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.
In short
Sulfur is one of the oldest medicines in dermatology, and unlike most century-old remedies it still earns its shelf space. As a topical (usually 3–10%), it gently unclogs pores through keratolysis and suppresses the acne-relevant bacteria and fungus that thrive in blocked follicles, with a long track record in acne, rosacea, and seborrheic dermatitis. Its cosmetic drawback is the rotten-egg smell and potential dryness. Separately, MSM — an organic sulfur compound — is sold as a supplement for joint comfort and exercise recovery, where the evidence is promising but modest.
- Used for acne and rosacea for over a century
- Topical sulfur is keratolytic and mildly antimicrobial
- Signature smell and dryness are the main trade-offs
- MSM (organic sulfur) is a separate joint/recovery supplement
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.
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
strong evidenceClinical trials and decades of use support sulfur 3–10% for inflammatory and comedonal acne, alone or combined with sodium sulfacetamide or resorcinol.
Rosacea and seborrheic dermatitis
moderate evidenceSulfur and sulfacetamide combinations are established prescription and OTC treatments, particularly for the papulopustular type of rosacea and for scalp seborrhea.
MSM for joints and recovery
moderate evidenceSmall trials report reduced osteoarthritis pain and improved exercise-recovery markers with 1.5–3 g of MSM daily; effects are modest and need confirmation.
Side effects & safety
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
How it's used
In skincare
OTC products use 3–10% sulfur as washes, masks, or spot treatments. Start every other day, leave-on products for short contact times, and moisturize well. MSM supplements: 1.5–3 g daily in divided doses with meals.
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.
Popular products containing Sulfur
- Sulfur Ointment 10%De La Cruz · Skincare
- EradiKate Acne Treatment — 3% sulfurKate Somerville · Skincare
- MSM 1,000 mgNOW Foods · Supplement
Product names and brands are shown for reference and belong to their respective owners.
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.
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.
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.
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.
The bottom line
Sulfur is the venerable acne ingredient that modern dermatology still respects: effective, inexpensive, and gentler than its reputation, at the cost of dryness and smell. MSM is a separate, modestly supported joint supplement — do not confuse the two.
References
- Topical sulfur for acne — literature search. PubMed (National Library of Medicine). https://pubmed.ncbi.nlm.nih.gov/?term=topical+sulfur+acne
- Sodium sulfacetamide and sulfur — literature search. PubMed (National Library of Medicine). https://pubmed.ncbi.nlm.nih.gov/?term=sodium+sulfacetamide+sulfur+rosacea
- MSM and osteoarthritis — literature search. PubMed (National Library of Medicine). https://pubmed.ncbi.nlm.nih.gov/?term=methylsulfonylmethane+osteoarthritis
- Sulfur compound summary. PubChem (National Library of Medicine). https://pubchem.ncbi.nlm.nih.gov/compound/5362487