Selenium disulfide explained

Tradename:Selseb, Selsun Blue, others
Routes Of Administration:Topical
Atc Prefix:D01
Atc Suffix:AE13
Legal Au:S5
Legal Uk:P
Legal Us:OTC
Legal Us Comment:/ Rx-only
Cas Number:7488-56-4
Unii:Z69D9E381Q
Pubchem:24087
Drugbank:DB00971
Chemspiderid:22519
Kegg:D05815
Chebi:135934
Chembl:1200680
Synonyms:Selenium sulfide
S:2
Se:1
Smiles:S=[Se]=S
Stdinchi:1S/S2Se/c1-3-2
Stdinchikey:JNMWHTHYDQTDQZ-UHFFFAOYSA-N
Density:3
Melting Point:111
Boiling Point:118 to 119
Boiling Notes:(decomposes)
Solubility:negligible

Selenium disulfide, also known as selenium sulfide, is a chemical compound and medication used to treat seborrheic dermatitis, dandruff, and pityriasis versicolor. It is applied to the affected area as a lotion or shampoo. Symptoms frequently return if treatment is stopped.

Side effects may include hair discoloration, skin irritation, and risk of systemic absorption and toxicity, among others.[1] Use is not recommended in children less than 2–5 years old.[1] Use in pregnancy or breastfeeding has not been studied.[2] It consists of a mixture of inorganic covalent compounds having an approximate empirical formulas of SeS2.[3] Selenium disulfide acts as a keratolytic and antifungal agent.[4] [5] [6]

Selenium disulfide was approved for medical use in the United States at least as early as 1951.[7] It is on the World Health Organization's List of Essential Medicines.[8] Selenium disulfide is available as a generic medication and over the counter.[9]

Medical uses

Selenium disulfide is sold as an antifungal agent in shampoos (such as Selsun Blue) for the treatment of dandruff and seborrheic dermatitis associated in the scalp with fungi of genus Malassezia.[10] [11] [12] It is also used on the body to treat tinea versicolor (pityriasis versicolor), a type of fungal skin infection caused by a different species of Malassezia.[13] [14]

A 2015 systematic review of topical treatments for seborrheic dermatitis of the scalp identified only a single randomized controlled trial evaluating selenium disulfide for the condition.[15] It was a three-arm trial of 246 people with moderate to severe dandruff and compared treatment with 2% ketoconazole shampoo (n=97), 2.5% selenium disulfide shampoo (n=100), and placebo (shampoo base with no antiseborrheic agent) (n=49) for 29days.[16] The study found a 73% reduction in dandruff score with ketoconazole, a 67% reduction with selenium disulfide, and a 45% reduction with placebo. Based on the study, the systematic review concluded that selenium disulfide may be effective in the treatment of dandruff but that the available evidence is limited and overall evidence quality is low. It also found that while selenium disulfide has infrequent side effects, it seems to have more side effects than ketoconazole shampoo. Consequently, the review concluded that selenium disulfide should not be considered as a first-line therapy but instead should be used as an alternative treatment after other therapies like ketoconazole shampoo have proven not effective.

A 2015 review recommended topical antifungal agents, topical corticosteroids, and topical calcineurin inhibitors like tacrolimus as the main treatments for seborrheic dermatitis based on good-quality evidence, rather than selenium disulfide for which evidence is much more limited.[17] However, the review did suggest use of over-the-counter selenium disulfide shampoos as an inexpensive option for managing mild symptoms of seborrheic dermatitis.

Available forms

Selenium disulfide is available in the form of a prescription drug as a 2.25% medical shampoo.[18] In the United States, a 1% strength is available over-the-counter, and a 2.5% strength is also available with a prescription.[19] In Canada, the 2.5% strength is available over-the-counter. Selsun Blue is an over-the-counter shampoo for dandruff with 1% selenium disulfide as its active ingredient.[20]

Side effects

Side effects of selenium disulfide shampoo for dandruff appear to be infrequent. A randomized controlled trial of 100 people who received selenium disulfide reported side effects of itching or burning sensation of the scalp (3people), eruption near the hairline (1person), psoriasis (1person), lightening or bleaching of hair color (2people), orange staining of the scalp (1person), and a chemical taste while shampooing (1person).

Selenium disulfide can cause discoloration of nails and light hair and can alter the color of hair dyes. Several scattered case reports of orange to red–brown scalp discoloration with selenium sulfide shampoo exist.[21] The discoloration resolved shortly following discontinuation of selenium disulfide shampoo and its removal could be facilitated by lightly swabbing with isopropyl alcohol. Selenium disulfide may also discolor metallic jewellery. Case reports of temporary diffuse hair loss with selenium disulfide shampoo exist as well.[22] [23] Excessive environmental or occupational exposure to selenium has also been associated with hair loss and other adverse effects. However, hair loss has not been reported with topical selenium disulfide in several large studies.

Selenium disulfide should not be applied to damaged skin as there is a risk of systemic absorption and associated toxicity. Systemic symptoms may include tremors, weakness, lethargy, lower abdominal pain, and occasional vomiting. These symptoms usually resolve within 10days following exposure.

Pharmacology

Pharmacodynamics

Selenium disulfide acts as an antifungal and keratolytic agent to treat seborrheic dermatitis and dandruff.

Pharmacokinetics

The systemic absorption and toxicity of orally administered selenium sulfide has been studied in animals.[24] Topical use of selenium sulfide in the form of a shampoo or lotion in humans does not appear to normally increase circulating or urinary selenium levels.[25] [26] [27] [28] [29] However, application of selenium disulfide to damaged skin can result in systemic absorption and has been associated with cases of toxicity. Selenium disulfide appears to be much less toxic than other selenium salts, which may be attributed to its low aqueous solubility and very poor systemic absorption.

Chemistry

Composition

Selenium disulfide has a composition that approximates to SeS2 and is sometimes called selenium sulfide. However, as used in proprietary formulations, it is not a pure chemical compound but a mixture of eight-membered-ring compounds where the overall Se:S ratio is 1:2. The specific chemicals contain a variable number of S and Se atoms, SenS8−n.[30]

Many selenium sulfides are known, as indicated by 77Se-NMR spectroscopy.[31]

History

Selenium sulfide was introduced for medical use in the United States in 1951.

Selenium monosulfide, along with elemental selenium and sulfur, has been used in medicinal preparations in the past,[32] causing confusion and contradiction[33] as to exactly what form selenium is in any given topical preparation.

Society and culture

Popular culture

In the film Evolution selenium was mentioned as an active ingredient of Head & Shoulders. A group of academics, therefore, tried to use this brand of shampoo to stop an alien invasion after discovering that the alien life form was sensitive to selenium.[34]

Research

Selenium disulfide has been suggested to be effective as a treatment for hyperkeratosis based on a small case series of three treated patients.[35] It has also been reported to be effective in the treatment of scalp psoriasis based on clinical observation of over 100treated patients and two case reports of dramatic response.[36]

Selenium sulfide is under development for the treatment of meibomianitis (meibomian gland dysfunction) and dry eyes in topical and ophthalmic formulations.[37] [38] As of March 2021, it is in phase 2/3 clinical trials for meibomianitis and phase 2 trials for dry eyes. The developmental code name of selenium sulfide for these uses is AZR-MD-001 and it is being developed by Azura Ophthalmics.

Further reading

Notes and References

  1. Book: WHO Model Formulary 2008 . 2009 . 9789241547659 . ((World Health Organization)) . Stuart MC, Kouimtzi M, Hill SR . 10665/44053 . World Health Organization . World Health Organization . 297 .
  2. Web site: Selenium sulfide topical Use During Pregnancy . Drugs.com. 13 January 2017. live. https://web.archive.org/web/20170116210227/https://www.drugs.com/pregnancy/selenium-sulfide-topical.html. 16 January 2017.
  3. Book: Mitchell SC . Biological Interactions Of Sulfur Compounds. 2003. CRC Press. 9780203362525. 174. en. live. https://web.archive.org/web/20170116155625/https://books.google.ca/books?id=bRw7mvUzq9MC&pg=PA174. 16 January 2017.
  4. Mitchell SC, Nickson RM, Waring RH . The Biological Activity of Selenium Sulfide . Sulfur Reports . August 1993 . 13 . 2 . 279–289 . 0196-1772 . 1029-0508 . 10.1080/01961779308048957 .
  5. Borda LJ, Perper M, Keri JE . Treatment of seborrheic dermatitis: a comprehensive review . The Journal of Dermatological Treatment . 30 . 2 . 158–169 . March 2019 . 29737895 . 10.1080/09546634.2018.1473554 . 13686180 .
  6. Gupta AK, Madzia SE, Batra R . Etiology and management of Seborrheic dermatitis . Dermatology . 208 . 2 . 89–93 . 2004 . 15056994 . 10.1159/000076478 . 22432032 .
  7. Web site: Selenium Sulfide. The American Society of Health-System Pharmacists. 8 January 2017. live. https://web.archive.org/web/20170118034224/https://www.drugs.com/monograph/selenium-sulfide.html. 18 January 2017.
  8. Book: ((World Health Organization)) . World Health Organization model list of essential medicines: 21st list 2019 . 2019 . 10665/325771 . World Health Organization . World Health Organization . Geneva . WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO . free .
  9. Book: Hamilton R . Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. 2015. Jones & Bartlett Learning. 9781284057560. 194.
  10. Web site: Selenium(IV) sulfide . Pharmacy Codes . https://web.archive.org/web/20080401233413/http://pharmacycode.com/Selenium(IV)_sulfide.html . 1 April 2008 .
  11. Web site: Chemicals of Selenium . selenium.se . https://web.archive.org/web/20080403192141/http://www.selenium.se/selenium-disulfide.html . 3 April 2008 .
  12. Web site: Selenium sulfide . DermNet NZ . New Zealand Dermatological Society Incorporated . 24 December 2007 . https://web.archive.org/web/20081226162736/http://dermnetnz.org/treatments/selenium.html . 26 December 2008 .
  13. Faergemann J . Management of seborrheic dermatitis and pityriasis versicolor . American Journal of Clinical Dermatology . 1 . 2 . 75–80 . 2000 . 11702314 . 10.2165/00128071-200001020-00001 . 43516330 .
  14. Savin R . Diagnosis and treatment of tinea versicolor . The Journal of Family Practice . 43 . 2 . 127–132 . August 1996 . 8708621 .
  15. Naldi L, Diphoorn J . Seborrhoeic dermatitis of the scalp . BMJ Clinical Evidence . 2015 . May 2015 . 26016669 . 4445675 .
  16. Danby FW, Maddin WS, Margesson LJ, Rosenthal D . A randomized, double-blind, placebo-controlled trial of ketoconazole 2% shampoo versus selenium sulfide 2.5% shampoo in the treatment of moderate to severe dandruff . Journal of the American Academy of Dermatology . 29 . 6 . 1008–1012 . December 1993 . 8245236 . 10.1016/0190-9622(93)70282-x .
  17. Clark GW, Pope SM, Jaboori KA . Diagnosis and treatment of seborrheic dermatitis . American Family Physician . 91 . 3 . 185–190 . February 2015 . 25822272 .
  18. Web site: Selenium sulfide shampoo . Bi-Coastal Pharma International LLC . January 2022 . DailyMed . 29 May 2023 . 29 May 2023 . https://web.archive.org/web/20230529055153/https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=dacbcc5a-d37c-4ea3-8f47-35abb64c7519&type=display . live .
  19. Gupta PK, Periman LM, Lain E, Donnenfeld E, Hovanesian J, Kim T, Trattler W, Yeu E, Holland E . 6 . Meibomian Gland Dysfunction: A Dermatological Perspective on Pathogenesis and Treatment Outlook . Clinical Ophthalmology . 15 . 4399–4404 . 2021 . 34785886 . 8590836 . 10.2147/OPTH.S327407 . free .
  20. Rapaport M . A randomized, controlled clinical trial of four anti-dandruff shampoos . The Journal of International Medical Research . 9 . 2 . 152–156 . 1981 . 7014286 . 10.1177/030006058100900213 . 41649828 .
  21. Gilbertson K, Jarrett R, Bayliss SJ, Berk DR . Scalp discoloration from selenium sulfide shampoo: a case series and review of the literature . Pediatric Dermatology . 29 . 1 . 84–88 . 2012 . 21453309 . 10.1111/j.1525-1470.2011.01410.x . 42996869 .
  22. Vinceti M, Wei ET, Malagoli C, Bergomi M, Vivoli G . Adverse health effects of selenium in humans . Reviews on Environmental Health . 16 . 4 . 233–251 . 2001 . 12041880 . 10.1515/reveh.2001.16.4.233 . 6596336 .
  23. Grover RW . Diffuse hair loss associated with selenium (selsun) sulfide shampoo . Journal of the American Medical Association . 160 . 16 . 1397–1398 . April 1956 . 13306564 . 10.1001/jama.1956.02960510023006 .
  24. Henschler D, Kirschner U . [On the absorption and toxicity of selenium sulfide] . German . Archiv für Toxikologie . 24 . 4 . 341–344 . 1969 . 5795758 . 10.1007/BF00577584 . On the absorption and toxicity of selenium sulfide . 30908076 .
  25. Noisel N, Bouchard M, Carrier G . Disposition kinetics of selenium in healthy volunteers following therapeutic shampoo treatment . Environmental Toxicology and Pharmacology . 29 . 3 . 252–259 . May 2010 . 21787610 . 10.1016/j.etap.2010.02.001 . 2010EnvTP..29..252N .
  26. Kalivas J . Lack of serum selenium rise after overnight application of selenium sulfide . Archives of Dermatology . 129 . 5 . 646–648 . May 1993 . 8481030 . 10.1001/archderm.1993.01680260118023 .
  27. Sánchez JL, Torres VM . Selenium sulfide in tinea versicolor: blood and urine levels . Journal of the American Academy of Dermatology . 11 . 2 Pt 1 . 238–241 . August 1984 . 6480923 . 10.1016/s0190-9622(84)70156-3 .
  28. Cummins LM, Kimura ET . Safety evaluation of selenium sulfide antidandruff shampoos . Toxicology and Applied Pharmacology . 20 . 1 . 89–96 . September 1971 . 5110829 . 10.1016/0041-008x(71)90092-5 . 1971ToxAP..20...89C .
  29. Slinger WN, Hubbard DM . Treatment of seborrheic dermatitis with a shampoo containing selenium disulfide . A.M.A. Archives of Dermatology and Syphilology . 64 . 1 . 41–48 . July 1951 . 14837491 . 10.1001/archderm.1951.01570070044007 .
  30. Cyclic selenium sulfides R. Steudel, R. Laitinen, Topics in Current Chemistry, (1982), 102, 177-197
  31. 10.1021/ic00019a022 . Chalcogen ring interconversion pathways. 77Se NMR spectroscopic study of the decomposition of 1,2,3,4,5-Se5S2 to 1,2,3,4,5,6-Se6S2 and 1,2,3,4-Se4S2 . 1991 . Pekonen P, Hiltunen Y, Laitinen RS, Pakkanen TA . Inorganic Chemistry . 30 . 19 . 3679.
  32. Web site: Definition: selenium sulfide . Online Medical Dictionary.
  33. Web site: Selenium Sulfide . DrugBank . DB00971 . live . https://web.archive.org/web/20070427191823/http://redpoll.pharmacy.ualberta.ca/drugbank/cgi-bin/getCard.cgi?CARD=APRD01323.txt . 27 April 2007 .
  34. Web site: Evolution (2001) . . 19 May 2020 . 8 November 2020 . https://web.archive.org/web/20201108132248/https://www.imdb.com/title/tt0251075/trivia . live .
  35. Cohen PR, Anderson CA . Topical Selenium Sulfide for the Treatment of Hyperkeratosis . Dermatology and Therapy . 8 . 4 . 639–646 . December 2018 . 30203232 . 6261123 . 10.1007/s13555-018-0259-9 .
  36. Borglund E, Enhamre A . Treatment of psoriasis with topical selenium sulphide . The British Journal of Dermatology . 117 . 5 . 665–666 . November 1987 . 3689688 . 10.1111/j.1365-2133.1987.tb07503.x . 36783670 .
  37. Web site: AZR MD 001 . AdisInsight . Springer Nature Switzerland AG .
  38. Web site: ARVO 2021: Investigational Agent Containing Selenium Sulfide Shows Promise for Meibomian Gland Dysfunction. 11 February 2022. PracticeUpdate. en. 11 February 2022. https://web.archive.org/web/20220211154628/https://www.practiceupdate.com/content/arvo-2021-investigational-agent-containing-selenium-sulfide-shows-promise-for-meibomian-gland-dysfunction/118093. live.

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