FDA warns against using corrosive "black salve" — a deadly cure-all that's disfiguring lives

I spent the afternoon, mouth agape, scrolling through "black salve" Facebook groups—where folks, desperate to cure their skin, breast, lung, and other cancers "naturally," have turned to a "cure all" paste made from bloodroot and other toxic ingredients. The photos that folks have posted as proof of the salve "working"—i.e. burning holes in flesh—are horrifying. And according to what I've seen, many folks have been permanently disfigured by the salve, and some have even lost their lives.

Despite the health risks, folks all over Twitter and Facebook—in addition to sharing graphic images of their own flesh being eaten away—are posting links to buy the salve and sharing videos explaining how to make it. One fan of the stuff posted a link to a video that's widely shared in the black salve community (link here if you must see) along with the text: "How to make Black Salve. This is NOT Medical Advice, so please DYOR. However, from the stories of people using Black Salve, they have been able to draw out Cancers. Including Breast Cancer, Prostate Cancer, & Skin Cancer."

I watched the video (titled "One Answer to Cancer") and it's basically one long conspiratorial screed about how "big pharma" and "big government" have pushed toxic mainstream medical cures for cancer and have suppressed the natural black salve cure because "big pharm" can't make money from it. The folks in the video — who are affiliated with the Hippocrates Health Centre of Australia, whose website provides your typical supplement-hawking, "health freedom," and COVID and anti-vaccine disinformation fare–advocate for the use of black salve to cure pretty much any cancer, and encourage both topical and internal use of the substance, calling it "nature's scalpel."

To detox my brain from that pseudoscience poison, I also listened to this episode of Behind the Bastards from April 2023, "The People Who Turned Burning Your Face Off Into A Healthcare Fad," which provides an informative debunking of black salve and dives into its history (they trace the first snake-oil-cure-all hawking of black salve back to 1842) and its current popularity.

I also read a peer-reviewed article entitled "Black Salve: A Dangerous Corrosive Disguised as an Alternative Medicine," published in June 2023 in Cureus. In that piece, Andrew Ordille (Biomedical Sciences, Cooper Medical School of Rowan University, Camden, USA), Ashley Porter (Internal Medicine, Cooper University Hospital, Camden, USA), and Amy Scholl (Internal Medicine, Cooper University Hospital, Camden, USA) provide a terrific overview and critique of black salve. The article's abstract reads:

Black salve is a dangerous compound that has long been used as an alternative and complementary medicine despite clear warnings of its hazards from the medical community and governmental agencies. A paucity of information exists for clinicians seeking guidance regarding the management of black salve-related adverse outcomes. Secondary infection is a common sequela of black salve application to skin lesions. This case report presents a summary of the management of a secondary infection in a patient who applied black salve to an open skin wound. The resolution of this patient's symptoms was a function of the interdisciplinary care provided by infectious disease specialists, an acute surgical care team, and dermatologists. The patience, clinical expertise, and judgment provided by these healthcare teams resulted in an appropriate diagnosis while also avoiding unnecessary medical procedures. This case sheds light on one of the varied consequences of black salve use and advocates for the incorporation of multiple medical teams in the management of black salve-related events.

They conclude that:

Black salve is a topical corrosive disguised as an alternative and complementary medicine. Despite multiple reports of its dangers and regulatory efforts made by governmental agencies, black salve continues to be used as a home remedy for a variety of dermatologic findings. One of the common side effects associated with black salve use is secondary infection, including cellulitis. Despite the paucity of guidance available on managing black salve-related skin and soft tissue infections, clinicians must maintain a high level of suspicion in treating black salve complications. Management of atypical skin lesions, like those seen with black salve, should involve multiple disciplines within health care to provide appropriate and effective treatments guided by clinical expertise.

In October of 2020, due to increasing reports of harmful outcomes from the use of black salve, the FDA issued a warning against the use of any products containing bloodroot, alone or in combination with zinc chloride. The FDA warning states:

Salve products containing corrosive ingredients, including black salve, are dangerous and are not approved by the U.S. Food and Drug Administration (FDA) to treat or cure any skin condition, particularly not skin cancer. Specifically, the FDA is warning consumers not to use any salves or other topically applied products that list any of the following potentially dangerous ingredients: sanguinarine, Sanguinaria canadensis, or bloodroot, alone or in combination with zinc chloride.

Although not all salves are dangerous, topically applied products with the above ingredients can destroy the skin and result in permanent disfigurement, tissue necrosis (death of cells in living tissue), and can result in infection. Furthermore, using salve products such as black salve for serious conditions like skin cancer can result in delayed cancer diagnosis and cancer progression.

The FDA has identified 24 cases of adverse events (bad side effects) associated with black salve. Fifteen of these cases were reported within the past five years.

These have included instances of permanent disfigurement and cancer progression. The FDA is aware of at least one death that resulted from a person who opted to use a corrosive salve rather than pursue proven cancer therapies. The agency urges consumers to see a health care professional to obtain an accurate diagnosis and receive appropriate treatments. The agency also continues to send warning letters and take enforcement action against companies making false claims about these products. 

Sadly, many folks are not heeding this warning, as I witnessed today in the many black salve groups proliferating on social media—if you're curious, a quick search on Facebook is all you need. If you want to visit a great group that is debunking black salve and trying to educate others about its harms, head over to "Detox, AntiVax, and Woo Insanity"—the group's description reads, "Dedicated to exposing pseudoscience hucksters and the woonatics that follow them, one laugh at a time." I'll warn you in advance, though, you're gonna see some really disturbing images.