Abstract
BACKGROUND: Sulfur has been historically used in dermatological therapy due to its broad-spectrum antimicrobial and immunomodulatory activities and demonstrates therapeutic efficacy in conditions such as scabies, tinea versicolor, psoriasis, and atopic dermatitis. However, systematic analyses of the therapeutic potential and mechanisms of different forms of sulfur (e.g., sublimed and precipitated sulfur) and bioactive derivatives (e.g., hydrogen sulfide), particularly their effects on cutaneous diseases, remain underrepresented in contemporary literature. AIM: Our study aimed to provide a comprehensive evaluation of pharmacological evidence and regulatory frameworks governing sulfur and its derivatives in dermatology, elucidating their mechanisms and therapeutic potential in various skin disorders. METHODS: A comprehensive PubMed search was conducted using medical terms including sulfur, sulfide, hydrogen sulfide, and dermatology. Relevant literature published between 1947 and 2025 was reviewed. RESULTS: This article not only summarizes the indications, potential therapeutic value, and mechanisms of sulfur and its derivatives in skin disorders, but also provides, for the first time, an overview of the usage restrictions and regulations established by food and drug administrations in most regions regarding the application of sulfur and its derivatives in dermatology. CONCLUSIONS: This review highlights critical gaps in understanding the therapeutic bioactivity of sulfur and its derivatives, underscoring the need for preclinical studies to explore their translational potential as adjuvant therapies in dermatology.