Friedman said that when he needed to prescribe hydroxychloroquine, he was forced to change the way he talked to patients. “I have now started to write a script:’Hey, I want you to start taking this medicine. You may have heard that it is related to the new coronavirus and it is used as a treatment, but it is not the case,'” he said. “It got a lot of negative news. However, in dermatology, we have been using it for decades to deal with these different things.”
To understand to what extent this confusion may also be the future of ivermectin, I went to r/Rosacea, which is a subreddit of recommendations on dealing with chronic diseases.
Patients with rosacea do not know that Ivermectin is an unproven new coronavirus drug, but an effective treatment that can help some patients with rosacea that can cause skin lumps. On subreddit, a user was puzzled by the sudden influx of attention and asked: “Why are ivermectin memes everywhere now? How do the mainstream know what it is?”
For people on subreddit, Ivermectin is a very persistent topic of discussion. There is an expensive topical cream called Soolantra that contains this drug, and a generic version was released this summer. But some of the users also know that horse ointment contains the same medicine, because some people who have been diagnosed with rosacea have also bought veterinary medicine-usually because they can’t get creams in other ways or can’t afford a prescription.
This practice is controversial among rosacea patients, and dermatologists have expressed concern about testing products that contain inappropriate doses or untested ingredients that may have adverse effects. However, Feinstein said that a patient with rosacea turned to horse paste for cost reasons, and was in a completely different medical and ethical world from people who eat horse paste to “cure” COVID-19. For patients with diagnosed rosacea who need ivermectin to control their condition, Feinstein said, “Unfortunately, the best medicine is the one that the patient can get.”
Feinstein said that as of now, people who use Soolantra or ivermectin generics are unlikely to experience shortages.Have report However, there is a shortage of horse sauce in the farm supply store. Apart from some actual interview questions-when reporting this story, I had a conversation with a man who had to buy horse ointment from the UK a few weeks ago to treat his pet rat-now there is an additional review and stigma.How do you explain that you use horse ointment on yourself, but don’t like it That?
“Attached to this simplistic idea”
The moderators of subreddit are already very familiar with the misinformation about ivermectin.
Like many online communities, people use the site to discuss and exchange information based on their experience: for example, discuss the best facial cleanser, ask how to avoid triggering an outbreak, or share how their treatment has progressed over time. But they can also incubate and spread misinformation, and the host must monitor and delete these misinformation.
Although there are some Facebook groups that promote horse ointment for people with rosacea, the r/Rosacea subreddit neither encourages nor prohibits discussion of its use. A host told me that the biggest risk is that people will self-diagnose rosacea and decide to treat themselves with a DIY version of the drug, even if it is for human use, it can only be used under the guidance of a doctor.
However, not all rosacea is the same, and the reason why ivermectin may be effective for some people is still the subject of scientific controversy.
There is a link between rosacea and Demodex, which lives in more or less hair follicles on everyone’s face. In people with any form of rosacea, there are too many of these mites. But the specific relationship is unclear. “The question is whether there was the chicken or the egg,” Friedman said. Is the patient with rosacea an ideal environment for demodex to live in excess, or is it “this overgrowth will exacerbate rosacea?”
Reddit moderator Ryan asked me to conceal his last name. He said that this uncertainty has led to some very dangerous suggestions on the Internet.
“People are attracted and attached to this over-simplistic idea that if they just kill the mites, their rosacea and problems will disappear,” he said. “We even saw some very crazy things, such as people suggesting to wear flea collars or use insecticides on their faces.”
Data blanks and poisoned wells
Online vendors of misinformation often use data gaps to tell people to search for specific terms that they know will lead to results that promote what they want to say.Worst of all, as a researcher of misinformation Renee DiResta once wrote, The most important results may ultimately come from people who believe and promote misinformation.