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Friedman says she had to change the way she spoke to patients when she had to prescribe hydroxychloroquine. “Now I’ve worked out my script: ‘Hey, I want to get you started on this drug. You may have heard that it is related to Covid, used for therapeutic purposes, and it is not.” “There is a lot of negative press. But we’ve been using it for decades for these different things in dermatology.”

To understand to what extent this confusion could be the future of ivermectin, I went to the subreddit r/Rosacea for advice on coping with the chronic condition.

categorically different.

People with rosacea know ivermectin not as an unproven covid remedy, but as a proven and effective treatment that has helped some people with a type of rosacea that causes bumps on the skin. On the subreddit, one user was confused by the sudden flow of attention and asked the question: “Why are ivermectin memes popping up everywhere right now? And how does the mainstream know what it is?”

For the folks on the subreddit, ivermectin is a pretty persistent topic of discussion. There is an expensive topical cream called Soolantra that contains the drug, and a generic version was launched this summer. But a subset of these users also knew that the same drug was in horse butter, because some people diagnosed with rosacea also bought the veterinary form – often because they couldn’t access or afford a prescription otherwise creams.

This practice is controversial among rosacea sufferers, and dermatologists have expressed concern about experimenting with an inappropriate dosage or a product containing untested ingredients with potentially negative effects. But Feinstein says that a person with rosacea who turns to horsemeat for cost reasons is in a categorically different medical and ethical universe than people who ate horsemeat to “cure” covid. For diagnosed rosacea patients who need ivermectin to control the condition, “unfortunately, it’s the best medicine patients can take,” says Feinstein.

Feinstein says people who use Soolantra or the generic version of ivermectin topically are currently less likely to experience famine. There is reports However, ranch supply stores that fall short in horse crush. In addition to some practical access issues – while reporting this story, I spoke to an individual a few weeks ago who had to purchase horse paste from the UK to treat their pet mice against mites – now there’s an added layer of scrutiny and stigma. How do you explain to yourself that you use horse paste but don’t like it? he?

“Depends on this over-simplified idea”

The moderators of the subreddit were already quite familiar with misinformation about ivermectin.

People, like many online communities, use the site to discuss and exchange information based on their experience: for example, to discuss the best facial cleansers, ask how to avoid triggering a flare-up, or share how their treatments have progressed over time. However, they can incubate and encourage misinformation that moderators should monitor and remove.

Although there are some Facebook groups that promote horse crush for rosacea sufferers, the r/Rosacea subreddit neither encourages nor prohibits discussion of its use. 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 a drug that should only be used under the guidance of a doctor, even in a form intended for human use. .

However, not all rosacea is the same, and the reasons why ivermectin works for some is still a matter of scientific debate.

There is a link between rosacea and demodex mites that live in the hair follicles on everyone’s face. People with any form of rosacea have an abundance of these mites. But the exact relationship is not clear. “The question is chicken or egg,” Friedman says. Are people with rosacea ideal environments for demodex mites to live in, or “or is it this overgrowth that exacerbates rosacea?”

Reddit moderator Ryan said that this ambiguity, asking me not to give his last name, has led to some pretty dangerous suggestions online.

“People are drawn and attached to this oversimplified idea that if they kill the mites, their rosacea and their problems will go away,” he said. “We’ve even seen some pretty crazy stuff like suggesting that people wear flea collars or use pesticides on their face.”

Data gaps and poison wells

Online misinformation vendors often exploit a data gap and tell people to search for specific terms they know will lead to encouraging results what they’re trying to say. Worst of all, as a misinformation researcher Renee DiResta wrote in the past, the best results can come from people who completely believe in and support misinformation.