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Buyer beware: A black salve caution

      To the Editor: Black salve ointments containing beeswax, cocoa butter, oil, charcoal, and clay have been used by the general public to treat boils, abscesses, bee stings, and other minor wounds. Other types of black salve products may also include zinc chloride or bloodroot extract (Sanguinaria canadensis), resulting in a biologically nonspecific corrosive escharotic agent capable of indiscriminately dissolving healthy and diseased tissue alike. Both types of products are advertised online as safe and effective for the treatment of more serious conditions, such as skin cancer, moles, warts, and skin tags. There are numerous testimonials online, but there are no scientific studies for clinical efficacy or safety. In addition, the wide diversity of poorly regulated black salve products, which often contain different ingredients and lack quality control, leads to confusion about the use of these products. We present a case that illustrates the danger of using poorly regulated online products perceived as safe and effective by the general public to treat serious dermatologic conditions.
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