Sulphur Still a Classic Treatment for Rosacea (2012 AAD San Diego)

Written by on March 28, 2012 in natural treatments, research, topicals with 9 Comments

The following Poster Session from the 2012 AAD meeting in San Diego aimed to raise the profile of the use of sulphur as a treatment in rosacea. Did you know that Sulfur was first proposed as a treatment for rosacea in 1855 !

I wasn’t aware that sulphur was able to kill demodex mites, this is news to me. I do have to wonder, though, why such a common element, available as a demodex treatment since 1955, it was not tested when researchers published a list of How to Kill Demodex Mites. I would want to see further proof of this first.

sulfur-rosacea

Those interested in trying an easy to obtain topical sulphur treatment, have a look at Prosacea or even Rosacea-LTD. Prescription preparations worth looking at include: Clarifoam EF, Klaron and Rosanil. Plexion has been discontinued in early 2011.

An Underrated Treatment ?

I am impressed with how well Prosacea is liked. This cheap and easily available treatment seems to be well received, especially for the usual papules and pustules of rosacea. I was also a fan or the Sulfur based Rosacea-LTD as well.

This poster session is a good reminder to re-examine topical sulfur.

Poster Session 5503

Sulphur for rosacea: Are we reinventing the wheel?

American Academy of Dermatology 70th Annual Meeting, March 16–20, 2012, San Diego, California. Poster Abstracts, Supplement to JAAD, April 2012, Volume 66, Number 4.

Catherine McKay, MBBS, Skin and Cancer Foundation, Darlinghurst, Australia; Keiron Leslie, MD, Department of Dermatology, San Francisco, CA, United States; Leone Snowden, NSW Medicines Information Centre, Darlinghurst, Australia; Margot Whitfeld, MBBS, Department of Dermatology, Darlinghurst, CA, United States

Rosacea is a common, chronic inflammatory facial condition that affects approximately 13 million individuals in the United States alone. It has been a human affliction since time immemorial. Despite this, the pathogenesis remains largely unclear.

Cutaneous Demodex mites, altered vascular reactivity, alcohol ingestion, Helicobacter pylori, and Staphylococcus epidermidis have all been implicated.

The therapeutic armamentarium to treat rosacea is extensive, and some rosacea remedies date back to before the Middle Ages. Sulphur, as a treatment for cutaneous disease, was described in the Ebers Papyrus, an ancient Egyptian medical scroll, dated circa 1550 BC.

James Morris in Lancet describes the first effective sulphur containing formulation to treat rosacea in 1855. This was followed by a modification of the Danish formula, originally used to treat scabies, by Ayers and Ayers in 1932. This formulation contained 11% sublimed sulphur.

In the 1950s, 10% sulphur with 5% Peruvian balsam was used for Demodex-associated eruptions. Modern sulphur containing formulations for rosacea incorporate 10% sodium sulfacetamide combined with 5% sulphur. The new foam formulations are easier to apply and exude fewer odors.

Antiseptic, antibacterial, and antifungal properties have been attributed to sulphur. These antibacterial properties have been demonstrated against Propionibacterium acnes, some Streptococci, and Staphylococcus aureus.

Sulphur has also been shown to kill Demodex mites, which have been implicated as a possible causative factor in rosacea.

In recent times, sulphur has declined in popularity, largely because of its odor.

With the emergence of antibacterial resistance to other agents, as well as sensitivity to other topical antibiotics, topical sulphur has once again become a useful therapeutic option.

We have translated these older formulations into modern recipes that can be compounded today.

The aim of this poster is to remind the modern dermatologist of a safe, affordable and currently underused ‘‘remedy’’ for the treatment of an age old dermatologic condition.

Commercial support: None identified.

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Read more about: natural treatments, research, topicals

About the Author

About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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9 Reader Comments

  1. Doug says:

    So do you think we need a formula that contains 10% sulphur instead of the 5% we get today? Maybe at 10% sulphur is where it kills demodex and not 5%? And is there any products that contain 10% sulphur?

    • kira says:

      Most treatments with above 10 percent in them are formulated for animals. I am using one such cream (intended for pets for cuts and grazes) mixed with tea tree oil and the results in just 4 days have astounded me.

  2. Bradee says:

    I use Prosacea at night and Finacea in the morning. Both keep my rosacea (mild) under control. I’d like to know also about any products that contain 10% sulphur. Finacea is said to be good for the skin in general,which is why I continue to use it.

  3. DaveM81 says:

    David, it was the reference to ‘Sulphur containing’ Danish ointment in the ‘How to kill demodex mites’ article that originally led me to sulphur.

    I’ve been treating with various sulphur products for over a year; all have helped, but none have been completely effective. I have recently switched to Prosacea – it’s still early days.

    Doug, I believe that Prosacea is 10% sulphur? They annoyingly insist on using the homeopathic reference of ‘sulphur 1x’ in the ingredient list. This would seem to mean 10%, however. I hope so, because the relatively high strength is what led me to this product.

  4. David Pascoe says:

    Just as a comment, I think the correct quote for Danish Oil is “compound polysulfide ointment”, which most likely doesn’t mean sulphur at all.

    I haven’t seen any proof that sulphur kills demodex, but certainly it has other properties that rosacea sufferers have liked in the past.

    dp.

  5. Irene McDonald says:

    “Organic sulphur” or MSM, chemical title methyl sulfonyl methane, is great for Rosacea and much more gentle than sulphur.

    MSM is an anti inflammatory and red faces mean inflammation is present. Take around 5grams of MSM daily and use creams and gels containing large amounts of MSM for treatment from the inside out and outside in.

    I’ve had complete relief between using MSM skincare and also 6 treatments of IPLL to remove the existing spider veins. A year later and my face is still clear. If the doctor has good medical insurance you’ll get a big rebate from Medicare for the IPLL – Intense Pulse Laser Light

    Another important part for controlling pustles and clogged pores has been switching to a lactic acid/glycolic acid gel cleanser. Rosacea skins tend to be thicker and have more layers of dead skin cells which need to be removed. You can get all these items from Australian company [removed].

  6. deb says:

    You can buy 10% sulfur at any walgreens, walmart, osco (you might have to try a few because I’ve found they’re often out) in the hispanic section made by de la cruz. Its in a small yellow jar and says 10% sulfer on the front label. There’s another larger jar that is 5% and includes a menthol – don’t use that. I’ve used it a number of times and it seems to do a good job. http://www.walgreens.com/store/c/de-la-cruz-sulfur-ointment-10-acne-medication-ointment/ID=prod2872361-product.

    Mayo Clinic has it on its website to get rid of scabies – use it 3 24/days – washing one time each day and reapplying head to toe for the full 3 days and then about 7 days later do it again. Sometimes people think they have dermodex but they really have scabies with atypical symptoms. (especially with the fluttery feelings around your face at night) My sister once had it.

    I’ve found one other trick though that seems to soothe the rosacea irritation very quickly.

    I go to Trader Joes in their section for cleaning etc. They have a hair conditioner there called Tea Tree Tingle. Apply a little of that to your rosecea before going to bed and it is much better in the morning. I don’t know if it works for all but it definitely works for me. There’s also a peppermint castile hemp soap in a bottle that includes coconut oil and several others and I’m starting to use it to wash my face and body and rinse off in the shower. I’m starting to experiment with their cleaning products because they are very natural and gentle.

    I took antibiotics for years and I have stopped because I began getting terrible infections every time I would cut myself or when I got sick – It was impacting my health. So I would go in to get a shot from the Dermatologist every time I would get a large painful welt usually on my nose. I don’t have it everywhere but I have a painful condition. So – for this to bring down and almost completely restore my welts – it surely will help others. I’m going to try and use this once a week and see if it helps to avoid altogether. I hope it brings some relief to some others out there. The lavender products also seem to be gentle and not provoke an outbreak.

    For some reason, wearing heavy sunglasses or glasses brings on a big painful rosacea bump. Wear light weight glasses.

  7. Tom says:

    Hi David,

    sulfur is quite interesting from my experience. After reading your article, I tried “Prosacea” and the results are really very good after 4 days! I´ve tried dozens of topicals and somes antibiotices, nothing worked like this. The only thing I had to consider is to give enough skin care (Physiogel Cream) some minutes after applying, because the sulfur is drying the skin. Now I´ve to wait for long term results. The idea to try Sulfur came from you / your article, so thank you very much for this from germany!!! :-)
    Nice greetings,
    Tom

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