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silver sulfadiazine

Generic Ssd
Used for Wound Care
Used for Wound Care

Silver sulfadiazine (SSD) is an antibiotic cream used to treat or prevent serious skin infections caused by second- or third-degree burns. Silver sulfadiazine (SSD) is typically applied once or twice a day, after the wound has been cleaned. This medication can cause some side effects, such as rash or skin redness. Rarely, it can lead to serious allergic reactions. Silver sulfadiazine (SSD) is available by prescription only.

Reviewed by:
reviewer
Allison Gourley, PharmD
reviewer
Kristianne Hannemann, PharmD
Last reviewed on August 30, 2023
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsCostContraindicationsAlternativesLatest newsReferencesPricesMedicare
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What is Silver sulfadiazine (SSD)?

What is Silver sulfadiazine (SSD) used for?

  • Prevention and treatment of infections caused by second- and third-degree burns

How Silver sulfadiazine (SSD) works

Silver sulfadiazine (SSD) kills multiple types of bacteria by damaging their protective coverings.

Drug Facts

Common BrandsSSD, Silvadene, Thermazene
Drug ClassAntibiotic
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityPrescription only
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$14.69(save 56.30%)
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$6.42
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What are the side effects of Silver sulfadiazine (SSD)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Temporary low number of white blood cells

Other Side Effects

  • Burning sensation
  • Rash
  • Skin redness
  • Kidney problems
  • Change in skin color

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Allergic reaction: rash, changes in skin color, itchiness, raised skin areas
  • Severe skin reactions: worsening skin pain, fever, blisters or sores, peeling skin
When do Silver sulfadiazine (SSD) possible side effects begin and end?
Time passed since treatment started:
HOURS
DAYS
WEEKS
MONTHS
Temporary low number of white blood cells

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Incidence not known

Back, leg, or stomach pains

blistering, peeling, or loosening of the skin

blue-green to black skin discoloration

dark urine

fever with or without chills

general body swelling

increased sensitivity of the skin to sunlight, especially in patients with burns on large areas

intense itching of burn wounds

light-colored stools

lower back or side pain

nausea or vomiting

pinpoint red spots on the skin

red skin lesions, often with a purple center

red, swollen skin

skin rash

sores, ulcers, or white spots in the mouth or on the lips

swollen or painful glands

unusual bleeding or bruising

unusual tiredness or weakness

upper right abdominal or stomach pain

yellow eyes and skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

Brownish-gray skin discoloration

burning feeling on treated areas

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Silver sulfadiazine (SSD)

thumbs-up

Pros

Works well against many different kinds of bacteria

Can help prevent infections caused by skin burns

Can be used with dressing, if needed

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Cons

Shouldn't be used if you have a sulfa allergy

Not recommended for pregnant females, especially those close to their due dates

Might not be the best choice if you have severe kidney or liver issues

pharmacist-tips

Pharmacist tips for Silver sulfadiazine (SSD)

pharmacist

  • Only put silver sulfadiazine (SSD) on your skin. Don't put it in or around your eyes because it could cause really bad irritation.

    • Wash your hands before and after applying silver sulfadiazine (SSD). It's best to wear sterile exam gloves before applying silver sulfadiazine (SSD) to prevent contaminating (spreading germs) to your burn wounds.

      • Burned areas should be covered with silver sulfadiazine (SSD) at all times. Reapply the cream if any rubs off in between uses. Dressings or bandages can be used if necessary to help keep the area covered with medication.

        • Silver sulfadiazine (SSD) is a sulfa medication. Be sure to tell your provider if you have an allergy to sulfa products. You might not be able to use this medication.

          • Let your healthcare provider know if you have severe kidney or liver issues. People with kidney or liver problems have a higher risk of side effects from silver sulfadiazine (SSD).

            faqs

            Frequently asked questions about Silver sulfadiazine (SSD)

            When should silver sulfadiazine (SSD) be used?
            Silver sulfadiazine (SSD) can be used in situations where you have experienced a second- or third-degree burn, if instructed by your provider. You typically apply it once or twice a day, making sure to reapply it if any rubs off in between doses.
            Can silver sulfadiazine (SSD) cream be used for rash?
            Silver sulfadiazine (SSD) isn't meant to be used on skin rashes. Rarely, it can cause rash as a side effect. If you have a skin rash that needs treatment, ask your healthcare provider for guidance.
            How long do you use silver sulfadiazine (SSD) for burns?
            You should use silver sulfadiazine (SSD) for as long as your provider instructs you to do so. Typically, this means until the wound has healed enough or until the burn area is ready for grafting. If you stop this medication too soon, you're at higher risk for infections. On the other hand, using silver sulfadiazine (SSD) for longer than recommended might slow wound healing.
            How long does it take for silver sulfadiazine (SSD) to work?
            Silver sulfadiazine (SSD) can help treat and prevent infections. How long it takes silver sulfadiazine (SSD) to treat infections can differ depending on several factors, such as how severe or big your burn is, or the type of bacteria that's causing the skin infection. As a general rule of thumb, keep a close eye on your burn and report any signs of worsening or infection (e.g., redness or swelling) to your provider immediately.
            Does silver sulfadiazine (SSD) cream expire?
            After the expiration date has passed, silver sulfadiazine (SSD) might not work as well. This means you'll be at a higher risk for developing infections. It's always best to contact your pharmacy for a refill if it's past the expiration dates on your medications.
            Can you use silver sulfadiazine (SSD) cream on sunburns?
            Silver sulfadiazine (SSD) is only approved for second- and third- degree burns, if prescribed by your provider. Mild sunburn is considered a first-degree burn, meaning only the top layer of the skin is burned. Typically, your provider will recommend that you treat a mild sunburn at home with aloe vera instead. More serious sunburns can be considered second- and third- degree burns. If your sunburn is blistering or has opened up, you need medical attention right away. If that's the case, ask your provider whether silver sulfadiazine (SSD) is a good option for you to prevent infection.
            Can you use silver sulfadiazine (SSD) on an open wound?
            Yes. You can use silver sulfadiazine (SSD) on an open wound (caused by a burn) if your provider instructs you to do so. After you've cleaned the burn wound(s), apply silver sulfadiazine (SSD) directly to the wound to help prevent it from getting infected with bacteria.
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            What are the risks and warnings for Silver sulfadiazine (SSD)?

            Silver sulfadiazine (SSD) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

            risk-warning

            Severe allergic and skin reactions

            • Risk factors: Allergy to sulfa medications

              In some rare cases, severe allergic reactions to silver sulfadiazine (SSD) can happen, including life-threatening problems like Stevens-Johnson syndrome (SJS) or anaphylaxis (closing of the throat). Call 911 if this happens. If you notice painful blisters all over the body, hives, a rash, swelling of the lips or tongue, or difficulty breathing after using silver sulfadiazine (SSD), call your healthcare provider right away. Let your provider know if you have an allergy to sulfa medications before you start using silver sulfadiazine (SSD).

              risk-warning

              Changes in levels of blood cells

              Although rare, using silver sulfadiazine (SSD) might lead to blood-related problems, such as low levels of blood cells. You might not feel any symptoms when this happens. But sometimes, it can lead to weakness, dizziness, tiredness, and bleeding that's difficult to stop. Let your provider know if you experience those symptoms.

              risk-warning

              Possible risk of fungal infections

              • Risk factors: Using silver sulfadiazine (SSD) for a long time

                People using silver sulfadiazine (SSD) for a long time can sometimes develop a fungal infection where they're applying the cream. If you are going to be using this medication for a while, your provider will most likely keep a close eye on your wound(s) for signs of a fungal infection.
                If you notice new or worse skin redness, itchiness, or burning while using silver sulfadiazine (SSD), talk to your provider right away.

                dosage

                Silver sulfadiazine (SSD) dosage forms

                The average cost for 1 tube of 25g of 1% of Silver sulfadiazine (SSD) is $6.42 with a free GoodRx coupon. This is 56.3% off the average retail price of $14.69.
                jar of cream
                Jar of cream
                DosageQuantityPrice as low asPrice per unit
                50g of 1%1 jar$14.99$14.99
                400g of 1%1 jar$28.74$28.74
                tube of cream
                Tube of cream
                DosageQuantityPrice as low asPrice per unit
                25g of 1%1 tube$6.42$6.42
                50g of 1%1 tube$14.99$14.99
                85g of 1%1 tube$18.53$18.53

                Typical dosing for Silver sulfadiazine (SSD)

                The typical dose is to apply a thin layer to the burn(s) one to two times a day. Apply enough silver sulfadiazine (SSD) to cover the affected area(s) completely and evenly. If needed, apply more cream to replace any medication that has come off on bandages, clothing, or bed linens. Typically, your provider will ask you to continue treatment until the burn area has healed or is ready for grafting.

                interactions

                Interactions between Silver sulfadiazine (SSD) and other drugs

                Silver sulfadiazine (SSD) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Silver sulfadiazine (SSD). Please note that only the generic name of each medication is listed below.

                Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

                • Methenamine

                Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                • Aminolevulinic Acid
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                How much does Silver sulfadiazine (SSD) cost?

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                Ssd (brand)
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                $6.42

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                contraindications-icon

                Silver sulfadiazine (SSD) contraindications

                Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Silver sulfadiazine (SSD) will not be safe for you to take.

                • Pregnant females close to their due dates

                • Babies in their first 2 months of life

                alternatives

                What are alternatives to Silver sulfadiazine (SSD)?

                There are a number of medications that your doctor can prescribe in place of Silver sulfadiazine (SSD). Compare a few possible alternatives below.
                Silver sulfadiazine (SSD)
                Used for:

                • Prevention and treatment of infections caused by second- and third-degree burns

                $6.42 Lowest GoodRx priceView Prices
                Sulfamylon (mafenide)
                Used for:
                $1177.34 Lowest GoodRx priceView Prices

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                References

                Best studies we found

                Ascend Laboratories, LLC. (2022). Silver sulfadiazine cream [package insert]. DailyMed.

                MedlinePlus. (2017). Silver sulfadiazine.

                Oaks, R. J., et al. (2023). Silver sulfadiazine. StatPearls.

                View All References (3)

                Prohaska, J., et al. (2023). Skin grafting. StatPearls.

                Rosen, J. M., et al. (2015). Topical silver sulfadiazine retards burn wound healing in a murine model. Journal of the American Academy of Dermatology.

                Warby, R., et al. (2023). Burn classification. StatPearls.

                GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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