black salve heard about the products from a family member or friend. Only 30% of those who tried the escharotics had spoken with a dermatologist beforehand.

Reasons given for trying the escharotic included a desire for a non-surgical option, or perceived convenience of a self-applied therapy.

In some cases, patients did not feel comfortable talking about black salve with their doctor.

“I’ve worked with many patients who have experienced the harmful side effects of black salve use,” said study lead author Dr. Sarah Cipriano, a dermatologist at University of Utah Health Care, said in the release. “We hope our research will raise awareness about the potential dangers of these products, which far outweigh the supposed benefits. We encourage patients to consult with a dermatologist or other health care provider before considering a home remedy like black salve.”

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