Rosacea Support Group

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


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.

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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