Today, 72% of Internet users in the US turn to Facebook for medical advice before consulting their doctors. In this virtual community, medical quackery thrives as users share medical concerns and the masses offer insight, drawing on personal experiences and Google searches. “Soak it in Epson salts,” “apple cider vinegar will do the trick,” “try a bread poultice,” or “how about dabbing on some turpentine?” Others take a more direct approach, performing a differential diagnosis from their pajamas and recommending essential oils, adding, this is an powerful healing oil…just Google it. I mean, you may want to follow your doctor’s instructions, but I have used these products for years and they work   (…paraphrased to protect anonymity of user). It is in this age of virtual quackery that public health professionals ought to turn back to the snake oil salesman of the early 20^th century for a lesson in regulatory need.

While the venue may be new, the phenomenon isn’t. Medical quackery dates back long before the age of Web 2.0. Throughout the 19^th century, products like William Radam’s Microbe Killer or Lydia E. Pinkham’s Vegetable Compound dominated the market. But patent medicines, like these, were too often therapeutically useless, if not dangerous. Radam’s Microbe Killer, a mixture of sulfuric acid and red wine, might kill microbes, but with inconsistencies in dosing and production quality, it could also kill the individual gambling on its panacea effects. And even though Pinkham’s Vegetable Compound, laden with black cohosh and fenugreek, would almost certainly have an impact on the expectant mother, it may also induce hemorrhaging and preterm labor. Without regulation, improper dosing and application rendered even potentially therapeutic compounds dangerous.

While the Pure Food and Drug Act of 1906, and similar legislation, attempted to respond to this public health concern, legal loopholes combined with todays social media boom have paved a new way for quackery. Today’s unintentional snake oil salesmen operate over Facebook and Twitter. It is in this virtual space that users seek medical advice, sharing user-generated content, transforming even the most ill informed into an armchair pharmacist. Despite a recent cease and desist letter from the FDA, doTerra Oils continue marketing their essential oils online, banking on careful labeling and word-of-mouth advertisement. Social media is dripping with independent doTerra sales reps, pushing essential oils for everything from heat rash to staph infections. Like patent medicines in the 19^th century, products such as these are often poorly regulated, leaving room for inconsistent dosing, and loosing potential health benefits in the process. For example, while lavender essential oil has therapeutic value, when it is not used appropriately its estrogen imitating qualities can lead to prepubertal gynecomastia (breast buds) in young children.

Today’s unintentional snake oil salesman can’t be found at the street corner shouting, but rather lurking over social media. They are not traveling apothecaries interested in making a buck, but they are Kim Kardashian, pushing an anti-nausea medication over Twitter. They are your Aunt Sue, posting to your Facebook page and instructing you to rub concentrated lavender oil all over your baby’s heat rash. But they do have one thing in common with yesterday’s panacea-pusher. They are encouraging the use of medicinal products that have escaped appropriate regulation through careful wording and loopholes. Compounds that when dosed correctly may have medicinal qualities, but left unregulated are far more likely to cause harm.

As the FDA and other regulatory bodies continue to try to navigate this new terrain of virtual quackery, it is up to the consumer to review products and applications with great scrutiny. We are our own regulatory body. Don’t take your Aunt Sue’s word for it—do some research for yourself, and be critical of your sources. Here are some tips to use when doing your own research on an otherwise questionably regulated product:

• Who’s the author? If there is no recognized author or body behind this work, it’s probably not a good source, and you should keep looking. If there is an author or organization listed, look them up–have they written other things? Do other scholars cite them?
• Where’s it published? The most reliable works are published through peer reviewed journals. This means that the article has already been reviewed by experts in the field for reliability and validity. As a result, this source is more likely to be a sound source of information.
  • If you see something published by a news source, look to see where the reporting body got their information, and be weary of flashy headlines. Often, news publications use sensationalized headings that render the findings misleading.
• If you want to get real nit-picky about the reliability of a source, do the CRAP Test.