An Overview of Silvadene Cream

What you need to know about this medication

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If you experience a second- or third-degree burn on your body, your healthcare provider may prescribe Silvadene cream to fight infection.

Silvadene, also known as silver sulfadiazine, is a topical, micronized form of silver that has antimicrobial properties. The prescription cream is simple to use, but you should follow the application guidelines to get the maximum benefit from it.

This article explains how Silvadene works and how to use it. It also addresses the potential side effects and the precautions you should take when using it.

Know Your Burns

Burns fall into several categories: those in the first-, second-, and third-degree, depending on how deeply they penetrate the skin:


  • First-degree burns affect only the outer layer of skin, with the burn site being dry, red, and painful. No blisters appear with these burns.
  • Second-degree burns involve the outer layer and part of the lower layer of the skin. The burn usually looks red and blistered and it may be swollen and painful. First- and second-degree burns are considered minor burns.
  • Third-degree burns destroy both top layers of the skin and may even penetrate the innermost layer. The burn site often looks charred and either black or white.

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 a 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.

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- 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:

  • Clean and debride the burn before applying the cream. Debriding involves removing dead tissue and any foreign material. (First, ensure that the area around you and your tools are clean.)
  • 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.
  • Cover the wound with gauze or a bandage, if you like, especially if you want to safeguard the burn from knocks and bumps. A covering will also reduce infection risks.
  • Reapply the cream as soon as possible if day-to-day activities (like washing the dishes) cause the cream to wear off.
  • Continue to use the cream until the burn area has healed sufficiently.

Contact your healthcare provider if you notice that the condition of your skin hasn't improved or is getting worse.

Side Effects

Some side effects are associated with Silvadene, and they can range from mild to serious. If you have bothersome symptoms that persist, talk with your healthcare provider so they can evaluate whether you should continue using the cream or switch to another method. The side effects can range from common (and mild) to severe:

Common

Common side effects may include::

  • Burning sensations
  • Itchy skin
  • Pain
  • Skin discoloration

Serious

Serious side effects are uncommon with Silvadene. Contact your healthcare provider as soon as possible if you experience:

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

Additionally, Silvadene poses a slight risk for leukopenia—a decrease in white blood cells (WBCs). 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 two or 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 affect treatment outcomes.

No Babies Allowed

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

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 right 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. In these cases, Silvadene could trigger 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.

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. This said, it's worth noting that there is an absence of reliable studies about using the cream during pregnancy.

Theoretically, drugs in the sulfonamide family may cause kernicterus—brain damage that results from excessive levels of bilirubin—in newborns. Therefore, pregnant women should use the cream only with the approval of their physician.

Similarly, notify your healthcare provider if you’re nursing. It's not known if Silvadene is excreted in breast milk, but because sulfonamides and its derivatives may contribute to kernicterus, it’s advised that you stop nursing or using the drug.

Summary

Silvadene, also known as silver sulfadiazine, defends against infectious agents by damaging both the cell membrane and the cell wall. This makes it effective at suppressing the growth of bacteria. However, Silvadene carries its share of side effects, and they can range from mild (like itching and burning) to serious (like unexplained bruising and bleeding). Silvadene may not be right for you if you are allergic to antibiotics in the sulfa family. For all reasons, it's important to keep the lines of communication open with your healthcare provider and call with questions or if you experience side effects.

A Word From Verywell

Like many people who use creams and ointments, you may be prone to overdoing an application. After all, it can be difficult to eyeball a tiny, 1/16th-of-an-inch application. To prevent an over-application, practice applying the cream in front of your healthcare provider. They could give you a tip that will ensure you apply just the right amount. For example, some providers recommend that creams be applied with a cotton swab or tongue depressor. Others draw a circle on a piece of paper and instruct their patients to fill it with cream before applying it. Whichever method you adopt, make sure you feel confident about it before leaving your provider's office. They're there to help you get things right.

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7 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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