Facebook: BlackSalve.BloodrootCapsuleUsersHealingCancer A member of a black salve Facebook group asks for advice about how to use it.

Even as Facebook has cracked down on anti-vaxxers and peddlers of snake oil cure-alls, a particularly grotesque form of fake cancer treatment has flourished in private groups on Facebook. Black salve, a caustic black paste that eats through flesh, is enthusiastically recommended in dedicated groups as a cure for skin and breast cancer — and for other types of cancer when ingested in pill form. There’s even a group dedicated to applying the paste to pets. A Facebook spokesperson told BuzzFeed News that these groups don’t violate its community guidelines. This summer, it launched an initiative to address “exaggerated or sensational health claims” and will downrank that content in the News Feed, similar to how it handles clickbait. But it’s not clear how it defines what a “sensational” health claim is. Citing user privacy, Facebook would not say whether or not it had downranked the black salve groups in the News Feed. Other platforms have taken a different approach. When BuzzFeed News asked YouTube about several videos where people discussed using black salve, YouTube said the videos were in violation and removed them. Amazon, which does not sell the salve itself, removed a book about black salve when BuzzFeed News asked about it. Doctors and medical literature are clear that black salve is not a safe or effective cure for cancer. The FDA does not allow the sale of the product in the US. But tech platforms are not in sync about how to handle it. And in the meantime, people are getting disfigured or dying.

Warning This image is graphic Tap to reveal Click to reveal Facebook Photos posted to a Facebook group that show the progress of using black salve.

Proponents of black salve in the Facebook groups believe that the paste, typically made from a flowering plant called bloodroot and zinc chloride, only eats away cancerous or diseased tissue. (In fact, cases in medical literature describe extensive tissue damage.) The salve eats away at tissue for a few days or weeks, usually needing several reapplications. In groups like “Black Salve Healing Support Group,” people post photos of their affected areas and ask for advice about how often to reapply or how to treat the resulting wounds. About seven Facebook groups for discussing the use of black salve are visible on the site (groups can choose to not be visible in search results). If you search “black salve” on the social network, these groups aren’t in the main results, but if you limit the search to the Groups tab, they all appear. They are private and you have to request to join. The largest group has about 21,000 members. A woman recently posted photos to a private group of a spot on her cheek that she had applied black salve seven times, asking if she should keep applying after it oozed pus several times. The next post was from a man and featured photos of a large wound on his ribs and the scab that had fallen off. In the comments, someone wrote, “Impressive!” People report that this process is exactly as painful as you’d expect — many users take painkillers while using the salve. After a while, the area will form an eschar (a giant type of scab) that will fall out in a huge clump, leaving behind a hole with scar tissue. If things don’t go well, the area can become infected or necrotic. In 2017, a woman posted on a group with 21,000 members that she put black salve on her breast to kill a tumor. When she bent over, she heard a popping noise, and blood and pus poured out. She went to the emergency room, where she was put on intravenous antibiotics; three months later, she wrote an update to say she was being treated by a traditional oncologist.

Facebook Search results for "black salve" show several groups.

Dr. Melanie Bui, assistant professor of dermatology at the University of Vermont Medical Center and coauthor of a paper on the dangers of black salve, said the people who are using it are good people who are just misinformed. “There’s a huge misperception that it’s selective to cancer only, and it’s not at all — it’ll kill any cells you put on it,” she told BuzzFeed News. People will apply the salve to a mole or spot, and when it starts eating away at the skin, they’ll take that as confirmation that it was indeed cancer, without seeking a doctor’s diagnosis. These supposed success stories add to the misinformation: People who put salve on a mole that may have not been cancer in the first place boast that they are now cancer-free. What makes black salve seductive as a fake cancer cure is some historical usage. Dr. Frederic Mohs, whose method for skin cancer surgery is still widely used, originally used a form of black salve when developing the technique that bears his name in the 1930s, but that has long since been replaced by more modern technology. Bui said that though it’s possible black salve could kill a skin cancer spot by destroying the tissue, there’s a danger that some cancer could be left behind. Even worse, it could actually cause the cancer to metastasize and spread, becoming deadly. “As a rule, basal cell never metastasizes, unless you put a mutantagenic on it like black salve, and then it will go rogue,” Bui told BuzzFeed News. The FDA considers black salve a fake cancer cure. In April 2017, it sent warning letters to peddlers of these kinds of false medicine, including sellers of black salve, the sale of which is prohibited in the United States. One Amish seller in Kentucky was arrested in 2017 and sentenced to six years in prison for selling black salve. But sellers overseas still ship to the US. In Facebook groups, people discuss where to buy or even how to DIY the paste from a recipe (the active ingredients are legally sold separately). One seller and proponent of black salve, Greg Caton, was arrested in 2004 for violating FDA rules about selling unapproved drugs. After he left prison, he moved to Ecuador and reopened his website, where he continues to sell black salve and ships to the US. When asked by BuzzFeed News about it, Amazon removed Caton’s book about black salve from sale on its site (his books on ayahuasca and government criminality are still for sale). People use black salve not just for skin cancer, but other skin conditions, including acne and unwanted moles. Milder, less corrosive forms of black salve are sold with recommendations from sellers to use as a vaginal douche or enema. In 2018, an Australian woman died after allegedly treating ovarian cancer by applying black salve topically to her abdomen.

“It’s important to note that a lot of people are using [black salve] are good people with good intentions and don’t understand the science.”

There’s a wide spectrum of what might count as health misinformation. What about wellness “woo,” like essential oils, crystals, an all-meat diet, or even Jack Dorsey’s EMF-blocking sauna? Is anything that isn’t backed by double-blind studies misinformation? There are groups for cupping, herbs that supposedly treat addiction, and even for pregnant women who choose “unassisted childbirth” — no doctors, midwives, or doulas for birth and no prenatal checkups, tests, or any doctor visits at all. This is certainly against the medical establishment’s advice, but do these groups count as spreading misinformation?

“Medically speaking, it’s important to note that a lot of people are using [black salve] are good people with good intentions and don’t understand the science,” said Bui. “There’s a subset of people preying upon the hope of people with cancer diagnoses, and they’re just evil.” There are many reasons a person might seek alternative treatments. Patients, doctors, and politicians agree that the US medical system is broken. The CDC estimates 1 in 4 cancer survivors borrow money, file for bankruptcy, or go into debt to pay for medical bills. And people with a serious or fatal illness like cancer might look to alternative treatments after traditional medicine fails them or as a potential sign of hope. The supposed success stories told in these black salve Facebook groups and YouTube videos are compelling and hopeful. Black salve is not the only fake cancer cure to proliferate online: In 2017, BuzzFeed News wrote about a bogus cure made of apricot seeds that had nearly died out in the 1970s and was having a revival online. Vaccine misinformation is an easy target for YouTube and Facebook (although its system of blocking anti-vax ads has been imperfect so far). It’s a highly public and visible controversy where there’s overwhelming public support to stop the spread of measles, which has had several large outbreaks in the US in the last few years. By taking a stance on anti-vax content, Facebook and YouTube have accepted some responsibility for misleading content about health claims. But dubious health claims — whether by some profiteering huckster or simply well-meaning people trying to improve their health — go far beyond just vaccines. And while anti-vaxxers have the potential to cause a widespread public health issue, these lesser-known fake health cures like black salve are potentially more deadly per capita.

When asked if these types of videos would a violation of its community standards, YouTube said they were and removed them.

In 2017, a woman named April documented her use of black salve to treat breast cancer over the course of 14 videos posted to YouTube. In her video descriptions, she said she had done chemo but declined surgery or radiation. Four months after her last video in early 2019, the top comment is from her own account, but written by her son, who said that she had died. These videos have not been removed by YouTube.

The top results for “black salve” on YouTube are from reputable sources like the Mayo Clinic or CBS News, which describe it as a dangerous and ineffective cancer treatment. But after the first few results, there are videos that show real people who have used the salve, along with the gory images of their resulting wounds. When asked if these types of videos would a violation of its community standards, YouTube said they were and removed them. YouTube didn’t say if black salve videos were already a topic that it was looking out for and proactively removing before being asked about specific ones. Despite the takedowns, there are still black salve videos on the platform, including ones with titles like “I Removed Four Breast Tumours Using Black Salve.”

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