DMSO (dimethyl sulfoxide)

Q: Is DMSO FDA-approved?

Yes. Rimso-50, a 50% DMSO solution placed in the bladder, was approved on April 4, 1978 for symptomatic relief of interstitial cystitis. DMSO is also an approved veterinary drug (Domoso) and the inactive penetration enhancer in prescription diclofenac solution. Other DMSO is sold as a solvent or in consumer products, which is why the grade on the label matters.

Q: Does DMSO carry other substances through the skin?

Yes. That is its main use in medicines: diclofenac carried in DMSO beat the DMSO vehicle alone in knee arthritis trials. It also means anything on the skin or mixed into the product can be carried in, so the diclofenac label calls for clean, dry skin and waiting until it dries before other products.

Q: Is it safe to drink DMSO?

Drinking DMSO is not an approved or established use. No DMSO product is FDA-approved to be swallowed: the only approved human drug, Rimso-50, is instilled into the bladder by a clinician. About 70% of an oral dose is absorbed, versus up to about 16% from the bladder. A systematic review of 109 studies found gastrointestinal and skin reactions were the commonest adverse reactions, rising with dose.

Q: Is DMSO safe on the skin?

Most reactions are mild and short-lived, such as burning, itch, redness and dryness, and they rise with concentration. In one trial over a quarter of people on 70% DMSO stopped for skin toxicity. Keep it out of the eyes and off open wounds.

Q: What is the difference between pharmaceutical and industrial DMSO?

The approved drug is USP-grade, sterile and non-pyrogenic, made to a set concentration. Solvent DMSO is sold for other purposes without those assurances. Because DMSO carries what is in it through the skin, its purity matters more than for most ingredients.

Q: Is DMSO the same as MSM?

No. MSM is dimethyl sulfone, one of the two compounds the body makes from DMSO. MSM is taken by mouth as a joint supplement; DMSO is mostly used on the skin or in the bladder.

Q: Why does DMSO make my breath smell like garlic?

Part of the DMSO is changed into dimethyl sulfide, a volatile compound that leaves through the breath and skin. The label describes a garlic-like taste within minutes and an odour that can last up to 72 hours.

Q: How is DMSO used for interstitial cystitis?

Per the Rimso-50 label, 50 mL is instilled into the bladder by catheter, held for about 15 minutes and then voided, repeated every two weeks until symptoms improve most, then spaced out. It is a prescription procedure done by a clinician.

Also called dimethyl sulfoxide, dimethyl sulphoxide, dimethylsulfoxide, methyl sulfoxide, Rimso-50, Domoso.

Best grade B across 21 graded outcomes Other Last checked Oct 21, 2026

The short answer

From 51 sources

DMSO is a solvent that crosses skin and carries other molecules with it, which is why it is used as a drug vehicle. It is FDA-approved as Rimso-50 for bladder instillation in interstitial cystitis (grade B). Small trials support 50% cream for CRPS type 1 and 99% liquid after chemotherapy leaks; DMSO alone did not ease knee arthritis.

Every graded outcome on this page

21 rows · line = participants

Grade BSymptom, problem and pain scores in interstitial cystitis (pooled)Interstitial cystitisn 554
Grade BBladder pain and urinary symptoms in interstitial cystitisInterstitial cystitisn 96
Grade BSymptom and urodynamic improvement in interstitial cystitisInterstitial cystitisn 33
Grade CKnee osteoarthritis pain in older DMSO trials (systematic review)Knee osteoarthritisn 681
Grade CHerpes zoster course with idoxuridine carried in DMSO vs oral acyclovirCarrier formulationsn 171
Grade CCRPS type 1 impairment: DMSO cream vs N-acetylcysteineCRPS type 1n 146
Grade CInterstitial cystitis symptoms: DMSO mix vs a bupivacaine, triamcinolone and heparin mixInterstitial cystitisn 70
Grade CPain in reflex sympathetic dystrophy (open study)CRPS type 1n 37
Grade CCRPS type 1 signs and pain (acute reflex sympathetic dystrophy)CRPS type 1n 31
Grade CPain and limb function in CRPS type 1 (hospital series)CRPS type 1n 29
Grade CEarly CRPS of the hand: DMSO vs guanethidine nerve blocksCRPS type 1n 26
Grade DGenital herpes symptoms with idoxuridine carried in DMSOCarrier formulationsn 135
Grade DSkin ulceration after chemotherapy extravasationChemotherapy extravasationn 127
Grade DHand ulcers in systemic sclerosisSkin ulcersn 84
Grade DHeel pain in plantar fasciitis with plant terpenes carried in 15% DMSOCarrier formulationsn 62
Grade DBiopsy-confirmed clearance of low-risk basal cell carcinoma with ascorbic acid carried in DMSOCarrier formulationsn 25
Grade DSkin ulceration after anthracycline extravasationChemotherapy extravasationn 20
Grade DMacular amyloidosis: CO2 laser plus DMSO vs laser aloneMacular amyloidosisn 20
Grade DPigmentation and itch in macular amyloidosis: DMSO vs tretinoinMacular amyloidosisn 18
No effectKnee osteoarthritis pain and function with DMSO alone (45.5% vehicle)Knee osteoarthritisn 775
No effectKnee osteoarthritis pain with DMSO alone (vehicle) vs a low-DMSO placeboKnee osteoarthritisn 248
18 more graded outcomes, in the evidence chapter

Key facts

Regulatory status: FDA-approved as Rimso-50 (DMSO 50% w/w, prescription bladder instillation) for symptomatic relief of interstitial cystitis, approved April 4, 1978 (NDA 017788). Other DMSO is sold as a solvent or in consumer products, so grade matters^2,1,35
The carrier role: The penetration enhancer in prescription diclofenac topical solution (45.5% w/w DMSO); diclofenac in DMSO beat the DMSO vehicle alone in three knee-arthritis trials (248 to 775 people)^3,4,23,22,24
Strongest human evidence: Interstitial cystitis (B): in 96 patients, 50% DMSO in the bladder every 2 weeks lowered symptom scores more than placebo over 12 weeks^8,7,9,10
CRPS type 1: The Dutch CRPS-1 guideline says DMSO 50% cream reduces symptoms (level 2); in 31 patients it improved the CRPS score more than placebo cream over 2 months (C); a 2023 Cochrane overview found no high-certainty evidence for any CRPS therapy and rated the DMSO vs N-acetylcysteine evidence low certainty^16,13,51
DMSO alone on knee arthritis: The 45.5% DMSO vehicle without diclofenac did no better than a placebo solution in a 775-person, 12-week trial (no effect)^22,24
How the body handles it: Converted to dimethyl sulfone (MSM) and dimethyl sulfide, which causes the garlic-like breath; dimethyl sulfone can stay in blood more than two weeks after one bladder dose¹
Common effects: Garlic-like taste within minutes, breath and skin odour for up to 72 hours, and skin dryness, burning or itch where it is applied^1,20,19
Veterinary approval: Domoso (90% DMSO solution or gel) is FDA-approved for horses and dogs to reduce acute swelling due to trauma (prescription, 21 CFR 524.660)^5,6
Vitamin C in DMSO for skin cancer: In one 25-person trial, 30% ascorbic acid in 95% DMSO cleared 13 of 15 low-risk basal cell carcinomas at 8 weeks vs 8 of 14 with imiquimod; a 2026 scoping review found only four studies (two RCTs) of topical vitamin C for actinic keratoses and non-melanoma skin cancers^29,49
Evidence base: 21 human study rows: interstitial cystitis (B), CRPS type 1 (C), knee arthritis with DMSO alone (no effect), and small skin, carrier-formula and extravasation studies (C to D)^{8,13,22,19,29}

What it is

DMSO (dimethyl sulfoxide) is a small sulfur solvent that passes through skin and carries other molecules with it.

How it works

Established

DMSO is a small (78 Da), polar, aprotic solvent that mixes with water and dissolves both water-soluble and fat-soluble molecules, and it crosses skin and other membranes. As a penetration enhancer it is thought to loosen the packed lipids between skin cells, interact with keratin, and act as a solvent for the drug inside the skin. Lab studies also describe hydroxyl-radical scavenging, histamine release from mast cells, nerve-conduction block, vasodilation and anti-inflammatory effects; how much each contributes to results in people is not settled.^{38,39,36,40,37,1}

Forms and grades: pharmaceutical, veterinary and solvent DMSO

5 forms named in our sources. The rest show what our data holds, and say plainly where it holds nothing yet.

DMSO (dimethyl sulfoxide) forms compared

5 forms

DMSO (dimethyl sulfoxide) forms compared: 5 forms by 3 attributes. Empty cells are labelled No data yet, or Not graded in the evidence row.
5 forms	Rimso-50: 50% w/w sterile solution for the bladder (prescription)	DMSO as the vehicle in diclofenac topical solution (45.5% w/w, prescription)	DMSO 50% cream (compounded fatty cream base)	90% to 99% liquid (veterinary Domoso; 99% in extravasation studies)	Solvent and consumer products (liquids, gels, roll-ons, balms)
Absorption in people	Instilled as 50 mL and held for 15 minutes; DMSO is absorbed and distributed in tissues, and its metabolite dimethyl sulfone can persist in blood over two weeks after one instillation.¹	Carries diclofenac into the knee tissues; the vehicle alone gave no more pain relief than a 2.3% DMSO placebo.^3,22	No human pharmacokinetic data for the cream; a sulfurous breath smell in 12 of 37 users shows systemic uptake.¹⁷	Applied to skin and left to dry; no human absorption data by concentration.²⁰	No human data by brand or format. DMSO named on a consumer cream is not always the active ingredient or stated as a percentage.⁴⁴
Skin tolerance	Garlic-like taste within minutes, odour up to 72 hours, discomfort on instillation that usually lessens with repeat use, and transient chemical cystitis.¹	Dry skin (32%), contact dermatitis (9%) and itch (4%) at the application site in controlled trials of the 1.5% solution.³	Mild dryness and scaling of the skin; breath odour.¹⁷	Burning on application, itch, redness, scaling, occasional blisters and breath odour in the extravasation studies.^20,19	Skin reactions rise with concentration: over a quarter of patients on 70% DMSO withdrew for skin toxicity in one trial.^32,34
Studied for	Interstitial cystitis (FDA-approved indication; grade B here)	Knee osteoarthritis (as the carrier for diclofenac)	CRPS type 1 (five times daily in the Dutch trials; grade C)	Chemotherapy extravasation (99%, every 6 to 8 hours; grade D); veterinary swelling (90%)	Not tested as sold; trial preparations were pharmaceutical or compounded

Rimso-50: 50% w/w sterile solution for the bladder (prescription)
Absorption in people
Instilled as 50 mL and held for 15 minutes; DMSO is absorbed and distributed in tissues, and its metabolite dimethyl sulfone can persist in blood over two weeks after one instillation.¹
Skin tolerance
Garlic-like taste within minutes, odour up to 72 hours, discomfort on instillation that usually lessens with repeat use, and transient chemical cystitis.¹
Studied for
Interstitial cystitis (FDA-approved indication; grade B here)
DMSO as the vehicle in diclofenac topical solution (45.5% w/w, prescription)
Absorption in people
Carries diclofenac into the knee tissues; the vehicle alone gave no more pain relief than a 2.3% DMSO placebo.^3,22
Skin tolerance
Dry skin (32%), contact dermatitis (9%) and itch (4%) at the application site in controlled trials of the 1.5% solution.³
Studied for
Knee osteoarthritis (as the carrier for diclofenac)
DMSO 50% cream (compounded fatty cream base)
Absorption in people
No human pharmacokinetic data for the cream; a sulfurous breath smell in 12 of 37 users shows systemic uptake.¹⁷
Skin tolerance
Mild dryness and scaling of the skin; breath odour.¹⁷
Studied for
CRPS type 1 (five times daily in the Dutch trials; grade C)
90% to 99% liquid (veterinary Domoso; 99% in extravasation studies)
Absorption in people
Applied to skin and left to dry; no human absorption data by concentration.²⁰
Skin tolerance
Burning on application, itch, redness, scaling, occasional blisters and breath odour in the extravasation studies.^20,19
Studied for
Chemotherapy extravasation (99%, every 6 to 8 hours; grade D); veterinary swelling (90%)
Solvent and consumer products (liquids, gels, roll-ons, balms)
Absorption in people
No human data by brand or format. DMSO named on a consumer cream is not always the active ingredient or stated as a percentage.⁴⁴
Skin tolerance
Skin reactions rise with concentration: over a quarter of patients on 70% DMSO withdrew for skin toxicity in one trial.^32,34
Studied for
Not tested as sold; trial preparations were pharmaceutical or compounded

What the human research says

Human trials only, one row per outcome. The form line shows what each trial actually tested. Grades follow our evidence-grading policy.

Trial map

21 graded outcomes, largest study first

21 graded outcomes: 13 improved, 3 mixed, 5 no effect. The largest, a 2009 randomized trial of 775 people on knee osteoarthritis pain and function with DMSO alone (45.5% vehicle), found no effect. Outcomes that improved came from smaller studies: a median of 33 people, against 135 for no effect.

By sizeTable

1Knee osteoarthritis pain and function with DMSO alone (45.5% vehicle)

No effect · No-effect grade · RCT, 775 people, 2009

Adults with radiologically confirmed, symptomatic primary knee osteoarthritis (five-arm trial)

Dose, result and source

Every graded outcome on this page, largest study first
Outcome	Found	People	Study	Who was studied
Knee osteoarthritis pain and function with DMSO alone (45.5% vehicle)	No effect	775	No-effect grade · RCT, 2009	Adults with radiologically confirmed, symptomatic primary knee osteoarthritis (five-arm trial)
Knee osteoarthritis pain in older DMSO trials (systematic review)	Mixed	681	Grade C · Systematic review, 2008	People with knee osteoarthritis in 4 randomized DMSO trials (297 on active DMSO)
Symptom, problem and pain scores in interstitial cystitis (pooled)	Improved	554	Grade B · Meta-analysis, 2025	People with interstitial cystitis/bladder pain syndrome in 5 randomized trials and 9 single-arm or cohort studies
Knee osteoarthritis pain with DMSO alone (vehicle) vs a low-DMSO placebo	No effect	248	No-effect grade · RCT, 2004	Men and women in southern Ontario with primary knee osteoarthritis and at least moderate pain
Herpes zoster course with idoxuridine carried in DMSO vs oral acyclovir	Improved	171	Grade C · RCT, 1992	Adults with herpes zoster of less than 4 days' duration (Spain, multicentre)
CRPS type 1 impairment: DMSO cream vs N-acetylcysteine	Mixed	146	Grade C · RCT, 2003	Outpatients with CRPS type 1 at two Dutch university hospitals
Genital herpes symptoms with idoxuridine carried in DMSO	No effect	135	Grade D · RCT, 1982	96 recurrent and 39 first episodes of genital herpes (USA)
Skin ulceration after chemotherapy extravasation	Improved	127	Grade D · Open-label trial, 1995	Patients with extravasation of doxorubicin, epirubicin, mitomycin, mitoxantrone, cisplatin, carboplatin, ifosfamide or fluorouracil (Italy); 144 enrolled, 127 assessable
Bladder pain and urinary symptoms in interstitial cystitis	Improved	96	Grade B · RCT, 2021	Japanese adults with bladder-centric interstitial cystitis/bladder pain syndrome (symptom index 9 or more, diagnosed by cystoscopy)
Hand ulcers in systemic sclerosis	No effect	84	Grade D · RCT, 1985	Patients with systemic sclerosis and digital ulcers (US multicentre)
Interstitial cystitis symptoms: DMSO mix vs a bupivacaine, triamcinolone and heparin mix	Mixed	70	Grade C · RCT, 2023	Women with newly diagnosed interstitial cystitis/painful bladder syndrome (USA); 83 randomized, 70 completed all instillations
Heel pain in plantar fasciitis with plant terpenes carried in 15% DMSO	Improved	62	Grade D · RCT, 2024	Adults with plantar fasciitis at a medical practice and a physical therapy clinic, Boise, Idaho, USA
Pain in reflex sympathetic dystrophy (open study)	Improved	37	Grade C · Open-label trial, 1993	Patients with acute signs of reflex sympathetic dystrophy (Netherlands)
Symptom and urodynamic improvement in interstitial cystitis	Improved	33	Grade B · Crossover RCT, 1988	30 women and 3 men (mean age 48, symptoms for a mean 5.5 years) with biopsies suggestive of interstitial cystitis (Canada)
CRPS type 1 signs and pain (acute reflex sympathetic dystrophy)	Improved	31	Grade C · RCT, 1996	Adults with acute reflex sympathetic dystrophy (CRPS type 1) after an accident (Netherlands); 32 randomized, 1 withdrawn for surgery
Pain and limb function in CRPS type 1 (hospital series)	Improved	29	Grade C · Observational, 2012	Patients with CRPS type 1 of less than 1 year at a traumatology hospital (Valencia, Spain); retrospective
Early CRPS of the hand: DMSO vs guanethidine nerve blocks	Improved	26	Grade C · RCT, 1994	Patients with reflex sympathetic dystrophy of the hand, treatment started within 3 months of diagnosis (Netherlands)
Biopsy-confirmed clearance of low-risk basal cell carcinoma with ascorbic acid carried in DMSO	Improved	25	Grade D · RCT, 2022	25 patients with 29 biopsy-confirmed low-risk nodular or superficial basal cell carcinomas (Boise, Idaho, USA)
Macular amyloidosis: CO2 laser plus DMSO vs laser alone	No effect	20	Grade D · Open-label trial, 2024	Patients with macular amyloidosis (Egypt)
Skin ulceration after anthracycline extravasation	Improved	20	Grade D · Open-label trial, 1988	Patients with anthracycline extravasation (USA); 16 observed for 3 months
Pigmentation and itch in macular amyloidosis: DMSO vs tretinoin	Improved	18	Grade D · RCT, 2020	Adults with bilateral primary macular amyloidosis (Iran)

Every graded row

21 rows

Form tested

Showing 21 of 21 outcomes. Human trials only.

Grade BSymptom, problem and pain scores in interstitial cystitis (pooled)Interstitial cystitis−5.59 symptom points from baselineMeta-analysis · 14 studies
n 554 · 2025

Improved Compared with before treatment, the symptom index fell 5.59 points, the problem index 5.14 points and pain scores 3.27 points (all p < 0.00001). Adverse events occurred in 37.6%, mostly mild.

Design: Meta-analysis, 14 studies, n = 554, 2025
Population: People with interstitial cystitis/bladder pain syndrome in 5 randomized trials and 9 single-arm or cohort studies
Form: DMSO instilled into the bladder
Dose: As given in each included study
Duration: Varied by study
Source: Reference 9 · PubMed 40205912 (opens PubMed)

Grade BBladder pain and urinary symptoms in interstitial cystitisInterstitial cystitis−1.8 symptom points vs placeboRCT
n 96 · 2021

Improved The O'Leary-Sant symptom index fell 5.2 points with DMSO vs 3.4 with placebo (difference −1.8, 95% CI −3.3 to −0.3; P = 0.0188). Bladder pain, urination frequency, voided volume and global response also improved more than with placebo; side effects were mild to moderate.

Design: RCT, n = 96, 2021
Population: Japanese adults with bladder-centric interstitial cystitis/bladder pain syndrome (symptom index 9 or more, diagnosed by cystoscopy)
Form: KRP-116D, 50% DMSO solution into the bladder
Dose: One bladder instillation every 2 weeks
Duration: 12 weeks
Source: Reference 8 · PubMed 33580603 (opens PubMed)

Grade BSymptom and urodynamic improvement in interstitial cystitisInterstitial cystitis53% vs 18% markedly improvedCrossover RCT
n 33 · 1988

Improved 53% were markedly improved on DMSO vs 18% on placebo (subjective), and 93% vs 35% improved on objective urodynamic measures. No significant side effects were noted.

Design: Crossover RCT, n = 33, 1988
Population: 30 women and 3 men (mean age 48, symptoms for a mean 5.5 years) with biopsies suggestive of interstitial cystitis (Canada)
Form: 50% DMSO vs saline into the bladder
Dose: One instillation every 2 weeks
Duration: Two sessions of 4 instillations each (crossover)
Source: Reference 7 · PubMed 3288775 (opens PubMed)

Grade CKnee osteoarthritis pain in older DMSO trials (systematic review)Knee osteoarthritis2 of 4 trials positiveSystematic review · 4 studies
n 681 · 2008

Mixed Two of the four DMSO trials reported significantly better pain outcomes than comparators, but poor methodology (possible unblinding, questionable dose and duration) meant no definitive conclusion could be drawn.

Design: Systematic review, 4 studies, n = 681, 2008
Population: People with knee osteoarthritis in 4 randomized DMSO trials (297 on active DMSO)
Form: Topical DMSO (various preparations)
Dose: As given in each trial
Duration: Varied by trial
Source: Reference 25 · PubMed 18417375 (opens PubMed)

Grade CHerpes zoster course with idoxuridine carried in DMSO vs oral acyclovirCarrier formulationsBetter on 7 of 14 measuresRCT
n 171 · 1992

Improved The idoxuridine-in-DMSO group (85) did better than the acyclovir group (86) on 7 of 14 measures, including time to vesicle drying, last day of moderate-to-severe pain and last day of analgesic use.

Design: RCT, n = 171, 1992
Population: Adults with herpes zoster of less than 4 days' duration (Spain, multicentre)
Form: 40% idoxuridine in DMSO on the skin vs oral acyclovir (double-dummy)
Dose: Topical solution for 4 days; tablets for 7 days
Duration: Until resolution
Source: Reference 28 · PubMed 1560699 (opens PubMed)

Grade CCRPS type 1 impairment: DMSO cream vs N-acetylcysteineCRPS type 1Similar to NAC overallRCT
n 146 · 2003

Mixed No overall difference between DMSO and NAC in impairment or general health at 17 and 52 weeks. Lower-limb function subscores favoured DMSO; DMSO did better in warm CRPS and NAC in cold CRPS.

Design: RCT, n = 146, 2003
Population: Outpatients with CRPS type 1 at two Dutch university hospitals
Form: DMSO 50% cream vs N-acetylcysteine 600 mg tablets (double-dummy)
Dose: DMSO cream five times daily to the affected limb; NAC three times daily
Duration: 17 weeks (follow-up to 52 weeks)
Source: Reference 14 · PubMed 12670672 (opens PubMed)

Grade CInterstitial cystitis symptoms: DMSO mix vs a bupivacaine, triamcinolone and heparin mixInterstitial cystitis63% vs 43% responders (n.s.)RCT
n 70 · 2023

Mixed A fall of more than 29.5% in the symptom index occurred in 63% with DMSO vs 43% with BTH (p = 0.15, not significant). Pain and night-time urination fell significantly more with DMSO; bladder capacity rose in both groups.

Design: RCT, n = 70, 2023
Population: Women with newly diagnosed interstitial cystitis/painful bladder syndrome (USA); 83 randomized, 70 completed all instillations
Form: DMSO with triamcinolone vs bupivacaine, triamcinolone and heparin (BTH)
Dose: Six weekly bladder instillations
Duration: 6 weeks
Source: Reference 11 · PubMed 36747494 (opens PubMed)

Grade CPain in reflex sympathetic dystrophy (open study)CRPS type 1VAS 5.3 → 0.9Open-label trial
n 37 · 1993

Improved Pain (VAS 0 to 10) fell from 5.3 to 0.9 (p < 0.01). Twelve patients noticed a sulfurous smell on the breath; the skin became mildly dry and scaly.

Design: Open-label trial, n = 37, 1993
Population: Patients with acute signs of reflex sympathetic dystrophy (Netherlands)
Form: DMSO 50% in a fatty cream base
Dose: Applied to the affected limb, with physiotherapy
Duration: Mean 3.4 months
Source: Reference 17 · PubMed 8455741 (opens PubMed)

Grade CCRPS type 1 signs and pain (acute reflex sympathetic dystrophy)CRPS type 1Better CRPS score vs placebo creamRCT
n 31 · 1996

Improved Both groups improved on the RSD score and pain (VAS), but the RSD score improved significantly more with DMSO cream (P < 0.01).

Design: RCT, n = 31, 1996
Population: Adults with acute reflex sympathetic dystrophy (CRPS type 1) after an accident (Netherlands); 32 randomized, 1 withdrawn for surgery
Form: DMSO 50% in a fatty cream vs the same cream without DMSO
Dose: Applied to the affected limb, with physiotherapy
Duration: 2 months
Source: Reference 13 · PubMed 8721469 (opens PubMed)

Grade CPain and limb function in CRPS type 1 (hospital series)CRPS type 1VAS −3.09Observational
n 29 · 2012

Improved Pain (VAS) fell by 3.09 points overall, quality-of-life (Likert) rose 1.36 points, and range of motion and strength improved; side effects were scarce.

Design: Observational, n = 29, 2012
Population: Patients with CRPS type 1 of less than 1 year at a traumatology hospital (Valencia, Spain); retrospective
Form: DMSO 50% cream (pharmacy-compounded) added to a stepwise treatment algorithm
Dose: Topical, alongside oral drugs and interventional techniques
Duration: Up to 1 year of follow-up
Source: Reference 18 · PubMed 22266201 (opens PubMed)

Grade CEarly CRPS of the hand: DMSO vs guanethidine nerve blocksCRPS type 1Better than Ismelin blocksRCT
n 26 · 1994

Improved After 9 weeks there was a better result in the DMSO group (13 patients) than the Ismelin group (13 patients).

Design: RCT, n = 26, 1994
Population: Patients with reflex sympathetic dystrophy of the hand, treatment started within 3 months of diagnosis (Netherlands)
Form: DMSO vs regional intravenous guanethidine (Ismelin) blocks
Dose: DMSO cream (dose not given in the abstract)
Duration: 9 weeks
Source: Reference 15 · PubMed 8172505 (opens PubMed)

Grade DGenital herpes symptoms with idoxuridine carried in DMSOCarrier formulationsNo clinical differenceRCT
n 135 · 1982

No effect Viral shedding was shorter with idoxuridine in DMSO, but it had no effect on symptoms, new lesions, healing time or recurrence. Local burning, generalised contact dermatitis and one vulvar carcinoma in situ were reported with idoxuridine in DMSO.

Design: RCT, n = 135, 1982
Population: 96 recurrent and 39 first episodes of genital herpes (USA)
Form: 30% idoxuridine in DMSO vs DMSO alone vs saline
Dose: Four times daily
Duration: 7 days
Source: Reference 27 · PubMed 7047788 (opens PubMed)

Grade DSkin ulceration after chemotherapy extravasationChemotherapy extravasation1 ulcer in 127Open-label trial
n 127 · 1995

Improved Only one patient developed an ulcer. Mild local burning and a characteristic breath odour were the only side effects.

Design: Open-label trial, n = 127, 1995
Population: Patients with extravasation of doxorubicin, epirubicin, mitomycin, mitoxantrone, cisplatin, carboplatin, ifosfamide or fluorouracil (Italy); 144 enrolled, 127 assessable
Form: 99% DMSO on the skin, plus intermittent cooling for the first 3 days
Dose: Every 8 hours over the extravasation site
Duration: 7 days (up to 6 weeks in some patients)
Source: Reference 19 · PubMed 7595748 (opens PubMed)

Grade DHand ulcers in systemic sclerosisSkin ulcersNo difference; skin toxicity at 70%RCT
n 84 · 1985

No effect No significant differences among the three groups in number or area of open ulcers, infected or inflamed ulcers, or pain. Over a quarter of patients on 70% DMSO were withdrawn for significant skin toxicity.

Design: RCT, n = 84, 1985
Population: Patients with systemic sclerosis and digital ulcers (US multicentre)
Form: 70% DMSO vs 2% DMSO vs 0.85% saline
Dose: Topical (schedule not given in this abstract)
Duration: Not stated in this abstract
Source: Reference 32 · PubMed 3884019 (opens PubMed)

Grade DHeel pain in plantar fasciitis with plant terpenes carried in 15% DMSOCarrier formulationsLess heel pain at 10 daysRCT
n 62 · 2024

Improved 78.1% of patients on the active solution reported a 85% or greater fall in Foot Function Index pain score by day 10; placebo had no effect (p < 0.01). No adverse events were reported; 2 per group withdrew because of the smell.

Design: RCT, n = 62, 2024
Population: Adults with plantar fasciitis at a medical practice and a physical therapy clinic, Boise, Idaho, USA
Form: Camphor, menthol, eugenol, eucalyptol and vanillin solution with 15% DMSO, 1% limonene and rosemary oil, vs a tea tree oil in canola oil placebo
Dose: 1 mL on the heel twice daily
Duration: 10 days
Source: Reference 52 · PubMed 39085322 (opens PubMed)

Grade DBiopsy-confirmed clearance of low-risk basal cell carcinoma with ascorbic acid carried in DMSOCarrier formulations86.7% vs 57.1% clearedRCT
n 25 · 2022

Improved Post-treatment biopsy showed complete resolution in 13 of 15 lesions (86.7%) with ascorbic acid in DMSO vs 8 of 14 (57.1%) with imiquimod (p < 0.05); non-inferior at 12 weeks, with fewer adverse effects. Residual hypopigmentation at 30 months: 70% with imiquimod vs 0%.

Design: RCT, n = 25, 2022
Population: 25 patients with 29 biopsy-confirmed low-risk nodular or superficial basal cell carcinomas (Boise, Idaho, USA)
Form: 30% ascorbic acid in 95% DMSO vs imiquimod
Dose: Ascorbic acid solution applied twice daily
Duration: 8 weeks; follow-up to 30 months
Source: Reference 29 · PubMed 35217280 (opens PubMed)

Grade DSkin ulceration after anthracycline extravasationChemotherapy extravasation0 ulcers in 20Open-label trial
n 20 · 1988

Improved No extravasation progressed to ulceration or needed surgery. Side effects were burning on application, itch, redness and mild scaling, blisters in 4 patients and breath odour in 6.

Design: Open-label trial, n = 20, 1988
Population: Patients with anthracycline extravasation (USA); 16 observed for 3 months
Form: 99% DMSO applied to about twice the affected area and left to air-dry
Dose: Every 6 hours
Duration: 14 days, then 3 months of follow-up
Source: Reference 20 · PubMed 3183703 (opens PubMed)

Grade DMacular amyloidosis: CO2 laser plus DMSO vs laser aloneMacular amyloidosisNo added benefitOpen-label trial
n 20 · 2024

No effect Pigmentation, itch and amyloid deposits fell on both sides, with no significant difference between laser plus DMSO and laser alone.

Design: Open-label trial, n = 20, 2024
Population: Patients with macular amyloidosis (Egypt)
Form: Fractional CO2 laser followed by DMSO 50% solution vs laser alone, split lesion
Dose: DMSO after each monthly laser session
Duration: 4 sessions, assessed 3 months after the last
Source: Reference 31 · PubMed 39400574 (opens PubMed)

Grade DPigmentation and itch in macular amyloidosis: DMSO vs tretinoinMacular amyloidosisFaster fading, itch goneRCT
n 18 · 2020

Improved Pigmentation fell faster on the DMSO side (difference in slopes −6.03, 95% CI −12.06 to −0.01; P = .049), and itch cleared on the DMSO side from the first follow-up visit.

Design: RCT, n = 18, 2020
Population: Adults with bilateral primary macular amyloidosis (Iran)
Form: DMSO 50% solution on one side vs tretinoin 0.5% cream on the other
Dose: Applied to the assigned side
Duration: Not stated in the abstract
Source: Reference 30 · PubMed 32160368 (opens PubMed)

No effectKnee osteoarthritis pain and function with DMSO alone (45.5% vehicle)Knee osteoarthritisNo difference vs placeboRCT
n 775 · 2009

No effect No significant difference between the DMSO vehicle and placebo; diclofenac in the same DMSO vehicle beat both for pain, physical function and overall health.

Design: RCT, n = 775, 2009
Population: Adults with radiologically confirmed, symptomatic primary knee osteoarthritis (five-arm trial)
Form: 45.5% w/w DMSO vehicle solution vs placebo solution (2.3% DMSO)
Dose: 40 drops on the knee four times daily
Duration: 12 weeks
Source: Reference 22 · PubMed 19380203 (opens PubMed)

No effectKnee osteoarthritis pain with DMSO alone (vehicle) vs a low-DMSO placeboKnee osteoarthritis−2.5 vs −2.5 pointsRCT
n 248 · 2004

No effect WOMAC pain fell 2.5 points with the DMSO vehicle and 2.5 with the placebo; diclofenac in the DMSO carrier lowered it 3.9 points, more than either.

Design: RCT, n = 248, 2004
Population: Men and women in southern Ontario with primary knee osteoarthritis and at least moderate pain
Form: DMSO-containing carrier without diclofenac vs placebo with a token amount of DMSO
Dose: Applied to the painful knee (three-arm trial)
Duration: 4 weeks
Source: Reference 24 · PubMed 15313991 (opens PubMed)

What the numbers add up to

Each point is worked out from the data and the sources numbered on this page, with the arithmetic shown under it. It adds no new data and is not medical advice.

The carrier, not the active, in the knee trials

In the 775-person trial, WOMAC pain fell 6.0 points with diclofenac in DMSO, 4.7 with the 45.5% DMSO vehicle and 4.7 with placebo: the vehicle added nothing on its own, and the extra 1.3 points came with the diclofenac it carried.^3,22

Grams of DMSO in one bladder instillation

One 50 mL Rimso-50 instillation holds about 27 g of DMSO.¹

Equal volumes of DMSO and water make about 52%, not 50%

DMSO is denser than water, so mixing equal volumes of pure DMSO and water gives about 52% DMSO by weight; equal weights give 50% w/w. This is why a label should say w/w or v/v.¹

Much of the bladder improvement also happened on placebo

In the 96-patient trial the symptom score fell 3.4 points on placebo and 5.2 on DMSO, so about two-thirds of the change seen with DMSO also appeared with placebo; the difference of 1.8 points is DMSO's added effect.⁸

Ulcer rate after extravasation

With 99% DMSO and cooling, 1 of 127 assessable patients (0.8%) developed an ulcer; there was no untreated comparison group.¹⁹

The skin cancer result in absolute terms

Ascorbic acid in DMSO cleared 29.6 percentage points more lesions than imiquimod at 8 weeks, but the comparison rests on 15 and 14 lesions.²⁹

Studied doses

Doses used in research, shown against the official limits. They describe the studies, not a recommendation for you.

Studied doses in research, not advice. These are amounts used in research, not personal advice. Your clinician or pharmacist can say what fits you.

Doses studied in human trials

Doses studied in human trials ranged from 2% DMSO control solutions to 99% DMSO liquid. Trials used 50% cream on the affected limb five times a day for CRPS type 1 (2 to 17 weeks), 50% solution instilled into the bladder every 2 weeks for interstitial cystitis, 99% liquid on the skin every 6 to 8 hours for 7 to 14 days after chemotherapy extravasation, 45.5% DMSO as the vehicle in diclofenac solution four times a day for 12 weeks, and 95% DMSO as the solvent for 30% ascorbic acid twice a day for 8 weeks. These are research preparations, not product directions.^{32,13,14,8,19,20,22,29}

When trials measured an effect

5 outcomes

How long trials ran before effects were measured
Outcome	Measured at	Basis
Interstitial cystitis symptoms	Week 12 (primary endpoint), after instillations every 2 weeks	Placebo-controlled trial in 96 patients⁸
CRPS type 1 score	2 months (placebo trial); 17 weeks (vs NAC)	Dutch randomized trials^13,14
Extravasation site	Applied for 7 to 14 days; followed up to 3 months	Two uncontrolled studies^19,20
Basal cell carcinoma lesions (with ascorbic acid)	Biopsy at 8 weeks; checked again at 12 weeks and 30 months	One trial of 29 lesions²⁹
Knee osteoarthritis (DMSO alone)	No difference from placebo at 4 or 12 weeks	Vehicle arms of two diclofenac trials^24,22

Interactions and safety

Published interactions only: each row cites a source. No row means none was found in our sources, not that a combination is safe.

What DMSO meets

4 cited rows 1 tested together

Medicines 4

DMSO4 medicines · 1 supplement

Supplements and foods 1

Drug label or FDA notice
Reference summary
Case reports
Tested together in a graded trial

Also cited: 1 tested together

Any medicine taken during DMSO therapy
- Drug labelDrug label or FDA notice
  Any medicine taken during DMSO therapy, for example Medicines taken by mouth or applied to the skin: The Rimso-50 label says some data indicate DMSO potentiates other concomitantly administered medications and asks patients to tell their physician every medicine and dose they take.
  Source 1, Mylan Institutional LLC via DailyMed (NLM) (2021)
Other products on the same skin
- Drug labelDrug label or FDA notice
  Other products on the same skin, for example Sunscreen, insect repellent, lotion, moisturiser, cosmetics, other topical medicines: DMSO is a penetration enhancer, and the diclofenac-in-DMSO label says to wait until the treated area is completely dry before applying any of these to the same skin.
  Source 3, DailyMed (NLM) (2010); Source 38, Adv Drug Deliv Rev (2004)
Dexrazoxane (for anthracycline extravasation)
- ReviewReference summary
  Dexrazoxane (for anthracycline extravasation), for example Dexrazoxane infusion after a doxorubicin or epirubicin leak: A 2009 Prescrire review says combining dexrazoxane with DMSO is contraindicated, based on animal studies.
  Source 21, Prescrire Int (2009)
Sulindac
- Case reportCase reports
  Sulindac, for example Clinoril: A 63-year-old man on sulindac 200 mg twice daily developed a severe sensorimotor peripheral neuropathy after starting 90% DMSO on his arms and legs, with incomplete recovery; a 1985 review notes neurotoxic interactions with sulindac have been reported.
  Source 43, Arch Phys Med Rehabil (case report) (1982); Source 35, Rev Clin Basic Pharm (1985)
Vitamin CVitamin C page
- Tested together
  Biopsy-confirmed clearance of low-risk basal cell carcinoma with ascorbic acid carried in DMSO. Graded on the DMSO page; tested together is not a claim that they work better together.

Interactions

4 agents

Published interactions, grouped by kind
Agent	What the source says	Evidence
Medicines4
Any medicine taken during DMSO therapye.g. Medicines taken by mouth or applied to the skin	The Rimso-50 label says some data indicate DMSO potentiates other concomitantly administered medications and asks patients to tell their physician every medicine and dose they take.¹	Drug label
Other products on the same skine.g. Sunscreen, insect repellent, lotion, moisturiser, cosmetics, other topical medicines	DMSO is a penetration enhancer, and the diclofenac-in-DMSO label says to wait until the treated area is completely dry before applying any of these to the same skin.^3,38	Drug label
Sulindace.g. Clinoril	A 63-year-old man on sulindac 200 mg twice daily developed a severe sensorimotor peripheral neuropathy after starting 90% DMSO on his arms and legs, with incomplete recovery; a 1985 review notes neurotoxic interactions with sulindac have been reported.^43,35	Case report
Dexrazoxane (for anthracycline extravasation)e.g. Dexrazoxane infusion after a doxorubicin or epirubicin leak	A 2009 Prescrire review says combining dexrazoxane with DMSO is contraindicated, based on animal studies.²¹	Review

Check with what you take

Kept on this device only

Add what you take. We list every interaction our evidence profiles cite between DMSO and your picks, and between your picks.

Add a supplement or medicine

Most cited:

Add a supplement or medicine you take to check it against DMSO.

Starting from one medicine? The interaction checker rates how serious each pair is, on a curated list of 19 entries for 11 medicines. This cabinet has no severity rating: it lists every interaction row our supplement pages cite.

Who should be careful

9 groups

Pregnancy: High doses caused birth defects in several animal species; there are no adequate studies in pregnant women, and the Rimso-50 label says it should be used in pregnancy only if the benefit justifies the risk.^1,3
Breastfeeding: LactMed reports milk levels from one mother given 50 mL of 50% DMSO into the bladder: milk DMSO peaked at 34.5 mg/L at 5 hours, an estimated 0.45% of the mother's weight-adjusted dose; its metabolite and any effect on milk odour were not measured. Up to about 16% of a bladder dose is absorbed versus about 70% of an oral dose, so this does not apply to oral use. The label advises caution while nursing.^50,1
Children: Safety and effectiveness in children have not been established (Rimso-50 label).¹
Eyes, nose and mouth: Keep DMSO products out of the eyes and mucous membranes; if eye contact occurs, the diclofenac-in-DMSO label says to wash the eye with water or saline and see a doctor if irritation lasts more than an hour. High doses changed the lens in some animals, so the Rimso-50 label asks for eye exams before and during treatment; in 46 people examined after 12 weeks of 70% DMSO or controls, no lens changes were found.^3,1,33
Broken or damaged skin: The diclofenac-in-DMSO label says not to apply it to open wounds; anything on or in broken skin can be carried in with the DMSO.^3,38
Bladder or urinary tract cancer: The Rimso-50 label says bladder instillation may be harmful in urinary tract malignancy because of DMSO-induced vasodilation.¹
People on sulindac or several medicines: A peripheral neuropathy followed topical DMSO in a man taking sulindac, and the label says DMSO may potentiate other medicines; list every medicine before using it.^43,1
Sensitive skin and high concentrations: Skin reactions are the most common side effect and are related to dose; in one trial over a quarter of patients on 70% DMSO were withdrawn for skin toxicity, and a 2023 review of local treatments for scleroderma ulcers noted significant local toxicity with DMSO.^34,32,48
Allergy or hypersensitivity: DMSO can release histamine, and occasional hypersensitivity reactions have been reported with topical use (Rimso-50 label).¹

The carrier effect, in practice

8 notes

DMSO carries other molecules through skin. That is why drug makers use it, and why the handling rules matter.

What the trials show: Diclofenac carried in DMSO beat the same DMSO vehicle in knee osteoarthritis trials of 326, 775 and 248 people, while the vehicle alone matched placebo. Idoxuridine in DMSO shortened pain by 1.3 days and time to crust loss by 1.7 days vs DMSO controls in 301 people with herpes labialis.^23,22,24,26
Approved uses as a carrier: DMSO is the penetration enhancer in US diclofenac topical solution and was used in an idoxuridine solution approved in Europe for herpes zoster.^39,3
How it gets through: Penetration enhancers such as DMSO disrupt the packed lipids between skin cells, interact with keratin and act as a solvent for the drug inside the skin.³⁸
It carries whatever is there: Reviews describe combinations of DMSO with other toxic agents as its greatest toxic potential, and the safety of DMSO with other drugs as not established. The purity of the DMSO and everything mixed with it or already on the skin count.^36,35
Clean, dry skin and clean hands: The diclofenac-in-DMSO label directs application to clean, dry skin and hand washing after use.³
Let it dry before anything else: The same label says to wait until the area is completely dry before covering it with clothing or applying sunscreen, insect repellent, lotion, cosmetics or another topical medicine, and not to use heat or occlusive dressings over it.³
A carried drug brings its own side effects: In a genital herpes trial, idoxuridine in DMSO caused local burning and generalised contact dermatitis; the diclofenac solution carries diclofenac's warnings as well as DMSO's.^27,3
Glass or plastic containers: We found no human study or drug label that compares containers for DMSO, so this page makes no claim either way; pure DMSO absorbs water from the air, so a closed container keeps its concentration.³⁶

Regulatory status

5 notes

DMSO is an approved prescription drug, an approved veterinary drug, a drug ingredient and a widely sold solvent.

Human drug: Rimso-50 (dimethyl sulfoxide 50% w/w solution, intravesical) was approved on April 4, 1978 (NDA 017788) and is labelled for symptomatic relief of interstitial cystitis. Drugs@FDA lists a therapeutically equivalent generic 50% intravesical solution (ANDA 220173).^2,1
Drug ingredient: Prescription diclofenac sodium topical solutions (1.5% and 2%) contain DMSO 45.5% w/w as an inactive ingredient.^3,4
Veterinary drug: Domoso (Zoetis, NADA 032-168) contains 90% DMSO and is approved by prescription for horses (up to 100 mL a day for 30 days) and dogs (up to 20 mL a day for 14 days) to reduce acute swelling due to trauma.^6,5
Solvent and consumer products: DMSO is widely available in the USA as a solvent, and DMSO-branded creams are sold over the counter; because these are not the approved drug, the grade and ingredient list on the label matter.^35,44
Clinical guidelines: The 2022 American Urological Association guideline groups interstitial cystitis care into behavioural, oral, bladder-instillation, procedural and surgical options; the Dutch CRPS-1 guideline advises a free-radical scavenger (DMSO or acetylcysteine) for inflammatory symptoms.^12,16

How the body handles DMSO

4 notes

It is absorbed quickly and leaves as two metabolites, one of them MSM.

Absorption: DMSO is absorbed rapidly through the skin or by mouth and is distributed in tissues and body fluids.^34,1
Metabolites: It is oxidised to dimethyl sulfone (MSM) or reduced to dimethyl sulfide. DMSO and dimethyl sulfone leave in urine and faeces; dimethyl sulfide leaves through the breath and skin.¹
Why the garlic smell: Dimethyl sulfide, the volatile metabolite, gives the garlic- or oyster-like odour; it can last up to 72 hours after a bladder dose.^34,1
Persistence: Dimethyl sulfone can persist in serum for longer than two weeks after a single bladder instillation, but no residual build-up of DMSO has been seen with long use.¹

Side effects on record

6 notes

Taste and odour: A garlic-like taste within minutes that can last hours, and breath and skin odour for up to 72 hours (Rimso-50 label); breath odour was reported in 12 of 37 cream users and 6 of 20 extravasation patients.^1,17,20
Skin: Burning on application, itch, redness, dryness and scaling are the usual skin effects; blisters occurred in 4 of 20 people using 99% DMSO.^20,17,19
Bladder instillation: Moderately severe discomfort that usually lessens with repeat instillations, and transient chemical cystitis; pooled adverse events across studies were 37.6%, mostly mild.^1,9
Dose matters: A review of 109 studies found gastrointestinal and skin reactions most common, mostly transient, and related to the dose of DMSO.³⁴
Infusion reactions: Flushing was reported in 204 of 1,439 infusions of stem cells frozen in DMSO; DMSO can release histamine, which may explain flushing and breathing or heart reactions.³⁴
A case of toxicity: A hospital pharmacy in Barcelona reported a case of toxicity after topical DMSO used as an extravasation antidote.⁴⁵

Eyes and the lens question

3 notes

Animal findings: High chronic doses changed lens refraction and caused lens opacities in monkeys, dogs and rabbits; another label notes no ocular abnormalities in rhesus monkeys given daily DMSO for 9 to 18 months.^1,3
What the label asks: Because of the animal findings, the Rimso-50 label recommends full eye examinations, including slit lamp, before and periodically during treatment, plus blood tests about every six months.¹
Human data: In 46 people with scleroderma examined before and after 12 weeks of 70% or 2% DMSO or saline, no lens changes were found.³³

A short history

5 notes

Origin: DMSO is a by-product of the wood-pulp and paper industry.^35,42
1964: The first medical report on DMSO as a drug was published in 1964; Stanley W. Jacob, a surgeon at Oregon Health & Science University, co-wrote it with Bischel and Herschler.^34,46,41
1965: A year later, use in humans was stopped after animal studies showed lens changes; it resumed later because the effect was only shown in animals.³⁴
1978: Rimso-50 was approved for interstitial cystitis on April 4, 1978.²
Cryopreservation: DMSO protects cells during freezing by reducing osmotic stress and dehydration, which lets stem cells be stored for years.^34,37

How to read the label

What to check on the Supplement Facts panel.

How to read the label

5 checks

Concentration and its basis

Look for the percentage and whether it is by weight (w/w) or volume (v/v). Rimso-50 is 50% w/w, which is 0.54 g of DMSO in each mL.¹

Grade

The approved drug is labelled USP, sterile and non-pyrogenic. DMSO is also widely sold as a solvent, and a solvent label makes no such claims.^1,35

Is DMSO the active ingredient?

Some over-the-counter creams named DMSO list menthol as the active ingredient and DMSO among the inactive ingredients, with no DMSO percentage.⁴⁴

Everything else in the bottle

Read the full ingredient list: DMSO's greatest toxic potential is in combination with other agents, and it can carry them through the skin.^36,38

Storage

DMSO melts at 18.3 °C, so it can turn solid in a cool room; pure DMSO pulls in water from the air. The Rimso-50 label says store at 20 to 25 °C and protect from strong light.^1,36

Frequently asked questions

Short answers to common questions; the numbers link to the sources below.

Common questions

8 answers

Is DMSO FDA-approved?

Yes. Rimso-50, a 50% DMSO solution placed in the bladder, was approved on April 4, 1978 for symptomatic relief of interstitial cystitis. DMSO is also an approved veterinary drug (Domoso) and the inactive penetration enhancer in prescription diclofenac solution. Other DMSO is sold as a solvent or in consumer products, which is why the grade on the label matters.^2,1,5,3,35

Does DMSO carry other substances through the skin?

Yes. That is its main use in medicines: diclofenac carried in DMSO beat the DMSO vehicle alone in knee arthritis trials. It also means anything on the skin or mixed into the product can be carried in, so the diclofenac label calls for clean, dry skin and waiting until it dries before other products.^22,23,3,38

Is it safe to drink DMSO?

Drinking DMSO is not an approved or established use. No DMSO product is FDA-approved to be swallowed: the only approved human drug, Rimso-50, is instilled into the bladder by a clinician. About 70% of an oral dose is absorbed, versus up to about 16% from the bladder. A systematic review of 109 studies found gastrointestinal and skin reactions were the commonest adverse reactions, rising with dose.^2,1,50,34

Is DMSO safe on the skin?

Most reactions are mild and short-lived, such as burning, itch, redness and dryness, and they rise with concentration. In one trial over a quarter of people on 70% DMSO stopped for skin toxicity. Keep it out of the eyes and off open wounds.^34,32,3

What is the difference between pharmaceutical and industrial DMSO?

The approved drug is USP-grade, sterile and non-pyrogenic, made to a set concentration. Solvent DMSO is sold for other purposes without those assurances. Because DMSO carries what is in it through the skin, its purity matters more than for most ingredients.^1,35,36

Is DMSO the same as MSM?

No. MSM is dimethyl sulfone, one of the two compounds the body makes from DMSO. MSM is taken by mouth as a joint supplement; DMSO is mostly used on the skin or in the bladder.¹

Why does DMSO make my breath smell like garlic?

Part of the DMSO is changed into dimethyl sulfide, a volatile compound that leaves through the breath and skin. The label describes a garlic-like taste within minutes and an odour that can last up to 72 hours.^1,34

How is DMSO used for interstitial cystitis?

Per the Rimso-50 label, 50 mL is instilled into the bladder by catheter, held for about 15 minutes and then voided, repeated every two weeks until symptoms improve most, then spaced out. It is a prescription procedure done by a clinician.¹

Sources

51 sources: trial abstracts, NIH fact sheets and reference databases. Numbers in the text link here.

Sources cited on this page

51 sources

1RIMSO-50 (dimethyl sulfoxide) irrigant: prescribing informationLabel Mylan Institutional LLC via DailyMed (NLM), 2021 · dailymed.nlm.nih.gov
2Drugs@FDA: NDA 017788, RIMSO-50 (dimethyl sulfoxide) 50% solution, intravesical; original approval 04/04/1978Database U.S. Food and Drug Administration, 1978 · accessdata.fda.gov
3PENNSAID (diclofenac sodium topical solution) 1.5% w/w: prescribing informationLabel DailyMed (NLM), 2010 · dailymed.nlm.nih.gov
4Diclofenac sodium topical solution USP, 2% w/w: prescribing informationLabel DailyMed (NLM), 2026 · dailymed.nlm.nih.gov
521 CFR 524.660 Dimethyl sulfoxide (conditions of use in horses and dogs)Guideline Electronic Code of Federal Regulations, 2014 · ecfr.gov
6Animal Drugs @ FDA: NADA 032-168, Domoso Solution (dimethyl sulfoxide), Zoetis Inc.Database FDA Center for Veterinary Medicine, 2026 · animaldrugsatfda.fda.gov
7A controlled study of dimethyl sulfoxide in interstitial cystitis.Crossover RCT J Urol, 1988 · PMID 3288775
8Efficacy and safety of intravesical instillation of KRP-116D (50% dimethyl sulfoxide solution) for interstitial cystitis/bladder pain syndrome in Japanese patients: A multicenter, randomized, double-blind, placebo-controlled, clinical study.RCT Int J Urol, 2021 · PMID 33580603
9The Efficacy and Safety of Dimethyl Sulfoxide Into the Bladder for the Treatment of Interstitial Cystitis/Bladder Pain Syndrome: A Systematic Review and Meta-Analysis.Meta-analysis Neurourol Urodyn, 2025 · PMID 40205912
10Dimethyl sulfoxide (DMSO) as intravesical therapy for interstitial cystitis/bladder pain syndrome: A review.Systematic review Neurourol Urodyn, 2017 · PMID 28220525
11A prospective, randomized trial comparing intravesical dimethyl sulfoxide (DMSO) to bupivacaine, triamcinolone, and heparin (BTH), for newly diagnosed interstitial cystitis/painful bladder syndrome (IC/PBS).RCT Neurourol Urodyn, 2023 · PMID 36747494
12Diagnosis and Treatment of Interstitial Cystitis/Bladder Pain Syndrome.Guideline J Urol (American Urological Association guideline), 2022 · PMID 35536143
13Treatment of acute reflex sympathetic dystrophy with DMSO 50% in a fatty cream.RCT Acta Anaesthesiol Scand, 1996 · PMID 8721469
14The treatment of complex regional pain syndrome type I with free radical scavengers: a randomized controlled study.RCT Pain, 2003 · PMID 12670672
15Reflex sympathetic dystrophy: early treatment and psychological aspects.RCT Arch Phys Med Rehabil, 1994 · PMID 8172505
16Evidence based guidelines for complex regional pain syndrome type 1.Guideline BMC Neurol, 2010 · PMID 20356382
17[Good results of treatment of reflex sympathetic dystrophy with a 50% dimethylsulfoxide cream].Open-label trial Ned Tijdschr Geneeskd, 1993 · PMID 8455741
18[Efficacy of a topical treatment protocol with dimethyl sulfoxide 50% in type 1 complex regional pain syndrome].Observational Farm Hosp, 2012 · PMID 22266201
19Topical dimethylsulfoxide for the prevention of soft tissue injury after extravasation of vesicant cytotoxic drugs: a prospective clinical study.Open-label trial J Clin Oncol, 1995 · PMID 7595748
20A prospective study of topical dimethyl sulfoxide for treating anthracycline extravasation.Open-label trial J Clin Oncol, 1988 · PMID 3183703
21Dexrazoxane: new indication. Anthracycline extravasation: continue using dimethyl sulfoxide.Review Prescrire Int, 2009 · PMID 19382398
22Efficacy and safety of topical diclofenac containing dimethyl sulfoxide (DMSO) compared with those of topical placebo, DMSO vehicle and oral diclofenac for knee osteoarthritis.RCT Pain, 2009 · PMID 19380203
23Efficacy and safety of a topical diclofenac solution (pennsaid) in the treatment of primary osteoarthritis of the knee: a randomized, double-blind, vehicle-controlled clinical trial.RCT Arch Intern Med, 2004 · PMID 15477437
24Effect of a topical diclofenac solution for relieving symptoms of primary osteoarthritis of the knee: a randomized controlled trial.RCT CMAJ, 2004 · PMID 15313991
25Systematic review of the nutritional supplements dimethyl sulfoxide (DMSO) and methylsulfonylmethane (MSM) in the treatment of osteoarthritis.Systematic review Osteoarthritis Cartilage, 2008 · PMID 18417375
26Early application of topical 15% idoxuridine in dimethyl sulfoxide shortens the course of herpes simplex labialis: a multicenter placebo-controlled trial.RCT J Infect Dis, 1990 · PMID 2153736
27Ineffectiveness of topical idoxuridine in dimethyl sulfoxide for therapy for genital herpes.RCT JAMA, 1982 · PMID 7047788
28[A topical solution of 40% idoxuridine in dimethyl sulfoxide compared to oral acyclovir in the treatment of herpes zoster. A double-blind multicenter clinical trial].RCT Med Clin (Barc), 1992 · PMID 1560699
29Randomized trial of topical ascorbic acid in DMSO versus imiquimod for the treatment of basal cell carcinoma.RCT Biomed Pharmacother, 2022 · PMID 35217280
30Efficacy of topical dimethyl sulfoxide (DMSO) 50% solution vs tretinoin 0.5% cream in treatment of patients with primary macular amyloidosis: A split-side single-blinded randomized clinical trial.RCT Dermatol Ther, 2020 · PMID 32160368
31Combined fractional CO(2) laser with dimethyl sulfoxide (DMSO) 50% versus fractional CO(2) Laser alone in the treatment of macular amyloidosis: clinical and histopathological assessment.Open-label trial Arch Dermatol Res, 2024 · PMID 39400574
32Double-blind, multicenter controlled trial comparing topical dimethyl sulfoxide and normal saline for treatment of hand ulcers in patients with systemic sclerosis.RCT Arthritis Rheum, 1985 · PMID 3884019
33Lack of ocular changes with dimethyl sulfoxide therapy of scleroderma.RCT Pharmacotherapy, 1989 · PMID 2755866
34Adverse reactions of dimethyl sulfoxide in humans: a systematic review.Systematic review F1000Res, 2018 · PMID 31489176
35Medical use of dimethyl sulfoxide (DMSO).Review Rev Clin Basic Pharm, 1985 · PMID 3916302
36Dimethyl sulfoxide (DMSO): a review.Review Cornell Vet, 1986 · PMID 3510103
37Multidisciplinary utilization of dimethyl sulfoxide: pharmacological, cellular, and molecular aspects.Review Biochem Pharmacol, 2003 · PMID 12663039
38Penetration enhancers.Review Adv Drug Deliv Rev, 2004 · PMID 15019749
39Dimethyl sulfoxide: an effective penetration enhancer for topical administration of NSAIDs.Review Phys Sportsmed, 2011 · PMID 22030943
40Pharmacology of DMSO.Review Cryobiology, 1986 · PMID 3007027
41Pharmacology of dimethyl sulfoxide in cardiac and CNS damage.Review Pharmacol Rep, 2009 · PMID 19443933
42Dimethyl sulfoxide (DMSO): a solvent that may solve selected cutaneous clinical challenges.Review Arch Dermatol Res, 2023 · PMID 36459193
43Peripheral neuropathy after concomitant dimethyl sulfoxide use and sulindac therapy.Observational Arch Phys Med Rehabil (case report), 1982 · PMID 6291491
44Easment DMSO cream (menthol 1.00%): drug facts labelLabel DailyMed (NLM), 2026 · dailymed.nlm.nih.gov
45Toxicity to topical dimethyl sulfoxide (DMSO) when used as an extravasation antidote.Observational Pharm World Sci (case report), 2002 · PMID 12426960
46DIMETHYL SULFOXIDE (DMSO): A NEW CONCEPT IN PHARMACOTHERAPY. Jacob SW, Bischel M, Herschler RJ. Curr Ther Res Clin Exp (PubMed record; no abstract)Database PubMed, 1964 · PMID 14135298
48Non-surgical local treatments of digital ulcers in systemic sclerosis: a systematic literature review.Systematic review Semin Arthritis Rheum, 2023 · PMID 37778090
49Topical Vitamin C in the Prevention and Treatment of Actinic Keratoses and Nonmelanoma Skin Cancers: A Systematic Scoping Review.Systematic review Dermatol Surg, 2026 · PMID 41052296
50Dimethyl SulfoxideDatabase LactMed (NCBI Bookshelf), 2026 · ncbi.nlm.nih.gov
51Interventions for treating pain and disability in adults with complex regional pain syndrome- an overview of systematic reviews.Systematic review Cochrane Database Syst Rev, 2023 · PMID 37306570
52Randomized placebo controlled trial of phytoterpenes in DMSO for the treatment of plantar fasciitis.RCT Sci Rep, 2024 · PMID 39085322

What changed

Every dated change to this page: what changed, who made it and why.

Change log

4 entries

Dated changes to this page
Date	Change	Who and why
Oct 21, 2026evidence, key facts, who should avoid, FAQ, questions, related	Added the LactMed entry (2026: milk levels in one mother after a bladder instillation) to the breastfeeding note, a 2023 Cochrane overview of CRPS treatments (DMSO vs N-acetylcysteine evidence rated low certainty) to the CRPS key fact and row notes, and a 2024 placebo-controlled trial of a terpene formula carried in 15% DMSO for plantar fasciitis (62 people, grade D). Trimmed the FAQ from 14 to 8 items: questions already answered by the evidence table and safety notes moved to page questions, the eye-lens findings moved into the eyes safety note, and the skin-cancer scoping review into a key fact; added an FAQ on drinking DMSO (not approved for oral use). Kept the RIMSO-50 framing as the only FDA-approved human use. LiverTox has no DMSO entry. Searched PubMed for 2023–2026 DMSO meta-analyses and RCTs: the 2025 interstitial cystitis meta-analysis is already in the table; the rest were dental, cryopreservation or embolization studies. Checked interactions: none new.	Writer: Kymata Health EditorialTrigger: A–Z audit against docs/supplements/AUDIT-STANDARD.md
Oct 20, 2026Where we buy	Removed the "Where we buy" card for Bella Bleu Naturals. Its line "We don't earn from Bella Bleu Naturals" stopped being true on 2026-10-20, when we began earning a commission on links to its shop. Its DMSO products, with sizes, prices, ingredients and our disclosures, are now on the Bella Bleu Naturals spotlight, linked under Related.	Writer: Kymata Health EditorialTrigger: Disclosure update
Oct 20, 2026related	Added a related link to the methylene blue page.	Writer: Kymata Health EditorialTrigger: methylene blue page rebuilt
Oct 19, 2026all	New page. Every PMID checked with NCBI E-utilities (esummary title, year and journal) and its abstract read with efetch; open full texts read in PMC where cited for details (Dutch CRPS guideline, DMSO adverse-reaction review). Regulatory facts read on Drugs@FDA (NDA 017788), Animal Drugs @ FDA (NADA 032-168), 21 CFR 524.660 on eCFR, and the Rimso-50, diclofenac solution and consumer cream labels on DailyMed on the date shown. The 1964 Jacob record has no abstract and is cited for authorship and date only. Diclofenac-vs-vehicle and idoxuridine-vs-DMSO-control trials measure the drug DMSO carries, so they appear in the carrier section rather than as graded DMSO outcomes.	Writer: Kymata Health EditorialTrigger: new page

Supplement & Nutrient Encyclopedia. Educational information only; it is not medical advice and does not replace a clinician. DMSO is not a dietary supplement: it is a prescription drug or drug ingredient and is also sold as a solvent. This page summarizes published studies and drug labels; it is not a guide to using any product.

DMSO (dimethyl sulfoxide)

Medicines 4

Supplements and foods 1

Any medicine taken during DMSO therapy

Other products on the same skin

Dexrazoxane (for anthracycline extravasation)

Sulindac

Vitamin CVitamin C page