Black salve does NOT cure cancer! (content warning - graphic pictures)

Do not use BLACK SALVE to treat your skin cancer!

As I was updating and tidying up the links on my website, I thought I might add a public service announcement under the links for types of skin cancer regarding this “alternative” treatment for skin cancer.

What is black salve?

Bloodwood plant (image from wikipedia)

Black salve is promoted as an “alternative” and “natural” treatment for skin cancer. It is a black paste that is typically made of two main ingredients - bloodroot (a wild flower) and zinc chloride - that is applied to the skin cancer. There is no standard formulation for black salve thus the term covers a variety of products. It is illegal to sell or import black salve in Australia. It is also banned in the USA.

How does black salve kill cancer cells?

My quick google search found that supporters of black salve claim that it is not harmful to normal skin. It simply causes an inflammatory reaction and the thick, black scar or ‘eschar’ left behind is the dead tumour. However, none of these sites provided evidence beyond personal accounts to back this up and a quick google image search demonstrates that healthy tissue is certainly being damaged with far worse cosmetic outcomes than mainstream, evidence based treatments (the photos are graphic - you have been warned).

It has been shown that in a study on squamous cell cancer cells in the lab (i.e. not in human or animal studies but in a petri dish) that a very specific and low dose of one of the chemicals in the blood root plant cancer be specific for killing the cancer cells. However, once the concentration went any higher, the chemical killed normal cancer cells. The natural concentration of this chemical in the plant is highly variable thus it is unlikely that any commercial formulation would have this specific concentration. Furthermore, other studies on cells have shown the opposite, that normal cells are more sensitive than the cancer cells to the bloodroot chemicals. Lastly, when the black salve scars or eschar are examined with a microscope both normal and cancer cells are present, debunking the claim that it is just the dead tumour.

Does black salve cure cancer?

There are no controlled clinical trials to answer this question. The problem is with black salve is that it simple erodes through skin that it touches, both cancerous and healthy. Logically speaking, if you apply enough and eat away enough of your skin, it is possible that you will cure the cancer. But you will likely be left with a large disfiguring hole that requires extensive plastic surgery to repair. This would be like cutting off your arm to fix a broken wrist - the broken wrist technically is no longer an issue!

On the flip-side, if you are more careful and don’t burn a massive hole in your skin there is no way to know by just looking at the skin if you have cured the cancer. When doctors cut out a skin cancer, it is sent to a lab so it can be looked at under the microscope to see that the cancer has been fully removed. If it has not, the doctor can go back and cut more and check again. This is not possible with black salve. There are many case reports of cancers coming back after they were ‘cured’ with black salve as well as metastases and deaths. In contrast, we know from large studies that the cure rate for surgery for BCC and SCC is about 95% (over 5 years) and for early melanomas is 96% (over 20 years).

What are the harms of black salve?

Black salve can be very painful to use and can cause intense burning. It causes an open wound which has to heal resulting in significant scarring; the healthy tissue does not just grow back. It can cause complete destruction of the anatomy of the nose. The open wounds can become infected. And as discussed above it can fail to cure the cancer leading to metastasis and death. It also can make any subsequent assessment by doctors and in the lab very difficult to interpret. There is also a possibility that the main chemical ingredient in black salve may itself be a carcinogen.

Photo from World's Greatest (youtube) via Daily Mail

Scarring post black salve treatment

Image: American Academy of Dermatology

Why would people use black salve?

It is not clear why people are using this treatment. From my google searches, it does seem an appealing alternative to the treatments that I offer to treat skin cancer. But this is because I am required by law, medical ethics and my own morality to tell patients all about the treatments I offer, including the harms, not just the benefits which these sites are doing. The ‘evidence’ reported by these sites are simply examples of people using the treatment. I would simply say, google image search black salve to see examples of people using the treatment and see if you think what you see is worth it. I understand that the idea of having something cut out and any potential disfigurement is scary and perhaps this is why some people choose black salve. But again, I point to the google image search as evidence. I can promise that no evidence based skin cancer treatment for the types of skin cancers I treat have horrendous outcomes seen with black salve.

I support evidence-based medicine but I also also understand that people need to make health choices that fit with their beliefs and values for any health treatment to be of benefit to them. I support these choices where the treatments are safe or at least unlikely to be harmful. In no way can I support this ‘natural’ treatment for skin cancer due to the risk of severe scarring and the high risk that it will not cure the cancer. If you have concerns about what I or any skin doctor has recommended for treatment for your skin cancer, please discuss your concerns with them so we can optimise your treatment and health care for you while following safe and evidence based guidelines.

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