Silver Sulfadiazine (Topical)

Silver sulfadiazine is a treatment used to prevent infections developing in open wounds caused by serious burns.


Silver sulfadiazine is a cream used as a preventative measure against infection. The skin works as a barrier against bacteria and pathogens, protecting the body from infection and disease. As soon as the skin is broken, this barrier is compromised and bacteria which has been harmlessly present on the outside of the body can make its way into the bloodstream. The break in the skin is an open door for bacteria to enter the body and cause infection.

Silver sulfadiazine is a preventative cream which works either by killing the bacteria on the skin or by preventing it from being able to grow and multiply. If the bacteria is stopped from reproducing, the infection cannot develop or spread. It is a necessary precaution when the skin becomes compromised and the possibility of harmful bacteria entering the body is increased.

This medication must not be ingested. Instead, it is to be applied directly to the skin where it has been broken. It can be applied generously and should be used multiple times throughout the day. Patients can then either leave the wound open to heal or cover it with a dressing to protect it. If in doubt about which of these options to take, ask a healthcare professional for advice relating to your specific condition.

In the case of burns, in addition to preventing infection, silver sulfadiazine cream can also provide lubricant between the wound and a dressing which can stop it from getting stuck to the skin. This can make the wound more comfortable for the patient during the healing process.

Conditions Treated

  • Open wounds
  • Burns
  • Minor infection
  • Skin ulcer

Type of Medicine

  • Antibiotic cream

Side Effects

If a doctor recommends the use of silver sulfadiazine, it will be after they have weighed up the benefits of the treatment against the risk of any side effects. If they recommend or prescribe silver sulfadiazine to you, it is because they believe that the benefit of its antibacterial properties outweighs any potential side effects which it might possibly cause.

The active ingredients are designed to work on the surface of the skin, against any bacteria which may be present there. The treatment stops the bacteria from being able to grow and reproduce, it not designed to change the way in the body responds to infection. This lack of intervention with the body's functions means that side effects are less likely.

As this cream is applied directly to the skin, it is not easy for large quantities to enter the body. This means that the potential side effects are much more limited than with other medications.

Potential side effects may include:

  • Pain in the area to which it was applied
  • Itching of the skin
  • Pale/blue hue to the skin
  • Blue/gray gums

None of the side effects listed above is likely to cause any long-term harm or be symptoms of more serious conditions. However, if you do experience one or more of these side effects and they are persistent or begin to get worse, you should seek medical attention from your doctor or pharmacist.

Despite using silver sulfadiazine, it is still possible for patients with open wounds to develop serious infections.

Any of the following symptoms are signs of a serious infection and should prompt patients to seek immediate medical attention:

  • Fever
  • Chills
  • Severe sore throat
  • Bruising more easily than usual
  • Anemia
  • Unusual tiredness
  • Unexplained weakness
  • Fast breathing which is difficult to control
  • Mood changes
  • Vomiting
  • Nausea
  • Stomach cramps
  • Kidney problems
  • Blood in the urine

It is very rare for patients to experience a severe allergic reaction to silver sulfadiazine. In very occasional circumstances, allergic reactions may occur.

Patients who experience any one or more of the following symptoms of an allergic reaction after using silver sulfadiazine should seek urgent medical attention:

  • Swollen tongue
  • Inflamed face
  • Sore throat
  • Difficulty breathing
  • Dizziness and confusion


Silver sulfadiazine is a cream which comes with a regulated strength of the active ingredient. The cream should be applied to cover the affected area with a layer of the ointment which is 1-2 millimeters (a sixteenth of an inch) thick. A dressing can be fixed over the wound on top of the cream to prevent it from rubbing off, but this is optional.

In order for this preventative treatment to be effective, the wound should always remain covered with a layer of cream. If the cream is absorbed by the skin or rubs off during the course of the day, it should be reapplied immediately to maintain the thickness of the layer. If any water comes into contact with the wound, there is a strong possibility that the cream will be washed away. It should, therefore, be reapplied after all contact with water or other liquids.

Treatment with silver sulfadiazine should continue until the wound has healed and the skin's natural barrier against infection has been restored. There is no minimum waiting time between doses, as long as the silver sulfadiazine is not ingested, it can be used at regular intervals throughout the day without problems.


It is sometimes necessary for doctors to prescribe more than one type of medication to be taken at the same time. This may be in order to treat more than one medical condition experienced by the same patient simultaneously, or it might be that a combination of drugs is required to treat a single condition. When more than one type of medication is used at the same time, there will be a risk of interaction between these two pharmaceuticals. An interaction between two or more drugs can lead to an alteration in the way in which they affect the body.

Interactions between different types of medication can increase the chance of a patient experiencing side effects, or they can increase the severity of side effects which are already being experienced. An interaction could also potentially cause the drug to be less effective in its treatment of a condition or it could aggravate pre-existing medical conditions.

It is not possible to list all of the medications which interact with silver sulfadiazine, some of which may not even be known yet. Below is a list of drugs which are currently known to interact with silver sulfadiazine in a way which could potentially cause harm to the patient:

  • Amyl nitrite
  • Sodium nitrite
  • Sodium thiosulfate
  • Topical Lidocaine
  • Topical Prilocaine
  • Epinephrine

It is also possible for there to be interactions between pre-existing medical conditions as well as interactions between pharmaceuticals. Some types of medication can aggravate particular symptoms or conditions. In the case of silver sulfadiazine, interactions have been reported with the following conditions:

  • Hematologic Toxicity
  • Hypersensitivity reactions
  • Liver disease
  • Kidney disease
  • Urinary obstruction
  • Crystalluria
  • Porphyria

Patients should always keep a detailed, comprehensive and up-to-date list of all of the medications that they are currently taking, both those which have been prescribed by a doctor and those which are being taken outside of a prescription. This should be presented to the doctor whenever they make a prescription in order to avoid any instances of interactions wherever possible.

Patients should speak to their doctor or pharmacist if they have any concerns about interactions between their medications or medical conditions.


Silver sulfadiazine should not be used on young babies. It is not suitable for use on premature babies, or new-born infants. Silver sulfadiazine should never be used in the first two months of life, and it should only be used on infants after this point if recommended by a healthcare professional.

Silver sulfadiazine should never be ingested or applied in any way other than by surface application to the skin. It should not be applied inside the mouth or near to the eyes unless a doctor has explicitly recommended it.

This cream should only be used once the wound has been cleaned thoroughly. Patients with open wounds should seek medical attention in case further medical treatment is required. Any dead tissue and foreign bodies should be removed by medical staff before silver sulfadiazine is applied.

It is important to maintain sterile conditions whilst applying silver sulfadiazine to a wound. This means that anyone applying the cream should make sure that sterile gloves are used and that any instruments used to apply the treatment have also been sterilized.

Silver sulfadiazine is suitable to treat relatively minor burns to small areas of the body. Patients who have severe burns or burns which cover a large surface on the body should go to a hospital to receive specialist medical care.


As is the case for all forms of medication, silver sulfadiazine should be stored in the original container it was provided in. The container should be clearly labeled so that the cream cannot be confused with another person's medication. It should be kept well out of the reach of children and pets so that it cannot cause harm to either.

When opening the container for the first time, it is important to check that the factory seal has not been compromised. After each use, the lid should be reapplied and a tight seal should be kept at all times. Silver sulfadiazine should be stored somewhere which is away from direct sunlight, such as a cupboard or drawer. It should be kept somewhere which is not exposed to extreme changes in temperature. Silver sulfadiazine should be kept away from moisture and therefore should not be stored in the kitchen or bathroom.

As silver sulfadiazine is often applied regularly throughout the day, patients may find it convenient to take it with them when they are outside of the house. This is not a problem, but patients should take care to observe the same conditions when out and about. Even whilst being carried, silver sulfadiazine should be kept in its original container, be kept safe from children and animals and not be exposed to direct sunlight or extreme temperatures.


Silver sulfadiazine is an antibiotic cream which is applied to the surface of the skin after it has been broken by a partial thickness or full thickness burn. It works by killing the bacteria on the surface of the skin or preventing it from multiplying before it can enter the body through the wound created by the burn.

The skin is a natural barrier against infection as it prevents bacteria and other pathogens from being able to enter the body. Silver sulfadiazine is used when this natural barrier is compromised through a burn. In this situation, the bacteria on the skin can become harmful as it can cause infection to spread in the area broken by the burn.

This drug comes in the form of a cream, which means that it can be applied directly to the affected area without being diluted by the rest of the body. It can, therefore, get to work quickly and effectively. The downside of being applied externally is that the cream can be washed or rubbed off during the course of the day, so should be reapplied at regular intervals to make sure that the area is always covered. After silver sulfadiazine has been applied, the wound can also be covered with a dressing if extra protection is required. Patients should consult with a medical professional if they are unsure whether to apply a dressing or leave the wound open.

There are few side effects associated with the use of silver sulfadiazine, however, patients may experience some pain or itching after it has been applied. Doctors will take into consideration the potential side effects when prescribing the drug and will make sure that the benefits of its use outweigh any potential risk of side effects.


Last Reviewed:
January 31, 2018
Last Updated:
April 05, 2018