Friedman says he was forced to change the way he talked to patients when he needed to prescribe hydroxychloroquine. “I’ve now worked on my scripting: ‘Hey, I want you to start this drug. You may have heard about it about covid that it’s being used as a cure and it’s not,'” he says. “It has received a lot of negative press. However, in dermatitis we have been using it for decades for these different things.
To understand if this confusion could be the future of ivermectin, I went to Subredit r / Rosacea for advice on dealing with a chronic condition.
People with rosacea use ivermectin not as an unproven covid drug, but as a proven and effective treatment that helps some people with a type of rosacea that causes skin irritation. In Subredit, a user was distracted by sudden attention, asking: “Why are ivermectin memes popping up everywhere right now? And how does the mainstream know it?”
For people of subreditate, ivermectin is a fairly enduring topic of discussion. There is an expensive topical cream called Sulantra that contains the drug and a generic version was released this summer. But a subset of those users also knew that the same drug was in horse paste, because some people with rosacea also bought veterinary forms – usually they could not otherwise enter the creams or carry the prescription.
This practice is controversial among rosacea patients, and dermatologists have expressed concern about testing a product that contains an unsuitable dose or an untested ingredient with potential side effects. However, Friedman says the person with the rosacea is leaning towards horse paste because of the cost, he is in a completely different medical and moral universe from what he is eating horse paste to “cure” Kovid. Diagnosed for rosacea patients who need ivermectin to control their condition, Friedman said, “Unfortunately, the best medicine is what a patient can get.”
People who use generic versions of Sulantra or Ivermectin are not likely to face a shortage right now, Friedman said. However, farm supply stores are reported to be running low on horse paste. In addition to some practical problems with access – while reporting this story, I spoke to a man who a few weeks ago had to buy horse paste from the UK for the treatment of his pet rats. Make sure you use horse paste on yourself, but don’t like it That?
“Connected to this very simple idea”
The moderators of Subredit were already quite familiar with the misinformation about ivermectin.
People use sites like many online communities to discuss and trade information based on their experience: for example, discussing the best facial cleansers, asking how to avoid burns, or sharing how their treatment progresses over time. But they can spread and propagate misinformation, which moderators need to monitor and remove.
Although there are some Facebook groups that promote horse paste for them, including rosacea, r / Rosacea does not encourage or ban discussions about the use of subreddit. One moderator told me that the biggest risk is that people will self-diagnose with rosacea and decide to treat themselves with a DIY version of the drug, even in a form intended for human use that should only be used under a doctor’s direction.
Not all rosacea are the same, however, and whether ivermectin may work for some is still a matter of scientific debate.
There is a connection between rosacea and Demodex mite, which is present in the hair follicles on the face of almost everyone. In any type of rosacea people, those mites are extra. But the exact relationship is not clear. “The question is chicken or eggs,” Friedman said. Can people in Rosacea’s ideal environment for Domodex mites live extra lives, or “or does this extra growth make Rosacea grow?”
That uncertainty has led to a number of dangerous suggestions online, Reddit moderator Ryan said, adding that I asked if I had put his last name.
“People are attracted to and attached to this very simple idea that if they just kill the mites, their rosacea and their problems will go away,” he said. “We’ve even seen a lot of insane things, like people suggest wearing fleece collars or using pesticides on the face.”
Data voids and toxic wells
Online sellers of misinformation often use a data invalid, asking people to search for specific words that they know will lead to results that will promote what they are trying to say. Worst of all, as misinformation researcher Rini Deresta has written in the past, top results can come entirely from people who believe and propagate misinformation.