An Overview of Silvadene Cream

What you need to know about this medication

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If you experience a serious wound or burn on your body, your healthcare provider may prescribe Silvadene cream to treat infections and prevent new ones from developing. That’s because Silvadene, also known as silver sulfadiazine, is a topical, micronized form of silver that has antimicrobial properties.

How It Works

When it comes to wound care and healing, silver isn’t new to the scene; it’s used in other methods besides Silvadene. For example, it’s infused in wound dressings and other products due to its potent, broad-spectrum infection-fighting qualities.

Silvadene belongs to the class of medications called sulfa drugs, but its exact mechanism of action is unknown. Unlike other drugs in the sulfa category, Silvadene doesn’t exert its anti-infective properties by inhibiting folic acid synthesis.

Instead, it defends against infectious agents by damaging both the cell membrane and the cell wall. This makes it suitable for suppressing the growth of bacteria and also of yeasts like Candida albicans.

When a wound or burn is present, Silvadene helps to stop infections from spreading to the surrounding skin or invading the bloodstream, where it could cause a life-threatening condition known as sepsis when used right.

how to use silvadene cream
Verywell / Brianna Gilmartin

How to Use

Silvadene is a topical antimicrobial agent that’s applied directly to the skin over wounds, most commonly, ones that are the result of second-degree and third-degree burns. There may be other skin infections where your healthcare provider recommends the cream as well.

The National Institutes of Health’s (NIH) lists the following guidelines for applying Silvadene cream:

  • Wounds resulting from burns should be clean and debrided before applying the cream.
  • Silvadene should be applied under sterile conditions.
  • The burns should remain covered with the cream at all times to eliminate and reduce infection risks.
  • Generally, the cream is applied two times per day with a thickness that’s equal to 1/16th of an inch.
  • If day-to-day activities hasten the removal of the cream, you should reapply it as soon as possible.
  • The cream can be used with or without wound dressings.
  • The patient should continue to use the cream until the burn area has healed to an adequate level or until the wound is ready for skin grafting.

Silvadene cream is for topical use only, and you should not consume it orally. Do not share your medication with other people.

You should continue to apply the cream to your wounds and burns as prescribed, unless you develop unwanted side effects or your healthcare provider discontinues your treatment for another reason. Consult with your healthcare provider if you notice your skin condition isn't improving or it worsens.

Side Effects

There are some side effects associated with Silvadene usage, and they can range from mild to severe. If you have bothersome symptoms that persist, talk with your healthcare provider so that they can evaluate whether treatment with the drug is right for you.


Side effects may include the following:

  • Pain
  • Itchy skin
  • Burning of the skin at the treatment site
  • Skin discoloration


Although many people can use this medication without significant problems, serious side effects can occur in some individuals. If you develop any of the following symptoms, notify your healthcare provider as soon as possible:

  • Unexplained bruising or bleeding
  • Fatigue
  • Joint aches and pains
  • Fever
  • Sore throat
  • Weakness
  • Blood in your urine
  • Rash on the skin
  • Yellowing of the eyes or skin

Additionally, some people may develop leukopenia—a decrease in white blood cells (WBCs)—when using Silvadene cream for wounds and burns.

Research shows that the onset of leukopenia tends to happen two to four days after treatment begins, with a recovery of the white blood cells occurring in two to three days after the initial drop or once the drug is discontinued. Leukopenia caused by the use of Silvadene doesn’t increase the risk of infections or impact treatment outcomes.

Precautions and Contraindications

If you have an increased sensitivity to silver sulfadiazine or the ingredients that make up the product, this medication may not be the right choice for you.

If you’re allergic to antibiotics in the sulfa family (like Septra, Bactrim, or erythromycin), discuss treatment options with your healthcare provider or pharmacist, as Silvadene could potentially cause an allergic reaction.

Silvadene may be contraindicated in people with certain liver, kidney, or blood diseases. These conditions may affect how the drug is metabolized and eliminated from the body. In some instances, the drug can accumulate in the body, and you and your healthcare provider will need to weigh the benefits of staying on the treatment or discontinuing it.

Silvadene cream is not recommended for premature babies, newborn babies, or children 2 months of age or younger.

Be sure to let your healthcare provider know if you’re pregnant because Silvadene isn’t recommended for use in women who are at or approaching their pregnancy due date. There aren’t sufficient and well-controlled studies of the use of the cream during pregnancy.

Theoretically, drugs in the sulfonamide family may cause kernicterus—brain damage that results from excessive levels of bilirubin—in newborns, and therefore should only be used with extreme caution in people who are pregnant.

Likewise, notify your healthcare provider if you’re nursing. It is not known if Silvadene is excreted in breast milk, but because sulfonamides and its derivatives may contribute to kernicterus, it’s advised that you halt nursing or consider stopping the use of the drug.


Let your healthcare provider know if you’re taking additional medications, vitamins, herbs, or other dietary supplements. Certain products may impede Silvadene’s ability to work correctly or contribute to side effects.

A Word From Verywell

When a patient starts a medication, an unfamiliar drug regimen sometimes feels overwhelming. It’s crucial to use Silvadene cream as prescribed and to attend your follow-up appointments to keep the lines of communication open between you and your healthcare provider.

This way, the healthcare provider can assess whether or not the medication is helping you heal and evaluate any additional symptoms and side effects you may be experiencing from treatment.

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6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Dai T, Huang YY, Sharma SK, Hashmi JT, Kurup DB, Hamblin MR. Topical antimicrobials for burn wound infections. Recent Pat Antiinfect Drug Discov. 2010;5(2):124-51. doi:10.2174/157489110791233522

  3. National Institue of Health. Silvadene.

  4. Willis MS, Cairns BA, Purdy A, et al. Persistent lactic acidosis after chronic topical application of silver sulfadiazine in a pediatric burn patient: a review of the literature. Int J Burns Trauma. 2013;3(1):1-8.

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