Sulfur is a tasteless, yellow crystalline solid. In nature, it can be found as the pure element or in sulfide and sulfate minerals. Sulfur is a constituent of petroleum, sulfuric acid, and natural gas. Its commercial uses are primarily in fertilizers, but it is also widely used in gunpowder, matches, insecticides, and fungicides.
Elemental sulfur is present in all living tissues. After calcium and phosphorus, it is the third most abundant mineral element in the human body. It is essential for life and is found in two amino acids, cysteine and methionine. Sulfur is found in foods such as meat, garlic, onion, dates, and broccoli. Dietary sulfur supplementation may be indicated for vegan athletes, children, the elderly, or patients with HIV, as these populations are at an increased risk for sulfur deficiency.
Sulfur is commonly used in homeopathic medicine to treat acne, rosacea (facial inflammation), scabies, seborrheic dermatitis (skin inflammation), tinea versicolor (fungal skin infection), recurrent upper respiratory tract infection, and dandruff. Sulfur, used alone or in combination with other agents, has demonstrated efficacy in the treatment of many skin conditions.
Balneotherapy (mineral baths) is one of the oldest forms of therapy for patients with arthritis. There is evidence supporting the use of sulfur baths for the treatment of rheumatism and rheumatoid arthritis. While is not enough clinical evidence to recommend sulfur baths in replacement of standard modes of therapy for osteoarthritis, it may be safely added to standard regimens.
Sulfur preparations have been studied for use in allergic rhinitis, ankylosing spondylitis (a form of arthritis), arthritis (psoriatic), atherosclerosis (hardening of the arteries), the common cold, dandruff, deafness (rhinogenic), fibromyalgia (muscle and soft tissue pain), inflammation (rhinopharyngotubaric phlogoses), pain (rheumatic disease), rheumatoid arthritis, rosacea (facial inflammation), scabies, and skin disorders. High-quality human trials supporting the use of sulfur for conditions other than osteoarthritis are lacking at this time.
Balneotherapy, brimstone, Dead Sea, mineral water, shiliuhuang (Chinese), sulfur water, sulphur, sulpur, thion, Toto.
Combination products: BHI Cold (sulfur and pulsatilla); Luffa comp-Heel™ nasal spray (Luffa operculata, Galphimia glauca, histamine, sulfur); Engystol® (swallow-wort, sulfur); Zeel comp® (Rhus toxicodendron, sulphur, radix Arnica montana, Sanguinaria canadensis, and dulcamara).
Note: This monograph focuses on elemental sulfur used to treat human medical conditions. The following items were excluded from this monograph: sulfur mustard, iron-sulfur clusters, sulfur dioxide, sulfur accumulation in plants, sulfur-containing antioxidants, sulfur-containing amino acids, volatile sulfur compounds, sulfur nutrition in plants, sulfur-containing compounds in garlic, and organosulfur compounds.
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Some evidence suggests that shampoo containing sulfur may be useful for dandruff control. Additional studies are needed to confirm these results.
Some evidence suggests that sulfur bath therapy may have an effect on osteoarthritis when added to standard therapy. Additional studies are needed to confirm these results.
Limited evidence suggests that a homeopathic nasal spray containing
Limited evidence suggests that a combination of climatic therapy, mud packs, and sulfur baths at the Dead Sea improved the condition of patients suffering from long-standing ankylosing spondylitis (a form of arthritis). Additional studies are needed to examine the effects of sulfur therapy alone.
Limited evidence suggests that addition of mud packs and sulfur baths to ultraviolet exposure from the sun and Dead Sea baths may have additive effects on reducing inflammatory back pain. Additional studies are needed to examine the effects of sulfur therapy alone.
Limited evidence suggests that sulfur water from the Wiesław spring in Busko-Solec, Poland, improved fat and cholesterol levels and clotting profiles in patients with atherosclerosis (hardening of the arteries). Further studies need to be performed to determine if sulfur was indeed the active agent in this spring water.
Limited evidence suggests that Engystol® (a homeopathic combination formula of swallow-wort and sulfur) may be a useful component of an integrated symptomatic therapy for the common cold. Studies on sulfur therapy alone need to be performed.
Limited evidence suggests that sulfur inhalation therapy using endotympanic ventilation or the Politzer method may improve middle ear function in children. Further studies in this area are needed.
There is preliminary evidence suggesting that treatment of fibromyalgia (muscle and soft tissue pain) at the Dead Sea is effective and safe. Further research is needed in this area.
Inflammation (rhinopharyngotubaric phlogoses)
Limited evidence suggests that sulfurous, salty, bromic, iodic thermal waters may improve IgA and albumin concentrations in nasal secretions. It is unclear if sulfur is the active agent in this treatment.
Pain (rheumatic disease)
Limited evidence suggests that sulfur baths may lower pain sensitivity in patients with rheumatic diseases of the soft tissues. Further research in this area is warranted.
Limited evidence suggests that sulfur baths may have beneficial effects in rheumatoid arthritis (RA) patients similar to that of Dead Sea bathing and mud pack therapy. Better-designed studies are needed in this area.
Preliminary evidence suggests that a 10% sodium sulfacetamide/5% sulfur emollient (SSSE) may have potential to improve rosacea (facial inflammation). Further research in this area is warranted.
Preliminary evidence suggests that a mixture of 2-8% precipitated sulfur petrolatum may effectively treat scabies in children under five years of age, as well as in pregnant and lactating women and the elderly, in whom other drugs are not recommended. Better-designed studies are warranted.
Studies of lesser quality suggest that sulfur may be useful in treating skin disorders. Better-designed studies are warranted.