Dimethyl Sulfoxide (DMSO): A Review of Its Therapeutic Potential and Safety Profile (2025)

Abstract:

Dimethyl sulfoxide (DMSO) is an organosulfur compound with unique pharmacokinetic and pharmacodynamic properties. Originally utilized as an industrial solvent, DMSO has gained recognition for its therapeutic potential, particularly in pain management, inflammation reduction, and tissue healing. Despite its broad spectrum of biological activities, regulatory challenges have limited its widespread clinical adoption. This review aims to provide a comprehensive evaluation of DMSO's pharmacological mechanisms, clinical applications, safety profile, and regulatory status to elucidate its potential role in modern medicine.

Introduction:

DMSO was first synthesized in 1866 and later identified for its distinctive ability to penetrate biological membranes. By the mid-20th century, researchers began investigating its pharmacological benefits, leading to its approval for limited medical applications. Despite promising therapeutic effects, controversies and regulatory constraints have hindered its full clinical integration. This review examines the available evidence on DMSO's efficacy, mechanisms of action, and safety considerations.

Pharmacological Properties

1. Membrane Permeability and Drug Carrier Potential: 
   DMSO’s ability to traverse lipid membranes allows it to serve as a vehicle for drug delivery. This property facilitates the transdermal absorption of various pharmaceuticals, improving their bioavailability.
2. Analgesic and Anti-Inflammatory Effects: 
   DMSO’s analgesic properties are attributed to its modulation of peripheral and central nociceptive pathways. It inhibits pro-inflammatory cytokines such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), reducing inflammation and associated pain. Additionally, DMSO can block sodium and calcium channels, altering pain transmission.
3. Antioxidant Activity: 
   DMSO exhibits free radical scavenging properties, mitigating oxidative stress-induced cellular damage. This mechanism has implications for neuroprotection and wound healing.
4. Antimicrobial and Antiviral Properties: 
   Preliminary research indicates that DMSO possesses antimicrobial effects against certain bacterial and fungal strains. Its potential antiviral applications, particularly in mitigating viral replication, warrant further investigation.

Clinical Applications:

1. Pain Management
   DMSO has been extensively studied for its role in managing acute and chronic pain conditions. In a clinical trial involving patients with complex regional pain syndrome (CRPS), DMSO application resulted in significant pain relief and functional improvement. It has also been used to treat interstitial cystitis, with studies indicating its effectiveness in reducing bladder pain and urinary urgency.

2. Musculoskeletal Disorders
   DMSO has demonstrated efficacy in treating musculoskeletal conditions, including osteoarthritis, rheumatoid arthritis, and tendonitis. A randomized controlled trial comparing a DMSO-based diclofenac solution to traditional NSAID gels found superior pain relief and joint mobility in the DMSO-treated group. Additionally, DMSO has been used as an adjunct therapy in sports injuries to accelerate healing and reduce inflammation.

3. Wound Healing and Dermatological Applications
   DMSO enhances wound healing by reducing inflammation, promoting angiogenesis, and preventing bacterial infections. Studies have reported its benefits in treating burns, pressure ulcers, and diabetic foot wounds. Its ability to enhance drug absorption has also been leveraged in transdermal drug formulations for dermatological conditions such as psoriasis and eczema.

4. Neuroprotective Effects
   Emerging research suggests that DMSO may have neuroprotective benefits in conditions such as traumatic brain injury (TBI) and stroke. Animal studies indicate that DMSO can reduce brain edema, improve cerebral blood flow, and mitigate neuronal damage. Further research is needed to explore its potential in neurodegenerative diseases such as Alzheimer’s and Parkinson’s.

5. Cryopreservation and Organ Transplantation
   DMSO is widely used as a cryoprotectant in the preservation of stem cells, sperm, and tissues for transplantation. Its ability to prevent ice crystal formation during freezing has been instrumental in regenerative medicine and organ storage.

Safety Profile:

DMSO is generally well-tolerated, but its use is associated with several side effects, including:

• Mild to Moderate Reactions: Garlic-like odor, skin irritation, nausea, and headache.

• Serious Adverse Effects: Rare cases of hemolysis, renal toxicity, and central nervous system disturbances have been reported at high doses.

• Regulatory Status: While DMSO is FDA-approved for the treatment of interstitial cystitis, its broader clinical applications remain limited due to regulatory constraints and concerns over quality control in commercially available formulations.

Discussion:

Despite its well-documented pharmacological benefits, DMSO remains underutilized in mainstream medicine. Regulatory hurdles, lack of standardized clinical guidelines, and limited awareness among healthcare providers contribute to its restricted use. The potential for DMSO as a transdermal drug carrier further underscores its value in pharmaceutical development.

Conclusion

DMSO presents a promising therapeutic agent with diverse applications in pain management, musculoskeletal injuries, wound healing, and neuroprotection. Its unique pharmacological properties, combined with a favorable safety profile, warrant further investigation. Large-scale, randomized clinical trials are needed to establish standardized treatment protocols and expand its clinical indications.

References

1. Rosenbaum WM, Rosenbaum EE, Jacob SW. The use of dimethylsulfoxide (DMSO) for the treatment of intractable pain in surgical patients. Surgery. 1965;58(1):258-266.

2. Kumar NS, Chacko A, Jimshad MI, Srinivas GY, Tamilselvan A. Improvement in pain relief using a DMSO-based diclofenac in comparison to conventional diclofenac gels in osteoarthritis – A randomized controlled trial. Int J Pharm Sci Res. 2019;10(9):4384-4390.

3. Geertzen JH, de Bruijn HP, de Bruijn-Kofman AT, Arntz IH. The use of DMSO in wound healing. A review. Wounds. 1994;6(2):56-67.

4. Dimethylsulfoxide. Memorial Sloan Kettering Cancer Center. Available at: https://www.mskcc.org/cancer-care/integrative-medicine/herbs/dimethylsulfoxide. Accessed February 14, 2025.