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.
      To read this article in full you will need to make a payment
      AAD Member Login
      AAD Members, full access to the journal is a member benefit. Use your society credentials to access all journal content and features
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Moran A.M.
        • Helm K.F.
        Histopathologic findings and diagnostic difficulties posed with use of escharotic agents for treatment of skin lesions: a case report and review of the literature.
        J Cutan Pathol. 2008; 35: 404-406
        • Brown Jr., C.W.
        • Goldstein G.D.
        • Birkby C.S.
        Dermatol Surg. 2001; 27: 975-978
        • McDaniel S.
        • Goldman G.D.
        Consequences of using escharotic agents as primary treatment for nonmelanoma skin cancer.
        Arch Dermatol. 2002; 138: 1593-1596
        • Jellinek N.
        • Maloney M.E.
        Escharotic and other botanical agents for the treatment of skin cancer: a review.
        J Am Acad Dermatol. 2005; 53: 487-495