Silvadene Cream: How It Works and Uses

A prescription cream for treating burns and wounds

Silvadene cream (silver sulfadiazine) is a prescription treatment that is applied to skin wounds and serious burns. It is a micronized form of silver with antimicrobial properties that can help prevent infection.

Silvadene may be used alone or in conjunction with other burn or wound treatments. Healthcare providers can also prescribe it for other skin infections.

This article explains how Silvadene works and how to use it. It also goes over the potential side effects of Silvadene and what you should know before you use it for a burn or skin injury.

How Silvadene Works

Silvadene is part of a group of medications called sulfa drugs. Researchers do not really know how it works because it does not prevent infection the way most sulfa drugs do. Instead, it defends against infection by damaging the germ's cell membrane and wall.

In people with very bad wounds or burns, Silvadene can help stop infections from spreading to the surrounding skin or getting into the bloodstream where it could cause a life-threatening condition called sepsis.

Silvadene is typically used for third-degree burns (those that destroy both top layers of skin and may even penetrate the innermost layer), but it may also be used for second-degree burns (those that involve the outer layer and part of the lower layer of skin).

Silvadene also helps prevent the growth of bacteria and yeasts like Candida albicans.

Silver has been used in wound care for a long time—centuries, in fact. Today, silver-infused wound dressings and other products are popular because they have strong and broad infection-fighting qualities.

How to Use Silvadene

how to use silvadene cream
Verywell / Brianna Gilmartin

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

  1. First, ensure that the area around you and your tools are clean.
  2. Clean and debride the burn before applying the cream (removing dead tissue and any foreign material).
  3. Plan and stick to an application schedule. The cream is usually applied twice a day with a thickness that’s equal to 1/16th of an inch.
  4. Cover the wound with gauze or a bandage—especially if you want to safeguard the burn from knocks and bumps. Covering it will also reduce infection risks.
  5. Reapply the cream as soon as possible if your daily activities (like washing the dishes) cause the cream to wear off.

Keep using the cream until the burn area has healed sufficiently. Contact your healthcare provider if you notice that the condition of your skin has not gotten better with the treatment or if it's getting worse.

Silvadene Side Effects

Silvadene can have side effects. Some are only mild while others can be serious and may mean that you cannot use the cream.

Common Side Effects

Common side effects of Silvadene include:

  • Burning sensations
  • Itchy skin
  • Pain
  • Skin discoloration

Serious Side Effects

Serious side effects of Silvadene are uncommon. However, if you have these side effects, tell your provider right away:

  • Blood in your urine
  • Fatigue
  • Fever
  • Joint aches and pains
  • A new rash on the skin
  • Sore throat
  • Unexplained bruising or bleeding
  • Weakness
  • Yellowing of the eyes or skin (jaundice)

Does Silvadene Lower Your White Blood Cell Count?

There is a small risk of having a lower white blood cell count (leukopenia) when you use Silvadene.

Research has shown that the low white blood cell count usually happens two to four days after a person starts treatment with Silvadene. The white blood cell usually goes back to normal within two or three days after the initial drop or when the treatment is stopped.

Having low white blood cells caused by using Silvadene does not increase your risk of getting infections or affect the outcome of the treatment.

Silvadene Precautions and Contraindications

If you’re allergic to antibiotics in the sulfa family (like Septra, Bactrim, or erythromycin), you may not be able to take Silvedene. You also should not use Silvadene if you're sensitive to silver sulfadiazine or any other ingredients in the product.

People with liver disease, kidney disease, or blood disorders may not be able to use Silvadene. These conditions can affect how the body breaks down and gets rid of the drug. In some cases, the drug may build up in the body and reach unsafe levels.

You and your healthcare provider will need to weigh the risks and benefits of using Silvadene.

Is Silvadene Safe for Babies?

Silvadene cream is not recommended for premature babies, newborns, or children under the age of 2 months old.

Use in Pregnancy and Breastfeeding

There have not been very many reliable studies about using Silvadene cream during pregnancy, but you should tell your provider if you're pregnant. They may not want you to use it, especially if you are close to your due date.

Drugs in the sulfonamide family have been linked to brain damage in newborns caused by excessive levels of bilirubin (a condition called kernicterus).

You should also tell your provider if you're breastfeeding. It's not known if Silvadene is excreted in breast milk, but because sulfonamides and similar drugs can contribute to kernicterus, you may need to stop nursing while you are using the medication.

Summary

Silvadene cream, or silver sulfadiazine, can be used to prevent infection in serious wounds or burns.

While the side effects are usually mild, people with certain health conditions may not break down the drug well enough for it to be safe to use. Your provider will go over the risks and benefits of using Silvadene before prescribing it for you.

People who are pregnant or breastfeeding may not be able to use Silvadene. There is not a lot of research on whether it's safe to use, but similar medications have been linked to brain damage in newborns.

Frequently Asked Questions

  • Can I buy Silvadene cream over the counter?

    Silvadene is only available by prescription. You can get generic silver sulfadiazine products at the pharmacy, but over-the-counter products are not as strong as Silvadene. They are only good for minor wounds or burns.

  • Can you put Silvadene on an open wound?

    Silvadene is applied directly to a wound or burn area on your skin. Just make sure that you've cleaned the area before you apply the cream.

  • What is better than silver sulfadiazine for burns?

    Some research has suggested that aloe might be better for second-degree burns than silver sulfadiazine.

10 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.
  1. 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.

  2. Pfizer. Silvadene cream.

  3. Spear M. Silver: an age-old treatment modality in modern timesPlast Surg Nurs. 2010;30(2):90-93. doi:10.1097/PSN.0b013e3181deea2e

  4. National Institutes of Health. Silvadene.

  5. 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.

  6. Munteanu A, Florescu IP, Nitescu C. A modern method of treatment: The role of silver dressings in promoting healing and preventing pathological scarring in patients with burn wounds. J Med Life. 2016;9(3):306-315.

  7. Memorial Sloan Kettering Cancer Center. Silver Sulfadiazine.

  8. Food and Drug Administration. Silvadene cream 1%.

  9. The University of Texas at Austin. Wound Care Instruction Sheet.

  10. Khorasani G, Hosseinimehr SJ, Azadbakht M, Zamani A, Mahdavi MR. Aloe versus silver sulfadiazine creams for second-degree burns: a randomized controlled studySurg Today. 2009;39(7):587-591. doi:10.1007/s00595-008-3944-y

By Jenny Lelwica Buttaccio, OTR/L
Jenny Lelwica Buttaccio, OTR/L, is a licensed occupational therapist and advocate for patients with Lyme disease.