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Acne and Zinc

Written by ColleenO, FoundHealth.

Zinc has been proposed as a treatment for acne, largely based on the fact that studies suggest that people with acne have lower-than-normal levels of zinc in their bodies.9,17,18

Effect of Zinc on Acne

Zinc is an important element that is found in every cell in the body. More than 300 enzymes in the body need zinc in order to function properly. The effect of zinc on acne is not clear, though studies show that many people with acne have a zinc deficiency, which is common in the general population.

Read more details about Zinc.

Research Evidence on Zinc

Several double-blind, placebo-controlled studies have found zinc more effective than placebo but less effective than antibiotic therapy.

In one of these studies, 54 people were given either placebo or 135 mg of zinc as zinc sulfate daily. Zinc produced slight but measurable benefits.1 Similar results have been seen in other studies using 90 to 135 mg of zinc daily,2-5 although others failed to find that zinc helped.7,8

Relatively weak evidence suggests that a lower and safer dose, 30 mg daily, may also be helpful.6,19

A large double-blind trial (332 participants) compared 30 mg daily of zinc against a tetracycline-family medication often used for acne (minocycline at 100 mg daily).14 The results showed minocycline is more effective than zinc. Tetracycline taken at a dose of 250 mg daily,9 appears to be no more effective than zinc, but when taken at 500 mg daily it seems to be considerably more effective.10

Keep in mind that the dosages of zinc used in most of these studies are much higher than daily requirements, and have the potential for causing toxicity. Indeed, case reports indicate that people have made themselves extremely ill by taking zinc in hopes of treating their acne symptoms.15,16

How to Use Zinc

For most purposes, zinc should simply be taken at the recommended daily requirements (see Side Effects and Warnings).

Some evidence suggests that 30 mg of zinc daily may be helpful for acne. This is a safe dose for most people. However, in most studies of zinc for acne, a much higher dose was used: 90 mg daily or more. Doses this high should only be used under physician supervision.

For best absorption, zinc supplements should not be taken at the same time as high-fiber foods.20 However, many high-fiber foods provide zinc in themselves.

Zinc gluconate may be slightly better absorbed than zinc oxide.21 When taking zinc long-term it is advisable to take 1 mg to 3 mg of copper daily as well, because zinc supplements can cause copper deficiency. Zinc may also interfere with magnesium23 and iron24 absorption.

Types of Professionals That Would Be Involved with This Treatment

A nutritionist or health professional who includes nutrition in their practice--such as a doctor or naturopath--may be knowledgeable about zinc as a treatment for acne.

Safety Issues

Zinc taken orally seldom causes any immediate side effects other than occasional stomach upset, usually when it's taken on an empty stomach. Some forms do have an unpleasant metallic taste. Use of zinc nasal gel, however, has been associated with anosmia (loss of sense of smell). 1 In fact, After receiving over 130 reports of anosmia, the FDA warned consumers and healthcare providers in 2009 to discontinue use of certain Zicam Cold Remedy intranasal zinc-containing products, including Zicam Cold Remedy Nasal Gel, Cold Remedy Nasal Swabs and Cold Remedy Swabs in kids size. 2 Furthermore, if the gel is inhaled too deeply, severe pain may occur.

Long-term use of oral zinc at dosages of 100 mg or more daily can cause a number of toxic effects, including severe copper deficiency, impaired immunity, heart problems, and anemia. 3 4 5 Zinc at a dose of more than 50 mg daily might reduce levels of HDL ("good") cholesterol. 6 In addition, very weak evidence hints that use of zinc supplements might increase risk of prostate cancer in men. 7 The US government has issued recommendations regarding "tolerable upper intake levels" (ULs) for zinc. The UL can be thought of as the highest daily intake over a prolonged time known to pose no risks to most members of a healthy population. The ULs for zinc are as follows: 8

  • Infants
  • 0-6 months: 4 mg
  • 7-12 months: 5 mg
  • Children
  • 1-3 years: 7 mg
  • 4-8 years: 12 mg
  • 9-13 years: 23 mg
  • Males and Females
  • 14-18 years: 34 mg
  • 19 years and older: 40 mg
  • Pregnant Women and Nursing Women
  • 18 years or younger: 34 mg
  • 19 years and older: 40 mg

There are also some interactions between zinc and certain medications to consider:

Use of zinc can interfere with the absorption of the drug penicillamine and also antibiotics in the tetracycline or fluoroquinolone (Cipro, Floxin) families. 9 10 11 12 13 The potassium-sparing diuretic amiloride was found to significantly reduce zinc excretion from the body. 14 This means that if you take zinc supplements at the same time as amiloride, zinc accumulation could occur. This could lead to toxic side effects. However, the potassium-sparing diuretic triamterene does not seem to cause this problem. 15

Interactions You Should Know About

If you are taking:

  • ACE inhibitors ; estrogen-replacement therapy ; oral contraceptives ; thiazide diuretics ; or medications that reduce stomach acid (such as H 2 blockers [ Zantac ] or proton pump inhibitors [ Prilosec ]): You may need to take extra zinc.
  • Amiloride : This medication could reduce zinc excretion from the body, leading to zinc accumulation, which could cause toxic side effects. Do not take zinc supplements unless advised by a physician.
  • Manganese ; calcium ; copper ; iron ; antacids ; soy ; or antibiotics in the fluoroquinolone (such as, Cipro , Floxin ) or tetracycline families: It may be advisable to separate your doses of zinc and these substances by at least 2 hours.
  • Penicillamine : Zinc interferes with penicillamine's absorption so it may be advisable to take zinc and penicillamine at least 2 hours apart.
  • Zinc supplements: You should also take extra copper and perhaps magnesium as well because zinc interferes with their absorption. Zinc interferes with iron absorption, too, but you shouldn't take iron supplements unless you know you are deficient.

References

  1. Jafek BW, Linschoten MR, Murrow BW. Anosmia after intranasal zinc gluconate use. Am J Rhinol. 18(3):137-41.
  2. FDA Public Health Advisory on Loss of Sense of Smell with Intranasal Cold Remedies Containing Zinc. Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/DrugSafety/PublicHealthAdvisories/ucm166059.htm. Accessed: July 9, 2009.
  3. Hoffman HN II, Phyliky RL, Fleming CR. Zinc-induced copper deficiency. Gastroenterology. 1988;94:508-512.
  4. Sandstead HH. Requirements and toxicity of essential trace elements, illustrated by zinc and copper. Am J Clin Nutr. 61(3 Suppl):621S-624S.
  5. Fosmire GJ. Zinc toxicity. Am J Clin Nutr. 51(2):225-7.
  6. Hughes S, Samman S. The effect of zinc supplementation in humans on plasma lipids, antioxidant status and thrombogenesis. J Am Coll Nutr. 25(4):285-91.
  7. Leitzmann MF, Stampfer MJ, Wu K, Colditz GA, Willett WC, Giovannucci EL. Zinc supplement use and risk of prostate cancer. J Natl Cancer Inst. 95(13):1004-7.
  8. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc (2001). National Academies Press website. Available at http://www.nap.edu. Accessed October 4, 2001.
  9. Lim D, McKay M. Food-drug interactions. Drug Information Bulletin (UCLA Dept. of Pharmaceutical Services). 1995;15(2).
  10. Drug Evaluations Annual. Milwaukee, WI: American Medical Association; 1993(2).
  11. Neuvonen PJ. Interactions with the absorption of tetracyclines. Drugs. 11(1):45-54.
  12. Mapp RK, McCarthy TJ. The effect of zinc sulphate and of bicitropeptide on tetracycline absorption. S Afr Med J. 50(45):1829-30.
  13. Polk RE, Healy DP, Sahai J, Drwal L, Racht E. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother. 33(11):1841-4.
  14. Reyes AJ, Olhaberry JV, Leary WP, Lockett CJ, van der Byl K. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J. 64(24):936-41.
  15. Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand. 208(3):209-12.
  1. Goransson K, Liden S, Odsell L. Oral zinc in acne vulgaris: a clinical and methodological study. Acta Derm Venereol. 1978;58:443-448.
  2. Verma KC, Saini AS, Dhamija SK. Oral zinc sulfate therapy in acne vulgaris: a double-blind trial. Acta Derm Venereol. 1980;60:337-340.
  3. Weimar VM, Puhl SC, Smith WH, et al. Zinc sulfate in acne vulgaris. Arch Dermatol. 1978;114:1776-1778.
  4. Hillstrom L, Pettersson L, Hellbe L, et al. Comparison of oral treatment with zinc sulphate and placebo in acne vulgaris. Br J Dermatol. 1977;97:681-684.
  5. Michaelsson G, Juhlin L, Vahlquist A. Effects of oral zinc and vitamin A in acne. Arch Dermatol. 1977;113:31-36.
  6. Dreno B, Amblard P, Agache P, et al. Low doses of zinc gluconate for inflammatory acne. Acta Derm Venereol. 1989;69:541-543.
  7. Weisman K, Wadskov S, Sondergaard J. Oral zinc sulphate therapy for acne vulgaris. Acta Derm Venereol. 1977;57:357-360.
  8. Orris L, Shalita AR, Sibulkin D, et al. Oral zinc therapy of acne. Absorption and clinical effect. Arch Dermatol. 1978;114:1018-1020.
  9. Michaelsson G, Juhlin L, Ljunghall K. A double-blind study of the effect of zinc and oxytetracycline in acne vulgaris. Br J Dermatol. 1977;97:561-566.
  10. Cunliffe WJ, Burke B, Dodman B, et al. A double-blind trial of a zinc sulphate/citrate complex and tetracycline in the treatment of acne vulgaris. Br J Dermatol. 1979;101:321-325.
  11. Igic PG, Lee E, Harper W, et al. Toxic effects associated with consumption of zinc. Mayo Clin Proc. 2002;77:713-716
  12. Porea TJ, Belmont JW, Mahoney DH Jr. Zinc-induced anemia and neutropenia in an adolescent. J Pediatr. 2000;136:688-690.
  13. Pohit J, Saha KC, Pal B. Zinc status of acne vulgaris patients. J Appl Nutr. 1985;37:18-25.
  14. Amer M, Bahgat MR, Tosson Z, et al. Serum zinc in acne vulgaris. Int J Dermatol. 1982;21:481-484.
  15. Meynadier J. Efficacy and safety study of two zinc gluconate regimens in the treatment of inflammatory acne. Eur J Dermatol. 2000;10:269 273.
  16. Nävert B, Sandström B, Cederblad A. Reduction of the phytate content of bran by leavening in bread and its effect on zinc absorption in man. Br J Nutr. 53(1):47-53.
  17. Siepmann M, Spank S, Kluge A, Schappach A, Kirch W. The pharmacokinetics of zinc from zinc gluconate: a comparison with zinc oxide in healthy men. Int J Clin Pharmacol Ther. 43(12):562-5.
  18. Spencer H, Norris C, Williams D. Inhibitory effects of zinc on magnesium balance and magnesium absorption in man. J Am Coll Nutr. 13(5):479-84.
  19. Yadrick MK, Kenney MA, Winterfeldt EA. Iron, copper, and zinc status: Response to supplementation with zinc or zinc and iron in adult females. Am J Clin Nutr. 1989;49:145-150.

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