Journal article
Black salve composition: an evaluation of the potential for normal tissue toxicity and treatment failure from black salve products
Journal of Herbal Medicine
2019
Metrics
76 Record Views
UN Sustainable Development Goals (SDGs)
This output has contributed to the advancement of the following goals:
Source: InCites
Abstract
<p><p id="x-x-spar0020">Black <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/salve" title="Learn more about Salve">salve</a>, used as an alternative <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/skin-cancer" title="Learn more about Skin Cancer">skin cancer</a> therapy, contains both herbal and chemical constituents, including extracts of the <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/rhizome" title="Learn more about Rhizome">rhizomes</a> of <em><a href="https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/sanguinaria" title="Learn more about Sanguinaria">Sanguinaria</a></em> canadensis and <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/zinc-chloride" title="Learn more about Zinc Chloride">zinc chloride</a>. Black salves may be ordered online and have been associated with cases of extensive <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/tissue-necrosis" title="Learn more about Tissue Necrosis">tissue necrosis</a> and <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/treatment-failure" title="Learn more about Treatment Failure">treatment failures</a> that have resulted in patient <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/fatality" title="Learn more about Fatality">fatalities</a>. Despite these <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/adverse-outcome" title="Learn more about Adverse Outcome">adverse outcomes</a> and continued use by patients, black salve products have not been quantitatively assessed to determine their constituent concentrations. <p id="x-x-spar0025">Thirteen different black salve products from eight manufacturers were analysed using validated <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/liquid-chromatography-mass-spectrometry" title="Learn more about Liquid Chromatography-Mass Spectrometry">HPLC-MS</a> and <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/inductively-coupled-plasma-mass-spectrometry" title="Learn more about Inductively Coupled Plasma Mass Spectrometry">ICP-MS</a> methods to assess <em>S. canadensis</em> <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/alkaloid" title="Learn more about Alkaloid">alkaloid</a> and zinc chloride concentrations. This analysis revealed a dramatic variation in constituent concentrations between manufacturers of black salve products. The alkaloid <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/sanguinarine" title="Learn more about Sanguinarine">sanguinarine</a>was found at concentrations significantly exceeding the cytotoxic IC50 of <a href="https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/normal-human" title="Learn more about Normal Human">normal human</a>epidermal <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/keratinocyte" title="Learn more about Keratinocyte">keratinocytes</a> in the majority of black salve products, with one black salve examined having a concentration 900 times the IC50 level. The majority of products contained zinc chloride at concentrations known to kill normal human tissue, while one black salve product was found to contain an elevated lead level of 258 ppm, which exceeds the 10 ppm <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/food-and-drug-administration" title="Learn more about Food and Drug Administration">FDA</a> determined lead limit for cosmetic products. Whilst some of the black salve products were found to contain high concentrations of constituents cytotoxic to normal tissue, others were found to contain insufficient cytotoxic constituents to be reasonably expected to exert any <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/antineoplastic-activity" title="Learn more about Antineoplastic Activity">anti-cancer activity</a>. <p id="x-x-spar0030">In their current formulations, the majority of black salves analysed pose a significant risk of harm to patients and should not be available for unregulated clinical use. Further black salve <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/toxicity-testing" title="Learn more about Toxicity Testing">toxicity testing</a> is urgently required.</p>
Details
- Title
- Black salve composition: an evaluation of the potential for normal tissue toxicity and treatment failure from black salve products
- Creators
- Andrew Croaker - Southern Cross UniversityGraham J King - Southern Cross UniversityJohn H Pyne - University of QueenslandShailendra Anoopkumar-Dukie - Griffith UniversityLei Liu - Southern Cross University
- Publication Details
- Journal of Herbal Medicine
- Identifiers
- 2025; 991012820484702368
- Academic Unit
- Faculty of Health; Science; Southern Cross Plant Science; Faculty of Science and Engineering
- Resource Type
- Journal article