Sulfur (pharmacy)

Short description: Molecule used for pharmaceutical treatment of skin conditions

Sulfur (pharmacy)

Clinical data
AHFS/Drugs.com| Multum Consumer Information
Routes of
administration| Topical, rarely oral
ATC code|

* D10AB02 (WHO)

Legal status
Legal status|

* US: OTC
* In general: Over-the-counter (OTC)

Identifiers

IUPAC name

* Octathiocane

CAS Number|

* 10544-50-0 Y
7704-34-9 (elemental sulfur)

PubChem CID|

* 66348

ChemSpider|

* 59726

UNII|

* 70FD1KFU70

ChEBI|

* CHEBI:29385

Chemical and physical data
Formula| S8
Molar mass| 256.48 g·mol−1
3D model (JSmol)|

* Interactive image

SMILES

* S1SSSSSSS1

InChI

* InChI=1S/S8/c1-2-4-6-8-7-5-3-1

* Key:JLQNHALFVCURHW-UHFFFAOYSA-N

Sulfur is used in pharmaceutical skin preparations for the treatment of acne and other conditions. It acts as a keratolytic agent and also kills bacteria, fungi, scabies mites and other parasites.

Chemically, it is the naturally occurring octasulfur (S8).

## Contents

* 1 Forms and uses
* 1.1 Topical uses
* 2 Adverse effects
* 3 Overdose
* 4 Mechanism of action
* 5 See also
* 6 References

## Forms and uses

Pulverised sulfur

* Flower of sulfur or sublimed sulfur (Latin: sulfur sublimatum) is the naturally occurring, unpurified form.[1] It comes in yellow flakes and has been used in traditional and alternative medicine for humans and animals, as well as in alchemy and sulfuring fruit before drying.
* Purified sulfur (sulfur depuratum) is prepared by washing sublimed sulfur with ammonia. It is a fine yellow powder. It was formerly used as a laxative, but this application is rare today.[1]
* Precipitated sulfur (sulfur praecipitatum) is prepared by boiling sulfur and calcium oxide in water and then precipitating with hydrochloric acid. It, too, is a fine yellow powder.[1]
* Colloidal sulfur (sulfur colloidale) is an extremely fine sulfur powder prepared by repeated precipitation, first from polysulfides with protein and then from a slightly alkaline solution with ethanol or acetone. It has a greyish-white colour. Colloidal solutions in water are milky, and bluish when viewed against the light due to the Tyndall effect.[1]

### Topical uses

Precipitated sulfur and colloidal sulfur are used, in form of lotions, creams, powders, soaps, and bath additives, for the treatment of acne vulgaris, acne rosacea, and seborrhoeic dermatitis.[1][2][3] Other topical uses included the treatment of superficial mycoses (infections with fungi) and scabies, but this is largely obsolete now.

## Adverse effects

Common adverse effects include irritation of the skin at the application site, such as dryness, stinging, itching and peeling.[4] Generalised allergic reactions are rare; they include hives as well as swelling of lips, tongue, and throat, potentially closing up the respiratory tract.[4]

## Overdose

Ingesting more than a few grams can lead to poisoning by hydrogen sulfide (H2S), which the gut flora produces from sulfur. H2S is also generated on the skin, but topical formulations do not induce toxic concentrations except when large quantities are used for small children.[1]

## Mechanism of action

Sulfur is converted to hydrogen sulfide through reduction, partly by bacteria. H2S kills bacteria (possibly including Propionibacterium acnes which plays a role in acne[2]), fungi, and parasites such as scabies mites. In the gut, H2S increases motility, acting as a laxative.[1] Sulfur's keratolytic action is also mediated by H2S; in this case, the hydrogen sulfide is produced by direct interaction with the target keratinocytes themselves.[5]

## See also

* Sulfur (general information about this chemical element)

## References

1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 (in German) Hagers Handbuch der Pharmazeutischen Praxis. 6B (4th ed.). Berlin–Heidelberg–New York: Springer. 1978. pp. 672–9. ISBN 3-540-07738-3.
2. ↑ 2.0 2.1 FDA Professional Drug Information: Perrigo Sodium Sulfacetamide and Sulfur.
3. ↑ (in German) Arzneibuch-Kommentar. Wissenschaftliche Erläuterungen zum Europäischen Arzneibuch und zum Deutschen Arzneibuch (23rd ed.). Stuttgart: Wissenschaftliche Verlagsgesellschaft. 2004. Monographie Schwefel zum äußerlichen Gebrauch [Monograph Sulfur for external use]. ISBN 978-3-8047-2575-1.
4. ↑ 4.0 4.1 Multum Consumer Information: Sulfur topical.
5. ↑ "Sulfur revisited". Journal of the American Academy of Dermatology 18 (3): 553–8. March 1988. doi:10.1016/S0190-9622(88)70079-1. PMID 2450900.

* v
* t
* e

Acne-treating agents (D10)

Antibacterial|

* Azelaic acid
* Benzoyl peroxide#
* 8-Hydroxyquinoline
* Blue light therapy
* Tea tree oil

Keratolytic|

* Glycolic acid
* Salicylic acid#
* Sulfur
* Benzoyl peroxide#

Anti-inflammatory|

* Nicotinamide
* Ibuprofen#
* Aspirin#
* Red light therapy

Antibiotics|

* Clindamycin
* Dapsone
* Erythromycin
* Sulfacetamide
* Tetracyclines (Lymecycline
* Minocycline
* Doxycycline)

Hormonal|

* Antiandrogens
* Bicalutamide
* Cyproterone acetate
* Drospirenone
* Flutamide
* Spironolactone)
* Estrogens
* Estradiol
* Ethinylestradiol

Retinoids|

* Adapalene
* Isotretinoin
* Motretinide
* Tazarotene
* Tretinoin
* Trifarotene

Other|

* Benzamycin
* Epristeride
* Mesulfen
* Pelretin
* Stridex
* Tioxolone

Combinations|

* Adapalene/benzoyl peroxide
* Benzoyl peroxide/clindamycin
* Clindamycin/tretinoin
* Erythromycin/isotretinoin
* Sulfacetamide/sulfur

* #WHO-EM
* ‡Withdrawn from market
* Clinical trials:
* †Phase III
* §Never to phase III

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