Sulfur

Also known as: Elemental sulfur, MSM, Methylsulfonylmethane, Sulphur

The century-old acne treatment that still works — keratolytic sulfur topicals, plus MSM's quieter joint-and-recovery claims.

Editorial review by the IngredientWiki Editorial Team
Updated 2026-09-26
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2 min read
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Amber skincare vial with serum, cream, and powder textures — Editorial illustration

Sulfur is an umbrella term for chemically different interventions. Topical sulfur has moderate support as an acne keratolytic, sodium-sulfacetamide/sulfur combinations have limited rosacea evidence, and oral MSM has limited osteoarthritis evidence; these uses cannot validate one another.^{1, 2, 4}

Used for acne and rosacea for over a century^{1, 2, 4}
Topical sulfur is keratolytic and mildly antimicrobial^{1, 2, 4}
Signature smell and dryness are the main trade-offs^{1, 2, 4}
MSM (organic sulfur) is a separate joint/recovery supplement^{1, 2, 4}

What is Sulfur?

Sulfur's dermatology career began in Victorian ointments and survives because the mechanism still makes sense: it loosens the bonds between dead skin cells so blocked pores can drain, while creating an environment hostile to Cutibacterium acnes and Malassezia yeast. Modern dermatologists still reach for sulfur washes and masks for patients who cannot tolerate benzoyl peroxide or retinoids, and the ingredient is enjoying a quiet revival in rosacea care. The supplement version, MSM, is a different molecule with a different audience — joints and recovery — and a smaller evidence base.⁵

Where it comes from

Natural sources

Elemental sulfur from volcanic deposits, refined for medical use
MSM (methylsulfonylmethane) occurs naturally in small amounts in milk, plants, and meat
Sulfur is the third most abundant mineral in the human body

How it's made

Topical products use precipitated or colloidal sulfur; MSM is manufactured by oxidation of DMSO.

What it does in products

Benefits

Acne

moderate evidence

Topical sulfur is an established keratolytic acne ingredient, but modern comparative evidence is limited and combination products make its independent effect harder to estimate.^{1, 2}

Cochrane evidence is less robust than the long history of use and regulatory monograph might suggest.

Rosacea and seborrheic dermatitis

limited evidence

A sodium-sulfacetamide-and-sulfur combination can improve rosacea or seborrheic symptoms, but the trial does not isolate sulfur's contribution.³

Combination-product evidence should not be converted into a claim for elemental sulfur alone.

MSM for joints and recovery

limited evidence

Small MSM trials report possible osteoarthritis symptom relief, but a systematic review found the evidence too limited for confident conclusions.^{4, 5}

MSM is an organosulfur supplement and is not interchangeable with topical sulfur used for acne.

Evidence scope and limitations

The review treats topical elemental sulfur, sodium-sulfacetamide/sulfur combinations, and oral MSM as different interventions.

The word sulfur covers chemically and clinically different materials that cannot share one evidence claim.
Many topical studies use combination products, while MSM joint studies are small and short.

Evidence last checked: 2026-09-26

Side effects & safety

Dryness, peeling, and irritation (common)Start with every-other-day use; pair with moisturizer.

Sulfur smell (common)Cosmetic, not medical — evening application or masked formulations help.

MSM stomach upset or headache (uncommon)Take MSM with food and start at lower doses.

Safety considerations

Topical sulfur is generally considered acceptable in pregnancy (it is a long-standing acne option); MSM supplements lack pregnancy data — avoid without medical advice.
Topical sulfur may increase sensitivity when combined with other drying actives (benzoyl peroxide, retinoids).
Not for: Allergy to sulfur or sulfonamides (sulfacetamide combinations)
Not for: Broken or sunburned skin

^{1, 2}

Amounts studied & product use

These figures describe research or common product use, not a personal dose or treatment recommendation.

In supplement studies and products

Oral MSM osteoarthritis trials use formulation-specific gram-level amounts for limited periods; those data do not apply to elemental sulfur or topical acne products.

In skincare studies and products

Topical acne products commonly use 3–10% sulfur, while prescription sulfacetamide/sulfur combinations are a separate intervention. Concentration, vehicle, contact time, and route prevent comparison with oral MSM.

^{1, 3, 4}

Regulatory status

Sulfur is a recognized OTC acne drug active at 3–10%. Sodium sulfacetamide combinations are prescription. MSM is a dietary supplement under DSHEA.
INCI name on cosmetic labels: Sulfur.

Why sulfur still has a place in modern acne care

Acne regimens have moved to benzoyl peroxide and retinoids, but sulfur retains a genuine niche: it treats both acne and the rosacea-flavored inflammation that often accompanies it, it does not bleach fabric like benzoyl peroxide, and it is gentle enough for skin that rejects other actives. Its mechanism — normalizing follicular shedding plus mild antimicrobial action — targets the two pillars of acne simultaneously. The price is tolerability and fragrance: dryness, and that signature smell. Combination products pairing sulfur with sodium sulfacetamide improve both the feel and the evidence base.

⁵

Frequently asked questions

How does sulfur help acne?

Sulfur loosens the dead-cell bonds that clog pores (keratolysis) while mildly suppressing C. acnes bacteria and reducing oil. It is slower than benzoyl peroxide but gentler, and it pairs well with other actives.^{1, 2, 4}

Is MSM the same as topical sulfur?

No. MSM is an organic sulfur-containing compound taken orally for joints and recovery; topical sulfur is elemental sulfur for skin conditions. They share the sulfur atom but not the uses or the evidence base.^{1, 2, 4}

Can I use sulfur products with retinol or acids?

Yes, but not all at once — sulfur is drying, and stacking it with retinoids or AHAs multiplies irritation. Use sulfur in the morning, other actives at night, or alternate days.^{1, 2, 4}

The bottom line

Always ask which sulfur compound, route, and condition is being discussed. Topical sulfur and oral MSM are not one evidence category.

References

Rulemaking history for OTC acne drug products. U.S. Food and Drug Administration (2025) · government guidance
Topical azelaic acid, salicylic acid, nicotinamide, sulphur, zinc and fruit acid for acne. Cochrane Database of Systematic Reviews (2020) · systematic review · PMID 32356369
Sodium sulfacetamide 10% and sulfur 5% cream versus metronidazole for rosacea. Cutis (2005) · randomized trial · PMID 16047874
Systematic review of dimethyl sulfoxide and methylsulfonylmethane in osteoarthritis. Osteoarthritis and Cartilage (2008) · systematic review · PMID 18417375
Sulfur compound summary. PubChem, National Library of Medicine (2026) · ingredient monograph · CID 5362487

Revision history

2026-09-26Replaced search-result citations with exact sources, mapped claims to evidence, and reassessed evidence strength.