June 17, 2024

Sulfur: A Timeless Treatment for Acne, Eczema, and Psoriasis

All living cells count sulfur as an essential component. Produced by the last breaths of dying stars, sulfur is the 10th most abundant element in the universe. This natural element is typically found in minerals and rocks, but it's also found in hair, skin, amino acids, and vitamins in the human body. It has a well-established history of use in medicine, and it is even used in wine-making!

In spite of all of this, sulfur’s reputation stinks–literally. It is in the gasses emitted by volcanoes, and its odor is said to permeate the depths of hell (“brimstone,” of “fire-and-brimstone” fame, is from an Old English word for sulfur).

Sulfur’s trademark “rotten egg” odor is off-putting, for sure. Did you know, though, that sulfur has an abundance of skin-healing properties?

That’s right. Sulfur has a long history of use in treating rosacea, psoriasis and eczema that continues today. These days, you don’t even have to suffer its “hellish” odor to get its benefits!

An Ancient Skincare Go-To

One of the oldest known medical texts is an Egyptian papyrus scroll dating from the reign of Pharaoh Amenhotep I (around 1536 BCE). Called the Ebers Papyrus, it measures over 2,000 meters in length and contains 108 columns of text.

The Ebers Papyrus contains detailed remedies for many common complaints, including various treatments meant to “still” the itch of symptoms we’d now recognize as eczema. One of these remedies is a paste made of ground sulfur. Other remedies involve pastes of vegetables such as leeks and garlic, which also contain sulfur.

The ancient Romans would use sulfur as an acne treatment. In 19th Century Denmark, sulfur was used to treat scabies. An 1855 issue of Lancet documents the successful treatment of rosacea with sulfur. In the 1950s, a preparation containing 10% sulfur was used to treat rashes associated with Demodex mites.

While it is not used as widely today, sulfur still has a place in dermatological treatments.Even now, it is used to treat rosacea. As it turns out, it’s also an exceptional tool for treating eczema.

Clearing Up A Misconception

Sulfur’s reputation stinks–justifiably. When exposed to the air, sulfur compounds have a strong odor similar to that of rotten eggs.

Today, however, topical treatments containing sulfur are made with ingredients that neutralize or mask the unpleasant smell. This allows eczema patients to make use of a highly-effective treatment without fear of the smell.

It’s Elemental

We know that sulfur is an effective treatment of eczema and other inflammatory skin conditions. We’ve also established that medicines containing sulfur needn’t have strong or unpleasant smells. But did you know that sulfur boasts a wealth of skin-healing properties?

In fact, sulfur is essential to life and to biological functions. It is one of the elements that allowed life to develop on Earth. It is necessary for protein synthesis, metabolism, and healing. Taurine, a sulfur-containing amino acid, is found in muscle tissue and is key to regeneration of muscle cells after injury or exertion.

In short, your body needs sulfur. It’s a necessary component in the generation and repair of DNA, and it protects your cells from damage. It contributes to the health of your skin, tendons, and ligaments.

Sulfur: A Skin-Healing Powerhouse

Eczema arises from a combination of environmental irritants, skin barrier defects, and immune system dysfunction. Many people with eczema have mutations on genes that regulate skin barrier function as well as genes regulating the immune system.

Understanding the skin barrier helps us have a clearer idea of how eczema develops. It also helps demonstrate sulfur’s role as a skin-healing powerhouse.

A Skin Cell’s Journey

The skin has three layers. From the bottom up, they are the hypodermis (or subcutaneous layer), the dermis, and epidermis.

The epidermis is the layer that we can see and touch; it can be further divided into the stratum basale (the deepest layer of the epidermis), the stratum spinosum, the stratum granulosum, and the stratum corneum, or the most superficial layer (the skin on the palms of the hands and the soles of the feet have another layer called the stratum lucidum).

Skin cells called keratinocytes are produced in the stratum basale. They migrate upwards through each layer of the epidermis as they mature, going through significant changes in each layer–a process known as differentiation.

The Skin Barrier

By the time keratinocytes reach the stratum corneum, they have shed their nuclei. Their plasma membrane is replaced by a “cornified envelope” consisting of bundles of keratin (a tough, stringy protein) surrounded by a lipid envelope. Once-living keratinocytes now become corneocytes–flattened, somewhat oblong cells that interlock in a brick-and-mortar pattern.

Lamellar bodies, organelles that once inhabited the keratinocytes’ plasma membrane, are ejected at the skin’s surface and begin to break down into lipids. Filaggrin, a protein produced by the keratinocytes, combines with the lipids secreted by the lamellar bodies to form the “mortar” between the corneocytes.

The interlocking corneocytes, the lipids produced by the lamellar bodies, and the filaggrin all combine to make your skin barrier. The skin barrier acts as a mechanical barrier against foreign molecules and external moisture, protecting the living cells beneath the stratum corneum from irritation and damage.

At the same time, it prevents needed moisture from evaporating from healthy cells–a process called transepidermal water loss (TEWL). The skin barrier also acts as a chemical barrier to harmful pathogens.

Eczema is largely characterized by dysfunction of the skin barrier. Flaws on a gene called FLG cause some people to produce insufficient amounts of filaggrin. Others have mutations on genes responsible for the lipid profile of the lamellar bodies–and subsequently the lipid content of the skin barrier. These mutations lead to weaknesses and breaches in the skin barrier that allow external antigens to irritate the skin.

The Inflammation Component

In addition to skin barrier dysfunction, people with eczema suffer from an abnormally reactive immune response to certain triggers. Typically, the immune system ensures that foreign antigens (such as those that breach damaged skin barriers) are either expelled or isolated and the damaged tissue healed. Once this is done, inflammation stops.

In people with eczema, the immune system responds disproportionately to harmless stimuli. The inflammatory response does not stop once the trigger is removed, so the skin stays red, itchy, and swollen for much longer than would normally be necessary.

The Microbial Component

The skin is home to many thousands of microbes. This includes over 1,000 species of bacteria, as well as yeasts and other microscopic organisms. These microbes make up your skin’s microbiome.

These microbes normally cause us no harm–in fact, some of them keep our pores free of debris, and others balance the lipids in our skin. Sometimes, though, an overgrowth of certain microbes can intersect with poor barrier function and hyperimmunity to trigger inflammation. People with eczema are often found to have an overgrowth of a bacterium called Staphylococcus Aureus or “staph,” which triggers inflammation.

Enter Sulfur

By now, you may be wondering what all of this has to do with sulfur. Well, sulfur is a powerful tool in combating eczema precisely because it battles the condition on each of these fronts. These are just a few of the ways sulfur helps restore the skin’s health:

It balances the microbiome. Sulfur is a powerful prebiotic, meaning that it encourages beneficial bacteria to grow and multiply. As populations of these bacteria increase, populations of staph, strep, and other disease-causing bacteria are limited.
It’s a keratolytic. Corneocytes are shed as new keratinocytes make their way to the stratum corneum. During flares of eczema or psoriasis, keratinocyte production speeds up so that damaged skin cells can be replaced. Unfortunately, this means that existing corneocytes do not have time to shed before new ones rise to the stratum corneum to replace them. As a result, the skin thickens and flakes in areas.

Sulfur combats flaking and thickening by breaking down keratin, as well as the proteins and lipids between corneocytes, and allowing them to slough off. This keratolytic effect makes sulfur an excellent tool for treating seborrheic dermatitis and psoriasis.
It’s an antifungal. Bacteria are not the only kinds of microbes found in your skin’s microbiome. Yeasts and other fungi dwell there, too. When some fungal species become too abundant, they can cause inflammation–as is the case with species of yeasts in the Malassezia family, which are associated with seborrheic dermatitis. Sulfur reduces the numbers of these fungi in the microbiome.
It’s an anti-inflammatory. Immune system dysregulation can cause inflammation, which leads to redness, itching, burning, skin thickening, swelling, and rash. Sulfur inhibits the production of pro-inflammatory molecules and alleviates these symptoms.

Sulfur vs. Sulfa

Many people are afraid to use treatments containing sulfur because they have allergies to a class of antibiotics known as “sulfa drugs.” The fear is understandable; reactions to sulfa drugs can be severe and life-threatening.

Sulfa and sulfur sound similar, but they are not the same things. Sulfa antibiotics do contain sulfur–as a part of synthetic compounds known as sulfanilamides. These compounds are not found in nature, and having an allergy to them does not mean you’re allergic to sulfur.

A sulfa drug known as sodium sulfacetamide is sometimes prescribed for treatment of skin complaints, but this is available by prescription only. Your doctor will not prescribe it if they know you have a sulfa allergy; it is not used in SmartLotionⓇ or in over-the-counter eczema treatments.

Conclusion

Sulfur is a great treatment option for those with eczema and psoriasis; it’s also beneficial to those with acne and rosacea. It balances the skin’s microbiome, it modulates inflammation, and it reduces thickening.

Patients should not be put off by sulfur’s “smelly” reputation. Today’s topical treatments utilize odor-neutralizing ingredients that allow you to enjoy its skin-healing benefits without offensive smells.

Sulfur shouldn’t be confused with sulfa drugs. Sulfa drugs use synthetic compounds that cannot be found in nature and which are not available without a prescription. Having an allergy to sulfa doesn’t mean someone is allergic to sulfur.

Would you like to manage your eczema better? HarlanMD’s groundbreaking SmartLotionⓇ makes use of sulfur’s prebiotic and anti-inflammatory properties to relieve and prevent eczema and psoriasis flares. Check out HarlanMD’s Knowledgebase to learn more.