Toronto dermatologist Dr. Michelle Levy writes about common skin problems, controversies and developments, and provides science-based answers to common questions in our dermatology blog.
With the current enthusiasm for products and treatments that are considered to be "natural", I've had a number of patients ask me whether they should use zinc to treat their acne. I've also recently seen zinc added to over-the-counter moisturizers intended for oily skin. Does taking zinc tablets or using zinc-containing skin care products lead to improvement in acne? Let's review a little background about zinc and its role in treating skin conditions.
What is Zinc?
Zinc is a metal ion that occurs naturally. It is an essential element that human's require in trace amounts, and which we obtain from foods such as meats, nuts, whole grains and legumes. Zinc deficiency is exceedingly rare in North America, and is usually seen in people with certain rare genetic syndromes or in those who are malnourished. Of our bodies' total zinc stores, eleven percent can be found in the skin, where it is required for wounds to heal.
How Does Zinc Work in treating Skin Conditions Such as Acne?
Zinc is thought to improve skin conditions via its anti-inflammatory, anti-bacterial and anti-fungal properties. It also serves as a skin-protectant and may decrease the skin's production of sebum.
Which Skin Conditions is Zinc Used For?
Zinc has been used for hundreds of years to soothe skin inflammation and prevent sunburn. It can be found as part of several compounds that serve as the active ingredients in many over-the-counter products. The most commonly used is zinc oxide, which is found in sunscreens and creams for diaper rashes. Various zinc-containing compounds can be found in products such as:
Diaper rash creams
Zinc has been studied in the treatment of many skin conditions. Oral zinc tablets have been studied in acne, rosacea and aphthous ulcers (canker sores), while topical zinc preparations have been studied in the treatment of warts, fungal infections, acne, rosacea, eczema and wounds, among other conditions.
Is Zinc Helpful in the Treatment of Acne?
The first studies of oral zinc in the treatment of acne date back to the 1970s. Since then, there have been over two dozen studies published that have looked at whether taking zinc by mouth or applying it topically to the skin is helpful in treating acne. Zinc is thought to work in acne by inhibiting the bacteria p.acnes, by decreasing inflammation, and possibly by decreasing sebum production.
There are a few studies that have shown a benefit to the use of oral zinc tablets (most commonly zinc gluconate) in the management of moderate or severe acne. These studies are not considered to be of high enough quality to draw a firm conclusion regarding the effectiveness of this treatment. Randomized studies that have compared oral zinc compounds to the antibiotics tetracycline and minocycline, which are frequently used in acne, have found the antibiotics to be more effective.
Studies of topical zinc in acne have been mixed, with some studies showing a benefit, and others showing equivocal or negative results. Most studies have used either zinc acetate or zinc sulfate (not zinc oxide, which is the zinc-containing compound found in sunscreens). It is considered to be safe, and its anti-inflammatory and anti-bacterial properties suggest that it might benefit acne-prone skin. At this point, however, we have far better evidence for the use of traditional, better-established acne treatments.
So...What is the Bottom Line?
Oral zinc tablets may be helpful in acne. Studies have shown, however, that these will not work as well as the oral antibiotics that dermatologists often use for moderate or severe acne.
If you have severe acne or acne that is causing scarring, please consider seeing a board-certified dermatologist rather than treating your acne at home. Acne scarring can be lifelong and you should seek out the most effective treatment available in order to prevent further scarring.
There isn't convincing scientific evidence at this point that topical creams that contain zinc compounds are especially helpful in the treatment of acne. The ways in which zinc works in the skin suggest that it might have benefit, but further studies are need to establish whether this is the case.