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Side effects of topical silver therapy Side effects of topical silver therapy include: General adverse effects of dressings (maceration, irritant or allergic contact dermatitis) Rarely, acute haemolytic anaemia or transient leukopenia (silver sulfadiazine) Rarely, electrolyte imbalance (silver nitrate) Contact dermatitis to silver dressing Toxicity of topical silver therapy Argyria Cytotoxicity to host cells (fibroblasts and keratinocytes) How to use topical silver therapy Refer to synthetic wound dressings for a guided choice in dressing suitable for the wound and patient