Alpha omega labs amazon black topical salve

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Science or Snake Oil: what is black salve?

Black salve is a topical escharotic used for the treatment of skin cancer. Although promoted as a safe and effective alternative to conventional management by its proponents, limited clinical research has been undertaken to assess its efficacy and potential toxicities.

Patients are increasingly utilizing the Internet as a source of health information. As a minimally regulated space, the quality and accuracy of this information vary considerably. This review explores four health claims made by black salve vendors, investigating its natural therapy credentials, tumour specificity, and equivalence to orthodox medicine in relation to skin cancer cure rates and cosmesis.

Based upon an analysis of in vitro constituent cytotoxicity, in vivo post black salve histology, and experience with Mohs paste, black salve is likely to possess normal tissue toxicity with some cancer cell lines being relatively resistant to its effects.

This may explain the incongruous case study reports of excessive scarring, deformity, and treatment failure. Complementary and alternative medicines CAM encompass a wide range of popular health interventions [ 1 ]. Despite conventional therapies having high cure rates for skin malignancies, a number of patients are opting to manage their skin cancers with CAM [ 7 ].

While the extent of this practice is yet to be determined, patients are motivated by a preference for natural therapies and a perception of lower toxicity for CAM compared to orthodox treatment modalities [ 8 ]. Despite questions regarding the effectiveness of CAM therapies [ 9 ] and their general lack of systematic scientific testing [ 10 ], herbal medicines should not be dismissed without consideration.

Due to the molecular diversity and structural complexity of natural products compared to synthetic compound libraries, there is renewed interest in natural product drug discovery [ 12 ]. Concerns however exist about the lack of regulatory control over the natural therapy sector and how this impacts quality control and patient safety [ 13 ]. Although used as medicines, regulators in some countries treat herbal therapies as dietary supplements [ 14 ]. Unlike pharmaceutical products, manufacturers are not always required to provide safety or efficacy evidence to regulators before their product can be sold to patients [ 15 ].

To better inform clinicians and patients, this literature review seeks to assess some of the health claims made regarding black salve. Black salve was originally developed by an American surgeon, Jesse Fell, its use first reported in the s [ 16 ].

Fell had heard of a plant growing on the shores of Lake Superior used by Native Americans to treat cancer reviewed in [ 17 ]. He identified it as S. Since then, other entrepreneurs have developed topical cancer therapies based on these two core ingredients, today's formulations being known as black salve [ 19 ].

Consumers often believe natural therapies are safe, having the ability to heal with a low risk of toxicity [ 21 ].

Portraying black salve as a natural product appeals to this naturalness bias, which in turn may increase black salve utilization by CAM users. Black salves usually contain bloodroot, the rhizome of Sanguinaria canadensis. Manufacturers have differing formulations that may also contain chaparral Larrea mexicana , graviola Annona muricata , oleander Nerium oleander , galangal Alpinia officinarum , ginger Zingiber officinale , red clover Trifolium pratense , sheep sorrel Rumex acetosella , burdock Arctium lappa , pokeroot Phytolacca decandra , and turmeric Curcuma longa [ 22 — 25 ].

Apart from its botanical ingredients, black salve contains zinc chloride ZnCl 2 with some formulations also containing dimethyl sulfoxide DMSO. ZnCl 2 is a chemical usually manufactured from zinc and hydrochloric acid and does not occur naturally apart from the very rare mineral simonkolleite Zn 5 OH 8 Cl 2 H 2 O [ 26 ].

ZnCl 2 is widely used for industrial processes such as textile manufacture and metallurgical fluxes for soldering galvanized iron [ 27 ]. The ZnCl 2 contained in black salve is a synthesized chemical and in some preparations the main ingredient by weight [ 28 ]. DMSO is added to enhance the epidermal penetration of some black salve formulations.

Although trace amounts of DMSO may be naturally found in cereals, fruits, and vegetables [ 29 ], DMSO is commercially manufactured from lignin, a byproduct of paper production [ 30 ]. Patients seeking natural skin cancer therapies may not realize black salve contains significant quantities of synthetic chemicals.

This knowledge may alter the treatment choices of CAM patients, a population often wanting to reduce their exposure to unnatural compounds [ 56 ]. Black salve is promoted as a safe skin cancer therapy, able to discriminate between cancerous and healthy tissue [ 57 ].

There are concerns about the accuracy of this claim with cases of extensive tissue necrosis reported in the literature from black salve use [ 38 , 58 ]. Two explanations may account for this finding.

Treated cancers were more extensive than they appeared clinically, or, in addition to having a destructive effect on malignant tissue, black salve can also cause normal tissue necrosis.

As a therapeutic product containing multiple bioactive compounds, the discriminating ability of black salve can be gauged by the cytotoxic potential of its individual constituents against malignant and normal cells. Native Americans called the plant puccoon and used it as a traditional medicine to treat a variety of conditions including cancer [ 18 ].

Bloodroot rhizomes predominantly contain a number of quaternary benzophenanthridine alkaloids QBA in addition to protopin alkaloids [ 59 ]. These plant defence toxins target multiple cellular pathways [ 60 ], being able to intercalate with DNA [ 61 ] and RNA [ 62 — 64 ], alter gene expression through the epigenetic modification of chromatin and core histones [ 65 ], inhibit microtubules needed for cell division [ 66 ], and generate oxidative stress [ 67 ].

Several studies have compared the antiproliferative and cytotoxic effects of these alkaloids against normal and malignant cells in vitro. In , Ahmad et al. Contradictory results however have shown sanguinarine to have greater cytotoxicity against normal skin fibroblasts compared to the same A squamous cancer cell line [ 32 ].

This suggests that sensitivity to sanguinarine cytotoxicity depends more on target cell characteristics than whether the exposed cells are malignant or benign. After hour exposure to the two main bloodroot alkaloids sanguinarine and chelerythrine gingival fibroblasts have shown low IC 50 values of 1. Various cancer cell lines in these studies showed greater resistance to sanguinarine cytotoxicity than nonmalignant cells, further undermining the argument that sanguinarine has tumour specific cytotoxicity.

Similar results from four biologically active S. The mechanism of sanguinarine cytotoxicity has not been fully elucidated and appears to vary for different cell types. In squamous carcinoma cells, sanguinarine induces cell death by apoptosis, while, in keratinocytes, sanguinarine induces cell death by necrosis [ 34 ]. Several apoptotic molecular pathways have been implicated such as caspase 3 and 7 activation in PC3 prostate cancer cells, rapid GSH depletion in murine L fibroblasts [ 68 ], and reduced bcl-2 with increased BH3 interacting domain death agonist Bid and proapoptotic B cell lymphoma 2 associated X protein Bax levels in gingival fibroblasts [ 69 ].

ZnCl 2 also has well described cytotoxicity against L murine fibroblast cultures, having an IC 50 of 0. Thus, current in vitro evidence suggests the two main ingredients of black salve, bloodroot and ZnCl 2 , are indiscriminate in their cytotoxic action at concentrations that may be present in black salve preparations.

Black salves contain additional botanical ingredients that may also have normal cell cytotoxicity Table 1. Graviola Annona muricata leaves are a rich source of acetogenin AGEs long chain fatty acids. Over AGEs have so far been identified in the plant, many with promising antitumour activity [ 74 ]. Cytotoxicity has been reported with an A. Oleander Nerium oleander may also be a constituent and contains antitumour cardiac glycosides [ 76 ] such as oleandrin [ 77 ].

Oleandrin at concentrations of 0. As a natural product, the alkaloid composition of S. Bloodroot rhizomes have been shown to have an up to fifteenfold variation in sanguinarine concentration [ 81 ]. When natural products are incorporated into therapeutic agents, it is often difficult to control the concentration and stability of the active ingredients to which patients are exposed. Even if sanguinarine has a narrow window of preferential tumour cell cytotoxicity, with the IC 50 of A epidermoid carcinoma cells being 0.

Surprisingly the chemical analysis of black salve has only been reported once in the literature, this being from a single sample with no quantitative analysis performed [ 47 ]. Currently the black salve constituent concentration range patients may be exposed to is unknown. With a number of black salve constituents possessing in vitro normal cell cytotoxicity at low concentrations, health claims regarding black salve tumour specificity appear false.

Normal cell cytotoxicity is usually assessed with single agent or single botanical source in vitro assays. Complex herbal formulations such as black salve present a challenge for assessing their cytotoxic potential.

Different compounds and botanical extracts may have antagonistic or synergistic effects of relevance to black salve therapeutic efficacy and toxicity. Studies that have examined the histopathology of skin following the application of black salve are also counter to claims of a discriminating destructive action.

Treated areas typically develop an eschar of dead tissue that sloughs off approximately ten days after salve application, leaving an ulcer [ 42 ]. Histologically these ulcers are surrounded by necrosis, suppurative inflammation, and limited residual viable tissue [ 44 ].

Moreover, extensive tissue necrosis has been found to develop from the epidermis to the dermis and into subcutaneous tissues [ 83 ]. Histological examination of a detached eschar following black salve administration showed it to contain both malignant and normal tissue, contradicting the claim that black salve only damages cancer cells [ 42 ].

Black salve may have other pathological implications and has been shown to induce cellular and structural atypia in tissues that can mimic malignancy [ 83 ]. Although initially used by patients to treat skin lesions, black salve can result in collateral clinical and histological pseudomalignancies that pose diagnostic challenges.

Mohs spent four years developing and testing a fixative paste that would histologically preserve human tissue in a controlled manner.

The paste functions like a reservoir that slowly releases ZnCl 2 , the depth of tissue death and fixation determined by the thickness, and surface area of paste application [ 85 ].

Mohs believed histological examination of the entire margin for tumour involvement would improve skin cancer cure rates. The Mohs fixed tissue technique involves tumour site fixation with Mohs paste.

Horizontal tissue sections are sequentially removed and histologically examined with tumour margin involvement being mapped; further tissue fixative is then applied to persisting tumour until clear margins are obtained [ 87 ]. In contrast to black salves, where ZnCl 2 concentration has not been reported, Mohs fixative paste contains Small millimetre-scale changes in paste thickness resulted in significant changes to the depth of fixative penetration.

To perform its function, Mohs paste fixes and kills both benign and healthy tissue. The Mohs histology slides of s of patients from the past 75 years attest to the indiscriminate toxicity of salves containing ZnCl 2 and S. The experience of Mohs fixed tissue technique highlights the potentially destructive power of escharotics. Mohs also used his paste to treat gangrene. The indiscriminate in vitro cytotoxicity of both S. The literature contains 14 journal articles and abstracts that report the use of black salves derived from S.

While case studies cannot determine efficacy or assess toxicity rates, they can provide information about potential toxicities and characterise treatment failures. Black salves have been used to treat melanoma, squamous cell carcinoma SCC , and basal cell carcinoma BCC with varying results as detailed below.

A number of Internet sites suggest that black salve can be used to treat melanoma effectively [ 91 , 92 ]. The scientific literature does not support this claim. Of the two documented patients that have used black salve to treat melanoma, both developed metastatic disease [ 38 , 39 ]. One of these patients had a superficial 0. Nonmelanoma skin cancers have also been treated with black salve.

While one patient showed no evidence of persisting SCC on partial biopsy of their black salve treatment site, the other two patients showed persisting malignancy. Basal cell carcinomas BCCs have had mixed results when treated by black salve. However, only two of these cases had the entire salve treatment area excised and examined histologically [ 42 , 43 ], with five other cases having a posttreatment biopsy that did not show BCC persistence [ 44 , 48 ].

Black salve BCC treatment failures resulted in 8-stage and stage Mohs surgery being required to completely remove a scalp and separate nose BCC in one patient [ 45 ].

This variation of Amazon Black Topical Salve is the same as the current Amazon Black Salve (current original), except that it contains 10% frankincense oil. If you have questions after a thorough reading, please call Alpha Omega for any clarification. (1) PREPARATION CAUTION: Healthy skin tissue may redden​.

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Black salve is a topical escharotic used for the treatment of skin cancer.

Cliff Rosendahl , The University of Queensland. But a quick google of the term will find just as many glowing reviews of miracle cancer cures. Black salve is a product derived from the plant Sanguinaria canadensis , a perennial flowering plant native to northeastern America.

Black salve in a nutshell

Black salve is an alternative topical therapy used to treat skin cancer. It is produced in a variety of formulations; most formulations contain two core ingredients: bloodroot Sanguinaria canadensis and zinc chloride. Bloodroot, a North American member of the poppy family, has rhizomes containing a red sap rich in cytotoxic alkaloids, 2 sanguinarine being the alkaloid with the highest concentration. Black salve may also contain several other botanical extracts and synthetic compounds. This lack of standardisation and the phytochemical variation inherent in its botanical constituents 4 make black salve a heterogenous product group with unpredictable clinical effects.

A Review of Black Salve: Cancer Specificity, Cure, and Cosmesis

Correspondence: Jerry D. Although black salve has not been proven to have anticancer properties, application of black salve has been shown to cause damage to healthy tissue and the need for further treatment. We describe a year-old woman whose one-time application of black salve to a healing biopsy site resulted in skin erosion and formation of a dermatitic plaque with subsequent scarring. Dermatologists and other health professionals need to be aware of this increasingly popular product to be able to better inform and treat their patients. Black salve is composed of various ingredients, many of which are inert; however, some black salves contain escharotics, the 2 most common are zinc chloride and bloodroot Sanguinaria canadensis extract. In high doses, such as those contained in most black salve products, these corrosive agents can indiscriminately damage both healthy and diseased tissue. Black salve is not regulated by the US Food and Drug Administration, resulting in poor quality control and inconsistent user instructions. We report the case of application of black salve to a biopsy site of a compound nevus with moderate atypia that resulted in the formation of a dermatitis plaque with subsequent scarring and basal layer pigmentation. A year-old woman with a family history of melanoma presented for follow-up of a compound nevus with moderate atypia on the right anterior thigh that had been biopsied 6 months prior.

Black salve , also known by the brand name Cansema , is pseudoscientific alternative cancer treatment.

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Black Salve and Bloodroot Extract in Dermatologic Conditions

He is also a published author and as such receives royalties and payments from proceeds of sales. He also lectures on skin cancer subjects for multiple academic and private commercial organisations in various countries for which he from time to time receives payment with respect to travel costs, accommodation and honorariums. View current jobs from University of Queensland. But a quick google of the term will find just as many glowing reviews of miracle cancer cures. Black salve is a product derived from the plant Sanguinaria canadensis , a perennial flowering plant native to northeastern America. The specific ingredients vary but commonly include zinc chloride a destructive agent, which is corrosive to metals as well as sanguinarine a toxic plant extract. Blood root was used by the American Indians, who harvested the plant from which they drained a red liquid. They thickened this into a paste, which they used to treat infected wounds. Early European settlers in America also used blood root to treat a variety of skin conditions including warts and moles. Blood root is a strong escharotic, meaning it is a caustic and destructive material. This can reasonably be compared to the result that would be expected from burning tissue by applying a strong caustic substance such as hydrochloric acid. Its use in contemporary society dates back to the s when researcher Fred Mohs used a preparation containing a low concentration of blood root to stabilise a tumour so he was able to examine it under a microscope. This historical use has been used to give credibility to the use of black salve to treat skin malignancies, despite the fact Mohs publicly renounced its use for this purpose.

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