What happens when your prescription drug becomes a center of Covid misinformation

Friedman says he was forced to change the way he talked to patients when he had to prescribe hydroxychloroquine. “Now I’m working on my script: ‘Hey, I want to start you with this medicine. “You may have heard about COVID being used as a medicine and not,” he said. “There is a lot of negative press. In dermatology, however, we have been using it for decades for these different things. ”

To find out to what extent this confusion may be the future of ivermectin, I went to r / Rosacea, the editor for advice on dealing with the chronic condition.

Definitely different

People with rosacea know ivermectin not as an unproven drug, but as a proven and effective treatment that helps some people with the type of rosacea that causes swelling of the skin. One user was confused by the sudden surge of attention and asked, “Why are ivermectin memes everywhere right now? And how does the mainstream know what that is? ”

For people on subreddit, ivermectin is a rather persistent topic of discussion. There is an expensive topical cream called Soolantra that contains the drug, and the general edition was released this summer. But a subset of these users also knew that the same drug was in horse paste, as some people diagnosed with rosacea also bought the veterinary form – usually because they could not otherwise access the creams or could not afford a prescription.

This practice is controversial among people with rosacea, and dermatologists have expressed concern about experimenting with a product that contains an inappropriate dose or untested ingredients with potentially adverse effects. However, says Friedman, a person with rosacea who turns to horse paste for cost reasons is in a very different medical and ethical universe than where people eat horse paste to “cure” COVID. For diagnosed patients with rosacea who need ivermectin to control the condition, Friedman says, “Unfortunately, the best medicine is what patients can get.”

People who use Soolantra or the generic version of ivermectin topically are currently unlikely to experience a deficiency, Friedman said. However, there are reports that farm supply stores do not have horse paste. In addition to some practical access issues – while reporting this story, I talked to a man who had to buy horse paste from the UK to treat his house rats for mites a few weeks ago – there is now an extra layer of control and stigma. How to explain that you use horse paste on yourself but you don’t like it that?

“Attached to this simple idea”

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

People use the site, like many online communities, to discuss and market information based on their experiences: for example, discussing the best facial cleansers, asking how to avoid inflammation, or sharing how to treat their progress over time. But they can also incubate and promote misinformation, which moderators should monitor and remove.

Although there are some Facebook groups that promote horse paste for those with rosacea, the r / Rosacea suborder neither encourages nor prohibits discussion of its use. One moderator told me that the biggest risk is for people to self-diagnose rosacea and decide to be treated with a DIY version of a drug that, even in a form intended for human use, should only be used with a doctor’s guidance.

However, not all rosaceas are the same, and the reasons why ivermectin may work for some are still the subject of scientific debate.

There is a link between rosacea and demodex mites that live in the hair follicles up and down each person’s face. in people with any form of rosacea, these mites are there in excess. But the exact connection is unclear. “It’s a chicken or an egg,” says Friedman. Are people with rosacea an ideal living environment for demodex mites or “or does this overgrowth make rosacea worse?”

This uncertainty has led to some rather dangerous offers online, said Ryan, a Reddit moderator who wanted to hide his last name.

“People are attracted to this simplistic idea that if they just kill the mites, the rosacea and their problems will go away,” he said. “We’ve even seen some pretty crazy things, like people recommending wearing flea collars or using pesticides on your face.”

Data cavities and poisoned wells

Online misinformation marketers often use data gaps to tell people to look for specific terms that they know will lead to results that promote what they are trying to say. In the worst case, as disinformation researcher Rene DiResta wrote in the past, the best results may ultimately come entirely from people who believe and encourage misinformation.