Background: In addition to tetracyclines, zinc may constitute an alternative treatment in inflammatory lesions of acne. Objective: To evaluate the place of zinc gluconate in relation to antibiotics in the treatment of acne vulgaris. Methods: Zinc was compared to minocycline in a multicenter randomized double-blind trial. 332 patients received either 30 mg elemental zinc or 100 mg minocycline over 3 months. The primary endpoint was defined as the percentage of the clinical success rate on day 90 (i.e. more than 2/3 decrease in inflammatory lesions, i.e. papules and pustules). Results: This clinical success rate was 31.2% for zinc and 63.4% for minocycline. Minocycline nevertheless showed a 9% superiority in action at 1 month and one of 17% at 3 months, with respect to the mean change in lesion count. Regarding safety, the majority of the adverse effects of zinc gluconate and of minocycline concerned the gastrointestinal system and weremoderate (5 dropouts with zinc gluconate and 4 with minocycline). Conclusion: Minocycline and zinc gluconate are both effective in the treatment of inflammatory acne, but minocycline has a superior effect evaluated to be 17% in our study.

Hillström L, Pettersson L, Hellbel L, Kjellin A, et al: Comparison of oral treatment with zinc sulphate and placebo in acne vulgaris. Br J Dermatol 1977;97:679–684.
Michaëlsson G, Juhlin L, Vahlquist A: Effects of oral zinc and vitamin A in acne. Arch Dermatol 1977;113:31–36.
Göransson K, Lidén S, Odsell L: Oral zinc in acne vulgaris: A clinical and methodological study. Acta Derm Venereol (Stockh) 1978;58:443–448.
Weimar VM, Puhl SC, Smith WH, Tenbroeke JE: Zinc sulphate in acne vulgaris. Arch Dermatol 1978;114:1776–1778.
Lidén S, Göransson K, Odsell L: Clinical evaluation in acne. Acta Derm Venereol Suppl (Stockh) 1980;89:47–52.
Verma KC, Saini AS, Dhamija SK: Oral zinc sulphate therapy in acne vulgaris: A double-blind trial. Acta Derm Venereol (Stockh) 1980;60:337–340.
Dreno B, Amblard P, Agache P, Sirot S, Litoux P: Low doses of zinc gluconate for inflammatory acne. Acta Derm Venereol (Stockh) 1989;69:541–543.
Weissman K, Wadskov S, et al: Oral zinc sulphate therapy for acne vulgaris. Acta Derm Venereol (Stockh) 1977;57:357–360.
Orris L, Shalita AR, Sibulkin D, London SJ, Gans EH: Oral zinc therapy of acne: Absorption and clinical effect. Arch Dermatol 1978;114:1018–1020.
Michaëlsson 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.
Cunliffe WJ, Burke B, Dodman B, Gould DJ: 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.
Revuz J, Amblard P, Dreno B, Lorette G, Ortonne JP, Puissant A: Efficacité du gluconate de zinc dans le traitement de l’acné inflammatoire. Abstr Dermatol 1990;77:2–4.
Dreno B, Bodokh I, Chivot M, Daniel F, Humbert P, Poli F, Clerson P, Berrou JP: ECLA grading: A system of acne classification for everyday dermatological practice. Ann Dermatol Vénéréol 1999;126:136–141.
Dreno B, Trossaert M, Boiteau HL, Litoux P: Zinc salt effects on granulocyte zinc concentration and chemotaxis in acne patients. Acta Derm Venereol (Stockh) 1992;72:250–252.
Guéniche A, Viac J, Lizard G: Protective effect of zinc on keratinocyte activation markers induced by interferon or nickel. Acta Derm Venereol (Stockh) 1995;75:19–23.
Sainte-Marie I, Jumbou O, Tenaud I, Dreno B: Comparative study of the in vitro inflammatory activity of three nickel salts on keratinocytes. Acta Derm Venereol (Stockh) 1998;78:169–172.
Sainte-Marie I, Tenaud I, Jumbou O, Dreno B: Minocycline modulation of alpha-MSH production by keratinocytes in vitro. Acta Derm Venereol (Stockh) 1999;79:265–267.
Sugimoto Y, Lopez-Solache I, Labrie F, Luu-The V: Cations inhibit specifically type I 5-alpha reductase found in human skin. J Invest Dermatol 1995;104:775–778.
Holland KT, Bojar RA, Cunliffe WJ, Cutcliffe AG, et al: The effect of zinc and erythromycin on the growth of erythromycin-resistant and erythromycin-sensitive isolates of Propionibacterium acnes: An in vitro study. Br J Dermatol 1992;126:505–509.
Habbema L, Koopmans B, Menke HE, Doornweerd S, et al: A 4% erythromycin and zinc combination (Zinerty) versus 2% erythromycin (Eryderm) in acne vulgaris: A randomized, double-blind comparative study. Br J Dermatol 1989;4:497–502.
Schachner L, Pestana A, Kittles C: A clinical trial comparing the safety and efficacy of a topical erythromycin-zinc formulation with a topical clindamycin formulation. J Am Acad Dermatol 1990;3:489–495.
Feucht CL, Allen BS, Chalker DK, Smith JG: Topical erythromycin with zinc in acne: A double-blind controlled study. J Am Acad Dermatol 1980;3:183.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.