HX16 Fake news in dermatology through the ages: from arsenic wafers to black salve and skinfluencers

Abstract

Dermatology has always existed at the intersection of medicine, appearance and commerce, making it uniquely vulnerable to misinformation. This presentation traces the evolution of ‘fake news’ in skin disease from antiquity to the digital era, demonstrating that dermatological myths are not a modern phenomenon but a recurring historical cycle. In antiquity, Hippocratic and Galenic humoral theory framed skin eruptions as the expulsion of internal ‘toxins’. Medieval and early modern Europe moralized visible dermatoses such as leprosy and scabies, associating them with impurity and sin, fuelling stigma and fear-based public beliefs. Early modern itinerant healers promoted secret ointments and purgatives, often supported by theatrical demonstrations and fabricated testimonials. The 18th and 19th centuries saw an explosion of patent medicines and cosmetic quackery. Products such as Brandreth’s Pills promised to purify the blood and cure eruptions, while dangerous beauty practices included arsenic complexion wafers and arsenic tonics such as Fowler’s Solution, marketed for fashionable pallor. The 20th century accelerated misinformation through advertising and mass media. Campaigns for products such as Pears’ Soap reinforced the enduring myth that acne reflected dirt and moral failure, while cosmetic marketing increasingly adopted pseudoscientific language. Meanwhile, genuine breakthroughs – including topical corticosteroids and retinoids – generated new anxieties exploited by alternative health movements. In the 21st century, dermatological misinformation has been turbocharged by social media algorithms and influencer culture. Viral narratives promote sunscreen scepticism, exaggerated steroid fear and mislabelling of inflammatory dermatoses as ‘detox reactions’. Harmful trends include DIY chemical treatments and dangerous cancer misinformation such as black salve, falsely marketed online as a natural cure for melanoma. By tracing these patterns across centuries it is clear that dermatological fake news evolves with communication technology but remains driven by fear, stigma and commercial incentive – requiring clinicians to respond with both scientific clarity and historical insight.