Keep Factually independent
Whether you agree or disagree with our analysis, these conversations matter for democracy. We don't take money from political groups - even a $5 donation helps us keep it that way.
What do dermatologists recommend for treating small skin cancers on the face, and is horse paste a viable option?
Executive Summary
Dermatologists consistently recommend evidence-based, site-sparing treatments—most commonly Mohs micrographic surgery, surgical excision, topical FDA‑approved therapies, photodynamic therapy, or cryotherapy—for small skin cancers on the face, because these approaches maximize cure rates and cosmetic outcomes [1] [2] [3]. Horse paste (equine ivermectin) is not endorsed by dermatologists as a treatment for skin cancer; laboratory and early‑stage research into antiparasitic drugs for cancer is exploratory and far from clinical acceptance for human skin cancers [4] [5].
1. What clinicians actually claim: the standard of care that works and why it’s favored
Dermatology and oncology authorities recommend treatments chosen for high cure rates and tissue conservation on cosmetically sensitive facial skin, with Mohs micrographic surgery highlighted for many small facial basal and squamous cell carcinomas because it combines margin control with maximal normal tissue preservation—cure rates cited up to 99 percent [1]. Alternative options—simple surgical excision, curettage and electrodessication, topical chemotherapies (e.g., 5‑fluorouracil, imiquimod), photodynamic therapy, and radiation—are used selectively based on tumor type, size, depth, location, and patient factors [2] [3]. These recommendations are grounded in clinical outcome data and long clinical experience, not anecdote, and they are the treatments practicing dermatologists discuss with patients in clinics [2] [3].
2. Why cosmetic outcomes and cure certainty drive facial skin‑cancer choices
Facial tumors pose dual priorities: eradicate cancer and preserve appearance, so clinicians prefer modalities with documented margin control and reproducible cosmetic results. Mohs surgery provides real‑time histologic margin assessment, making it the go‑to for non‑melanoma skin cancers in cosmetically high‑risk areas [1]. When surgery is contraindicated—for example, due to comorbidity or small superficial lesions—dermatologists may use topical therapies or photodynamic therapy, which offer non‑surgical alternatives but typically carry different cure rates and follow‑up needs [2] [3]. The choice hinges on tumor biology, patient preference, and tradeoffs between recurrence risk and cosmetic outcome, which guidelines and cancer centers balance in individualized treatment plans [2].
3. The horse‑paste claim: what the evidence shows and what it doesn’t
The term “horse paste” usually refers to equine ivermectin formulations. There is no clinical evidence supporting equine ivermectin as a safe or effective treatment for human skin cancers, and dermatology guidance does not recommend it [1] [3]. Preclinical and pharmacology literature explores repurposing antiparasitic agents—including ivermectin, fenbendazole, and related compounds—for anticancer mechanisms such as antiproliferative effects [4] [5]. Those studies are laboratory‑based or very early translational work; they do not establish appropriate dosing, safety, or efficacy for treating human skin cancers on the face. Using veterinary formulations risks incorrect dosing, impurities, and adverse reactions without proven benefit, so it stands apart from regulated oncology care [5].
4. Research trends, uncertainties, and commercial or social‑media agendas to watch for
Scientific interest in drug repurposing is legitimate: peer‑reviewed reviews and preclinical studies published through 2024–2025 discuss antiparasitic agents’ anticancer mechanisms and potential therapeutic avenues [4] [5]. However, these publications stop short of clinical practice recommendations and explicitly call for rigorous trials to assess safety and efficacy. Public promotion of “horse paste” often arises from online anecdote or misapplied extrapolation from lab findings; such messaging can reflect commercial incentives or viral social‑media narratives rather than clinical science [4] [6]. Dermatology and cancer centers emphasize that translational research timelines are long, and early mechanistic promise does not equal a safe treatment option for patients today [5].
5. Bottom line for patients: choose proven care and discuss any alternatives with your clinician
For small skin cancers on the face, follow established, evidence‑based options—Mohs surgery, excision, or appropriate topical/photodynamic approaches—selected by your dermatologist to balance cure and cosmesis [1] [2] [3]. Do not use equine ivermectin or “horse paste” as a cancer treatment: it lacks clinical validation, carries safety and dosing risks, and is not part of dermatologic practice [1] [5]. If you encounter claims about repurposed antiparasitics, ask your clinician about published clinical trial data, potential harms, and whether regulated trials exist; participate in research only through formal clinical trials run by reputable institutions, not via anecdotal or off‑label self‑treatment [4] [5].