How does sulfur work in acne, rosacea and seborrheic dermatitis ?


Sulfur is keratolytic (unclog skin pores), antifungal, and antibacterial activity. Accumulation of dry keratin of the skin surface and in the openings of the skin pores is the primary cause for blackheads whiteheads and future acne breakouts. When applied to the skin, sulfur interacts with cysteine to form hydrogen sulfide that can dissolve excessive keratin that accumulates in skin oil glands and on the skin's surface. Sulfur was also found to inhibit the overgrowth of P. acnes as well as some Streptococci, and Staphylococcus aureus.

How does sulfur work in Rosacea?

Sulfur has an inhibitory effect on Demodex mites, which explains its effect on rosacea. One study compared a 10% sulfur cream to taking oral antibiotics (tetracycline). This study showed that sulfur cream induced a more significant reduction in the inflammatory components of rosacea than oral antibiotic treatment. The relapse rate within six months was similar for both treatments.

How does sulfur work in Seborrheic Dermatitis?

Trials evaluating the effectiveness of sulfur in seborrheic dermatitis and dandruff, and pityriasis Versicolor were very effective. Adverse events were minimal and included a mild burning sensation and dry skin.

References:

Lin AN, Reimer RJ, Carter DM. Sulfur revisited. J Am Acad Dermatol 1988; 18: 553-558.

Sulfur. In: AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharamacists, Inc; 2003: 3426-3428.

Ayres S. Jr. Demodex folliculorum as a pathogen. Cutis 1986; 37: 441.

Erbagci Z, Ozgoztasi O. The significance of Demodex folliculorum density in rosacea. Int J Dermatol 1998; 37: 421-425.

Burns DA. Follicle mites and their role in disease. Clin Exp Dermatol 1992; 17: 152-155.

Forton F, Seys B. Density of Demodex folliculorum in rosacea: a case-control study using standardized skin-surface biopsy. Br J Dermatol 1993; 128: 650-659.

Roihu T. Kariniemi AL. Demodex mites in acne rosacea. J Cutan Pathol 1998; 25: 550-552.

Robinson TWE. Demodex folliculorum and rosacea. A clinical and histological study. Arch Dermatol 1965; 92: 542-544.

Mills OH Jr. Kligman AM. Is sulfur helpful or harmful in acne vulgaris? Br J Dermatol 1972; 86: 620-627.

Blom I, Hornmark AM. Topical treatment with sulfur 10 percent for rosacea. Acta Derm Venereol 1984; 64: 358-359.

Bamford JTM. Treatment of tinea versicolor with sulfur-salicylic shampoo. J Am Acad Dermatol 1983; 8: 211-213.

Leyden JJ, et al. 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: 557-561.

Sulfur 3% for acne, fungal acne and rosacea

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