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omment ry
ZINC AND ACNE: DOES IT WORK?
lOSEPH A. WITKOWSKI, M.D. AND LAWRENCE CHARLES PARISH, M.D.
froni {hvDL'p.irlmpnln f Dermatology,University i/ ennsylvania
School of Medicine.Philadelphia,
Zinc has replaced d-alpha tocopherol asthe best selling cure-all
and highly toutedpanacea of the twentieth century. Eventhough the
proponents of v itamin Eclaim thatit has devoured most of the disc
^ses listed inFretich s Index of Differontic^l Diag tinsii,,rumor
has it that zinc might gobble u|) evenmore conditions.'Zinc salts
have a long history ot usefulness,ranging from such topical
applications as an-tiperspirants and sty[3tic t)encils to
systemicuses,such as ihe treatment for acroderm
atitisenteropathica. Oral zinc is also known tt>produce oc|ually
good responses in iairogenitzinc deficiency, induced by total
intravenoushyperalimentation. It is helplul in combatingsome
acqLiired zinc deticiency states as-sociatedwith:malabsorption
syndromes, endstage renal disease, alcoholic cirrhosis, andweight
loss from fashionable crash diets.^Abt)ut ten years ago, zint was
suggested asa treatment for leg ulcers. Whether these ul-cers were
due to sickle cell anem ia, pressure
increased rate of healing seemed to oconly in zinc deficient
patients, whose seror plasma zinc was low and/or w ho hadclcal
evidence ofde ficiency or ofaconcomitdisease that caused increased
zinc loss.Within receni times, Michaelsson et ahave proposed the
use of thisli ace elementhe treatment of acne. In their
double-blstudy, they showed a statistically significreduction in
acne lesions, following thmonths of treatment w ith 45 mg of elem
enzinc adm inistered three times daily. Many vestigators tried to
duplicate their work. Oresults, * like those of many other Amcan
dermatologists, d id not confMic haelsson's findings. Since then,
other ports have shown good results with zinc. T
[ling-pong tournament has left us in quanas to how thera[)eutic
effects could be diametrically opposed.Theoretically, zinc should
have abenefitherapeutic effect in acne. A 1975 reviewthis lournal^
called attention to a decreasesebum levels after zinc
administration.more recent study also showed that suppmental zinc
sullate reduce the quantity of ssurface sebum.Is the effect of zinc
in acne one
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o, 9 ZINC AND ACNE Witkowski dnd Parish 70though such low
laboMtory values have beenfound in surveys of Americans. We are
notaw areof any acne patients who have also hadperiorificial
dermatitis or the peculiar zinc de-ficiency alopecia.
The biochemical role in man is related tohe zinc dependent
enzymes, that number 70.In animals, some experimental evidence
ormal chemotaxis in their monocytes. To
How could the therapeutic response be soinc used in America;*
The effervescentsulfate tablet used in Sweden is not ava il-
defi-
U.S.P.uld there be something as mundane as a
phytate-containing foods or dietary fibeprevents zinc
absorption. We attempted circumvent Ihis, as well as to reduce the
annoying nausea caused by zinc, with bedtimadministration on an
empty stomach. Onlyrare success story after three months therapy."
Whither goes zinceferen es1. Fulghum, D. D.; Zinc zealots and
/elelics. ArcDermatol. 104:210, 1971 .2- Sieger, ). W ., and l7uno,
C, T.: Acute zinc dep letisyndrome during parenterjl
hy[3t?ralimentation. I1. Derniatoi. 18:000, 1979..). Mi( haelsson,
C , luhlin,L. andVahlquist. A.: Effeof oral zinc and Vitamin A in
acne. Arch. Dermat113 :31 , 1977.4. Parish, L. C , anri W itkowski,
|. A.: Personal observtions, 1979,5. Go olama li, S, K., and
Comaish, ), S.: Zinc and tskin. Int. |. Dermatol. 14:182,
197.'",.6- Demetree, ). W.. Safer, L. S., and Artis, W. M.: Tetfect
of z inc on the sebum secretion rate. In pre7. Klevay, L. M-, Reck,
S. |., and Barcome, D. F.: Edence ot dietary copper and zinc
deficiencies. )AM241:1916, 1979.
