Over a year of suffering, misdiagnosis, and failed treatments — and then seven days of Yawanawa tobacco paste. A personal account of healing cutaneous leishmaniasis the traditional way.
Important notice
This is a personal account of one person’s experience and is shared for informational purposes only. It is not medical advice and should not be used as a substitute for professional medical diagnosis or treatment. Always consult a qualified healthcare provider before attempting any treatment for any medical condition. Traditional remedies carry risks and what worked in one case may not be appropriate for another.
After over a year of suffering — misdiagnoses, failed treatments, and excruciating nerve pain — a traditional Amazonian approach using tobacco healed what nothing else could. I share this not as medical advice, but as one person’s experience.
Background: What is Papalomoya?
Papalomoya is the common name in Costa Rica, Nicaragua, and other parts of Central and South America for cutaneous leishmaniasis, caused by Leishmania parasites transmitted by sandfly bites. It creates slow-healing skin ulcers, often on exposed areas, that can last months to years, cause scarring, and sometimes involve nerve pain.
Standard treatments include antiparasitic drugs like antimonials, miltefosine, or amphotericin B. These can be painful, expensive, unavailable in conflict zones, or carry serious side effects. In indigenous Amazonian traditions, plants including tobacco have long been used for wounds, infections, parasites, and skin issues. Some ethnobotanical studies note tobacco among plants used topically for leishmaniasis-like ulcers in Latin America.
The lesion as it appeared — January 2023
The lesion, detail view
My Experience: How It Began
In early 2023, the pain felt like a deep bruise or blow to the shin, with no visible injury. I also had radiating pain from my heel through my buttocks, likely sciatic nerve involvement, which I first blamed on standing work. Over four months, a small sore emerged from under the skin, grew larger, and became intensely painful.
I saw a skilled dermatologist in San José, Costa Rica, who initially treated me for vasculitis. At my follow-up a month later, a second lesion appeared, raising fears it was spreading. She then suspected leishmaniasis. Hospital PCR tests on the dry wounds came back negative twice — sampling issues with non-weeping lesions are common. Despite this, the symptoms matched leishmaniasis perfectly from my research.
Jan 2023
Unexplained pain begins in left shin. No visible injury. Radiating nerve pain from heel to buttocks.
Apr 2023
Sore emerges from beneath the skin. Dermatologist in San José treats for vasculitis. Second lesion appears.
Jun 2023
PCR tests return negative twice. Leishmaniasis suspected. Ivermectin tried with no change.
Sep 2023
Eight months in. Pain excruciating. No pressure on heel possible. Sleep impossible. Tobacco treatment begins.
Sep 22–30
Seven days of tobacco paste applied to wounds daily. By day 7, nerve pain vanishes completely.
Jan 2024
Lesions fully healed. No recurrence.
The lesion in detail — characteristic shape of cutaneous leishmaniasis
The wound, close view
The Tobacco Treatment
By September 2023, eight months in, the pain was excruciating: no pressure on my heel, couldn’t sit comfortably, and nerve pain from heel to buttocks made sleep impossible. The dermatologist mentioned government-hospital injections directly into the wounds, twice weekly for a month. Horrific and unavailable privately. I refused.
Yawanawa Tsunu rapé
Desperate, at a plant-medicine ceremony, a participant suggested tobacco. Friends in the Amazon confirmed: use rapé (traditional snuff) in wounds or wrap with tobacco leaves daily. I used Yawanawa Tsunu rapé, approximately 80% pure ground tobacco and 20% tree ash. Without leaves available, I made a paste, packed it into the wounds, and bandaged them.
The first application burned fiercely, forcing me to remove it after 20 minutes. I washed it off but persisted daily. By day 2 I tolerated an hour; by the final days, all day. The burn was brutal, but I reminded myself: this or hospital injections. I felt the tobacco actively fighting the parasite.
The wound during the tobacco treatment — healing underway
Healing progress — October 2023
After seven days, September 22 to 30, 2023, the nerve pain vanished completely. No more heel-to-buttocks agony. I slept peacefully for the first time in a year. Lesions healed fully by January 2024, with no recurrence.
“After suffering for over a year, tobacco healed my papalomoya when nothing else did. It was painful but empowering.”