Efficacy of zinc amino acid chelated and 0.025%tretinoin cream in moderate acne, a randomized double-blind placebo controlled trial
Keywords:
Zinc amino acid chelated, Zinc, AcneAbstract
Background : The treatment of acne with antibiotics such as tetracycline or erythromycin may enhance the development of bacterial resistance. From the pathogenesis of acne, zinc has been involved in many pathways of both inflammatory and non-inflammatory acne. Zinc amino acid chelated can increase oral bioavailability and reduce the side effects of zinc salt. Currently, there is no study about the efficacy of zinc amino acid chelated in treatment of moderate acne.
Objectives : To evaluate efficacy of zinc amino acid chelated and 0.025% tretinoin cream in moderate acne.
Materials and Methods : Seventy patients with moderate acne were enrolled. Each patient was randomized to receive either treatment with oral zinc amino acid chelated or placebo and 0.025% tretinoin cream nightly in both groups. Zinc amino acid chelated (75mg/tab) was given in the dosage of 225mg/day for 3 consecutive months. Clinical improvement was assessed at baseline and at the 4th, 8th and 12th week from the beginning of the study. Overall improvement was assessed by acne count, photographs taken by VISIA, which were evaluated by 3 independent dermatologists. The patient’s satisfaction was assessed by severity of acne, facial oiliness and adverse effects.
Result : The mean acne lesion counts of closed comedone, open comedone, papule, pustule and nodule were not statistically difference between zinc amino acid chelated combined with 0.025% tretinoin cream group and placebo combined with 0.025% tretinoin cream group (p>0.05). Similarly overall improvement score and Propionibacterium acnes count demonstrated no difference among two groups. However, the mean serum zinc level in zinc amino acid chelated group was significantly higher than the placebo group. (p<0.05) Gastrointestinal side effects were less reported in patients who received zinc amino acid chelated.
Summary: Zinc amino acid chelated and 0.025% tretinoin cream is not superior to placebo with 0.025% tretinoin cream in reducing closed comedone, open comedone, papule, pustule or nodule counts in spite of the significant increasing in serum zinc level.
References
Thiboutot D, Gollnick H, Bettoli V, Dreno B, Kang S, Leyden JJ, et al. New insights into the management of acne: an update from the Global Alliance to Improve Outcomes in Acne group. J Am Acad Dermatol 2009;60:S1-50.
Margolis DJ. Antibiotics, acne, and upper respiratory tract infections. LDI Issue Brief 2006;11:1-4.
Hassanzadeh P, Bahmani M, Mehrabani D. Bacterial resistance to antibiotics in acne vulgaris: an in vitro study. Indian J Dermatol 2008;53:122-4.
Aminov RI, Chee-Sanford JC, Garrigues N, Mehboob A, Mackie RI. Detection of tetracycline resistance genes by PCR methods. Methods Mol Biol. 2004;268:3-13.
Prasad AS. Zinc deficiency. BMJ 2003 22; 326:409-10.
King JC, Shames DM, Woodhouse LR. Zinc homeostasis in humans. J Nutr 2000;130:1360S-6S.
Michaelsson G, Juhlin L, Vahlquist A. Effects of oral zinc and vitamin A in acne. Arch Dermatol 1977;113:31-6.
Hillstrom L, Pettersson L, Hellbe L, Kjellin A, Leczinsky CG, Nordwall C. Comparison of oral treatment with zinc sulphate and placebo in acne vulgaris. Br J Dermato. 1977;97:681-4.
Goransson K, Liden S, Odsell L. Oral zinc in acne vulgaris: a clinical and methodological study. Acta Derm Venereol 1978;58:443-8.
Verma KC, Saini AS, Dhamija SK. Oral zinc sulphate therapy in acne vulgaris: a double-blind trial. Acta Derm Venereol 1980;60:337-40.
Weismann K, Wadskov S, Sondergaard J. Oral zinc sulphate therapy for acne vulgaris. Acta Derm Venereol 1977;57:357-60.
Weimar VM, Puhl SC, Smith WH, tenBroeke JE. Zinc sulfate in acne vulgaris. Arch Dermatol. 1978;114:1776-8.
Dreno B, Amblard P, Agache P, Sirot S, Litoux P. Low doses of zinc gluconate for inflammatory acne. Acta Derm Venereol 1989;69:541-3.
Meynadier J. Efficacy and safety study of two zinc gluconate regimens in the treatment of inflammatory acne. Eur J Dermatol. 2000;10:269-73.
Gandia P, Bour D, Maurette JM, Donazzolo Y, Duchene P, Bejot M, et al. A bioavailability study comparing two oral formulations containing zinc (Zn bis-glycinate vs. Zn gluconate) after a single administration to twelve healthy female volunteers. Int J Vitam Nutr Res 2007;77:243-8.
Burton JL, Goolamali SK. Zinc and sebum excretion. Lancet 1973;1:1448.
Michaelsson G, Juhlin L, Ljunghall K. A double-blind study of the effect of zinc and oxytetracycline in acne vulgaris. Br J Dermatol 1977;97:561-6.
Dreno B, Moyse D, Alirezai M, Amblard P, Auffret N, Beylot C, et al. Multicenter randomized comparative double-blind controlled clinical trial of the safety and efficacy of zinc gluconate versus minocycline hydrochloride in the treatment of inflammatory acne vulgaris. Dermatology 2001;203:135-40.
Orris L, Shalita AR, Sibulkin D, London SJ, Gans EH. Oral zinc therapy of acne. Absorption and clinical effect. Arch Dermatol 1978;114:1018-20.
Cunliffe WJ. Unacceptable side-effects of oral zinc sulphate in the treatment of acne vulgaris. Br J Dermatol 1979;101:363.
Leyden JJ, McGinley KJ, Mills OH, Kligman AM. Propionibacterium levels in patients with and without acne vulgaris. J Invest Dermatol 1975;65:382-4.
Leeming JP, Holland KT, Cuncliffe WJ. The microbial colonization of inflamed acne vulgaris lesions. Br J Dermatol 1988;118:203-8.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2011 Thai Journal of Dermatology

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
เนื้อหาและข้อมูลในบทความที่ลงตีพิมพ์ในวารสารโรคผิวหนัง ถือเป็นข้อคิดเห็นและความรับผิดชอบของผู้เขียนบทความโดยตรงซึ่งกองบรรณาธิการวารสาร ไม่จำเป็นต้องเห็นด้วย หรือร่วมรับผิดชอบใดๆ
บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการตีพิมพ์ในวารสารโรคผิวหนัง ถือเป็นลิขสิทธิ์ของวารสารฯ หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่ต่อหรือเพื่อกระทำการใดๆ จะต้องได้รับอนุญาตเป็นลายลักอักษรจากบรรณาธิการวารสารโรคผิวหนังก่อนเท่านั้น