Version May 2024
Dermatologic conditions: Topical: Shampoo: Initial: Wet the scalp or skin and massage enough shampoo to form a lather, massage area for 3 to 5 minutes, rinse thoroughly then repeat application. Use at least twice weekly recommended.
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
Refer to adult dosing.
(For additional information see "Sulfur and salicylic acid: Pediatric drug information")
Dandruff, scalp seborrhea: Limited data available: Adolescents: Topical: Shampoo: Initial: Wet the scalp or skin and massage enough shampoo to form a lather, massage area for 3 to 5 minutes, rinse thoroughly then repeat application. Use at least twice weekly (Ref).
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.
Local: Topical preparations containing 2% to 5% sulfur generally are well tolerated, local irritation may occur, concentration >15% is very irritating to the skin, higher concentration (eg, 10% or higher) may cause systemic toxicity (eg, headache, vomiting, muscle cramps, dizziness, collapse)
Use on large area of the body (seborrheic dermatitis or psoriasis)
Concerns related to adverse effects:
• Hypersensitivity reactions: Rare but serious and potentially life-threatening allergic reactions or severe irritation have been reported with use of topical OTC benzoyl peroxide or salicylic acid containing products; it has not been determined if the reactions are due to the active ingredients (benzoyl peroxide or salicylic acid), the inactive ingredients, or a combination of both. Hypersensitivity reactions may occur within minutes to a day or longer after product use and differ from local skin irritation (redness, burning, dryness, itching, peeling or slight swelling) that may occur at the site of product application. Treatment should be discontinued if hives or itching develop; patients should seek emergency medical attention if reactions such as throat tightness, difficulty breathing, feeling faint, or swelling of the eyes, face, lips, or tongue develop. Before using a topical OTC acne product for the first time, consumers should apply a small amount to 1 or 2 small affected areas for 3 days to make sure hypersensitivity symptoms do not develop (FDA Drug Safety Communication, 2014).
Special populations:
• Pediatric: Infants are more sensitive to sulfur than adults; do not use in children <2 years.
Other warnings/precautions:
• Appropriate use: For external use only; avoid contact with eyes; discontinue use if skin irritation develops.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Cleanser, topical [scrub]:
Pernox: Sulfur 2% and salicylic acid 1.5% (113 g, 141 g)
Shampoo, topical:
Sebex: Sulfur 2% and salicylic acid 2% (118 mL)
Sebulex®: Sulfur 2% and salicylic acid 2% (200 g [DSC])
Yes
Bar (SAStid Soap External)
3-5% (per each): $4.32
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
For external use only; avoid contact with eyes. Shake well prior to use.
Topical: Avoid contact with the eyes; for external use only. Shake well prior to use.
Dermatological conditions: Symptom control of dandruff, seborrheic dermatitis, and psoriasis
KIDs List: Salicylates, when used in pediatric patients <18 years of age with suspicion of viral illness (influenza, chickenpox), are identified on the Key Potentially Inappropriate Drugs in Pediatrics (KIDs) list and should be used with caution due to risk of Reye syndrome (weak recommendation; very low quality of evidence) (PPA [Meyers 2020]).
Refer to salicylic acid monograph.
Refer to salicylic acid monograph.
Salicylic acid works synergistically with sulfur in its keratolytic action to break down keratin and promote skin peeling
Absorption: 1% of topically applied sulfur is absorbed
Metabolism: Sulfur is reduced to hydrogen sulfide
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