Silvadene Cream: An Overview

What you need to know about this medication

If you experience a serious wound or burn on your body, your doctor 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 contains antimicrobial properties.

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, making it suitable for suppressing the growth of bacteria and 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
Illustration by Brianna Gilmartin, Verywell 

How Is Silvadene Used?

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 doctor recommends the cream as well.

The U.S. National Library of Medicine of the The National Institutes of Health’s (NIH) suggests the following guidelines when 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.
How to Treat Burns, Regardless of Severity

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 doctor 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 doctor 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, erythromycin, to name a few), discuss treatment options with your doctor or pharmacist, as Silvadene could potentially cause an allergic reaction.

Also, the use of Silvadene may be contraindicated in individuals who have certain liver, kidney, or blood diseases. Having an impairment in these areas 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 physician will need to weigh the benefits of staying on the treatment or discontinuing it.

Be sure to let your doctor know if you’re pregnant because Silvadene isn’t recommended for use in women who are at or approaching their pregnancy due date. The U.S. National Library of Medicine reports that 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 expectant women.

Likewise, notify your doctor 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.

Other Information

Let your doctor 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.

Please Note

Silvadene cream is for topical use only, and you should not consume it orally. Do not share your medication with other people. Silvadene cream is not recommended for premature babies, newborn babies, or children two months of age or younger.

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

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 physician. This way, the doctor 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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