SULFUR: Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews

Overview

Sulfur is a chemical element that is present in all living tissues. After calcium and phosphorus, it is the third most abundant mineral in the human body. Sulfur is also found in garlic, onions, and broccoli.

Sulfur is applied to the skin for dandruff and an itchy skin infection caused by mites (scabies). It is also applied to the skin for acne and skin redness (rosacea), and taken orally for many other conditions, but there is limited scientific evidence to support these uses.

How does it work ?

Sulfur is present in all living tissues. It is the third most abundant mineral in the human body. Sulfur seems to have antibacterial effects against the bacteria that cause acne. It also might help promote the loosening and shedding of skin. This is believed to help treat skin conditions such as seborrheic dermatitis or acne.

Uses & Effectiveness

Possibly Effective for

Dandruff. Sulfur is an FDA-approved ingredient used in common over-the-counter products to treat dandruff. However, available research on its effectiveness is limited. Some research shows that using a shampoo containing sulfur and/or salicylic acid twice daily for 5 weeks reduces dandruff. Shampoo containing both sulfur and salicylic acid seems to be most effective.
Itchy skin infection caused by mites (scabies). Applying a jelly containing sulfur to the skin appears to be an effective treatment for scabies in most people. Sulfur treatments are usually applied overnight for 3 to 6 nights. But this treatment is not pleasant due to the smell. Also, there are better and cheaper treatments available, including the drugs ivermectin and permethrin.

Insufficient Evidence for

Acne. Sulfur is an FDA-approved ingredient used in common over-the-counter products to treat acne. However, there is limited research available on its effectiveness. Most products include sulfur in combination with benzoyl peroxide, salicylic acid, or sodium sulfacetamide.
Hay fever. Early research shows that using a nasal spray containing homeopathic (diluted) amounts of sulfur, luffa, Galphimia glauca, and histamine for 42 days is as effective as common cromolyn sodium nasal spray.
A lung disease that makes it harder to breathe (chronic obstructive pulmonary disease or COPD). Early research shows that breathing in the air from warm sulfur water does not help the lungs to function in people with COPD.
Common cold. Early research suggests that taking a homeopathic (diluted) product containing sulfur and German ipecac (Engystol, Heel GmbH) by mouth for up to 2 weeks during a cold helps relieve symptoms.
High levels of cholesterol or other fats (lipids) in the blood (hyperlipidemia). Early research suggests that drinking water from a sulfurous spring three times daily for 4 weeks reduces total cholesterol, low-density lipoprotein (LDL or "bad") cholesterol, and triglyceride levels. However, it's not clear from this study alone if sulfur might reduce cholesterol.
A skin condition that causes redness on the face (rosacea). Early research suggests that applying a cream containing sulfur to the face once daily for up to 8 weeks reduces fluid-filled bumps on the face and other symptoms caused by rosacea. Some early research shows that sulfur cream may be as effective as the antibiotic tetracycline.
Shortness of breath.
Sore throat (pharyngitis).
Symptoms of menopause.
Lice.
Cold sores (herpes labialis).
Warts.
Rough, scaly skin on the scalp and face (seborrheic dermatitis).
Poison oaky, ivy, and sumac infections.
Other conditions.

More evidence is needed to rate sulfur for these uses.

Side Effects

When taken by mouth: There isn't enough reliable information to know if sulfur is safe or what the side effects might be. It might cause diarrhea in some people.

When applied to the skin: Sulfur is POSSIBLY SAFE when applied to the skin appropriately, short-term. Products containing sulfur in concentrations up to 10% have been used safely for up to 8 weeks. In some people, applying sulfur products to the skin may cause the skin to become dry.

Special Precautions and Warnings

Pregnancy and breast-feeding: Sulfur is POSSIBLY SAFE when applied to the skin appropriately, short-term. Products containing sulfur in concentrations up to 6% have been applied safely every night for up to 6 nights. There isn't enough reliable information to know if sulfur is safe to take by mouth when pregnant or breast-feeding. Stay on the safe side and don't take it by mouth.

Children: Sulfur is POSSIBLY SAFE when applied to the skin appropriately, short-term. Products containing sulfur in concentrations up to 6% have been used safely when applied nightly in children and adolescents for up to 6 nights. Products containing sulfur in concentrations up to 2% have been used safely when applied for 3 hours daily for up to 6 days in infants.

Sulfa allergy: It is commonly thought that people who are allergic to sulfa drugs might be allergic to sulfur containing products. This is not true. People with an allergy to "sulfa" react to the sulfonamide in some antibiotics and related drugs. They do not react to elemental sulfur.

Interactions

We currently have no information for SULFUR overview.

Dosing

ADULTS

APPLIED TO THE SKIN:

For dandruff: Shampoos containing 2% sulfur, alone or with 2% salicylic acid, have been used twice weekly for 5 weeks.
For scabies: Treatments containing between 2% and 20% sulfur in jelly have been applied overnight for 3 to 6 nights.

CHILDREN

APPLIED TO THE SKIN:

For scabies: Shampoos containing 2% sulfur, alone or with 2% salicylic acid, have been used twice weekly for 5 weeks.

View References

REFERENCES:

Akhavan, A. and Bershad, S. Topical acne drugs: review of clinical properties, systemic exposure, and safety. Am J Clin Dermatol 2003;4(7):473-92. View abstract.

Blom I, Hornmark AM. Topical treatment with sulfur 10 per cent for rosacea. Acta Derm Venereol 1984;64:358-9. View abstract.

Blum, J. E. and Coe, F. L. Metabolic acidosis after sulfur ingestion. N Engl J Med 1977;297(16):869-70. View abstract.

Diaz, M., Cazorla, D., and Acosta, M. [Efficacy, safety and acceptability of precipitated sulphur petrolatum for topical treatment of scabies at the city of Coro, Falcon State, Venezuela]. Rev Invest Clin 2004;56(5):615-22. View abstract.

FDA OTC ingredients list, April 2010. Available at: www.fda.gov/downloads/AboutFDA/CentersOffices/CDER/UCM135691.pdf (accessed 2/7/15).

Food and Drug Administration. Classification of benzoyl peroxide as safe and effective and revision of labeling to drug facts format; topical acne drug products for over-the-counter human use; final rule. Federal Register 2010;75(42):9767-77. View abstract.

Goszcz, A., Kostka-Trabka, E., Grodzinska, L., et al. [The effect of treatment with sulphur water from the spring in Wieslaw in Busko-Solec on levels of lipids, the fibrinolytic system and thrombogenic platelet function in patients with arteriosclerosis]. Pol Merkur Lekarski 1997;3(13):33-6. View abstract.

Gupta, A. K. and Nicol, K. The use of sulfur in dermatology. J Drugs Dermatol 2004;3(4):427-31. View abstract.

Leyden, J. J., McGinley, K. J., Mills, O. H., Kyriakopoulos, A. A., and Kligman, A. M. Effects of sulfur and salicylic acid in a shampoo base in the treatment of dandruff: a double-blind study using corneocyte counts and clinical grading. Cutis 1987;39(6):557-61. View abstract.

Lin, A. N., Reimer, R. J., and Carter, D. M. Sulfur revisited. J Am Acad Dermatol 1988;18(3):553-8. View abstract.

Naganuma, T., Naruse, K., Tohno, Y., et al. Age-dependent decreases of sulfur and magnesium in human round ligaments of the uterus and relationships among elements. Biol Trace Elem Res 2004;102(1-3):73-82. View abstract.

Nimni, M. E., Han, B., and Cordoba, F. Are we getting enough sulfur in our diet? Nutr Metab (Lond) 2007;4:24. View abstract.

Parcell, S. Sulfur in human nutrition and applications in medicine. Altern Med Rev 2002;7(1):22-44. View abstract.

Pelle, M. T., Crawford, G. H., and James, W. D. Rosacea: II. Therapy. J Am Acad Dermatol 2004;51:499-512. View abstract.

Roos, T. C., Alam, M., Roos, S., Merk, H. F., and Bickers, D. R. Pharmacotherapy of ectoparasitic infections. Drugs 2001;61(8):1067-88. View abstract.

Sanfilippo, A. and English, J. C. An overview of medicated shampoos used in dandruff treatment. P and T 2006;31(Jul):396-400.

Schmiedel, V. and Klein, P. A complex homeopathic preparation for the symptomatic treatment of upper respiratory infections associated with the common cold: An observational study. Explore (NY) 2006;2(2):109-14. View abstract.

Sharquie KE, Al-Rawl JR, Noaimi AA, Al-Hassany HM. Treatment of scabies using 8% and 10% topical sulfur ointment in different regimens of application. J Drugs Dermatol 2012;11(3):357-64. View abstract.

Strong, M. and Johnstone, P. Interventions for treating scabies. Cochrane Database Syst Rev 2007;(3):CD000320. View abstract.

Trumbore, M. W., Goldstein, J. A., and Gurge, R. M. Treatment of papulopustular rosacea with sodium sulfacetamide 10%/sulfur 5% emollient foam. J Drugs Dermatol 2009;8(3):299-304. View abstract.

Verhagen AP, Bierma-Zeinstra SM, Boers M, et al. Balneotherapy for osteoarthritis. Cochrane Database Syst Rev 2007;(4):CD006864. View abstract.

Weiser, M., Gegenheimer, L. H., and Klein, P. A randomized equivalence trial comparing the efficacy and safety of Luffa comp.-Heel nasal spray with cromolyn sodium spray in the treatment of seasonal allergic rhinitis. Forsch Komplementarmed 1999;6(3):142-148. View abstract.

Wilkinson RD, Adam JE, Murray JJ, Craig GE. Benzoyl peroxide and sulfur: foundation for acne management. Can Med Assoc J 1966;95(1):28-9. View abstract.

Abdel-Raheem TA, Méabed EM, Nasef GA, Abdel Wahed WY, Rohaim RM. Efficacy, acceptability and cost effectiveness of four therapeutic agents for treatment of scabies. J Dermatolog Treat. 2016 Oct;27(5):473-9. View abstract.

Akhavan, A. and Bershad, S. Topical acne drugs: review of clinical properties, systemic exposure, and safety. Am J Clin Dermatol 2003;4(7):473-92. View abstract.

Alipour H, Goldust M. The efficacy of oral ivermectin vs. sulfur 10% ointment for the treatment of scabies. Ann Parasitol. 2015;61(2):79-84. View abstract.

Blom I, Hornmark AM. Topical treatment with sulfur 10 per cent for rosacea. Acta Derm Venereol 1984;64:358-9. View abstract.

Blum, J. E. and Coe, F. L. Metabolic acidosis after sulfur ingestion. N Engl J Med 1977;297(16):869-70. View abstract.

Contoli M, Gnesini G, Forini G, et al. Reducing agents decrease the oxidative burst and improve clinical outcomes in COPD patients: a randomised controlled trial on the effects of sulphurous thermal water inhalation. ScientificWorldJournal. 2013 Dec 23;2013:927835. View abstract.

Dostal Webster A, Staley C, Hamilton MJ, et al. Influence of short-term changes in dietary sulfur on the relative abundances of intestinal sulfate-reducing bacteria. Gut Microbes. 2019;10(4):447-457. View abstract.