Table 1.

Therapeutic applications of zinc in the treatment of various skin disorders.

Disorder	Etiology	Treatment	References
Acne conglobata	Propionibacterium acnes	Successfully treated with a high dose of oral zinc sulphate.	[152]
Acne vulgaris	Propionibacterium acnes	Clindamycin or erythromycin in combination with zinc acetate or octoate was found to boost therapy efficacy.	[145,146,150,153,154,155,156,157,158,159,160,161,162]
		Papular and pustular acne can be cured with oral zinc sulphate.
		Oral zinc gluconate is effective in the management of inflammatory acne.
		Antioxidants combined with methionine-bound zinc complex was successful in treating mild to moderate conditions.
		The alternative route of treatment can be zinc alone or in combination with nicotinamide.
Actinic keratosis	UV exposure	Topical 25% zinc sulphate resulted in the disappearance of the lesions.	[163]
Alopecia areata	autoimmune disorder	Oral zinc supplementation showed a noticeable clinical response.	[164,165]
Athlete’s foot	Trichophyton rubrum	20% zinc-undecylenate-containing powder was found to be effective in reducing erythema, scaling, and itching.	[166,167]
Androgenetic alopecia	androgens, genetic predisposition	Significant hair growth was observed with topical zinc pyrithione 1% solution.	[168,169]
Behcet’s disease	autoimmune disorder	Behcet’s disease was treated with oral zinc sulphate.	[170,171]
Bromhidrosis	Corynebacterium sp.	Topical zinc salt such as sulphate and zinc oxide were found to be successful in the management of the condition.	[172,173]
Bromodosis	Sweat buildup leading to bacterial or fungal growth	A topical 15% zinc sulphate solution was found to eliminate foot odor.	[174]
Cutaneous leishmaniasis	Leishmania	Intralesional 2% zinc sulphate with meglumine and oral zinc sulphate was found to be effective in the management of cutaneous leishmaniasis.	[175,176,177]
Dissecting cellulitis of the scalp	Unknown	Complete cure with oral zinc sulphate.	[152,178,179]
Eczema	Immune system overactivity	Textiles treated with zinc oxide can be useful in the management of atopic dermatitis.	[180,181,182]
		For diaper dermatitis, zinc oxide paste was found to be effective in soothing and preventing skin rash.
		For hand eczema, a cream containing zinc sulphate (2.5%) combined with clobetasol (0.05%) has improved the condition.
Erosive pustular dermatosis of the scalp	Unknown	Treated with oral zinc sulphate.	[183]
Herpes genitalis	Herpes simplex virus type 2	Zinc acetate gel was effective in the prevention of sexual transmission of HSV-2 and HIV.	[184,185]
		Higher concentrations of zinc sulphate were found more effective in the treatment, and prevention of relapse.
Herpes simplex	Herpes simplex virus type 1	Polyethylene glycol-coated zinc oxide nanoparticles demonstrated antiviral potency against HSV-1	[186,187]
		Zinc gluconate and zinc lactate was found to effectively inactivate HSV-1 clinical isolates.
Hidradenitis suppurativa	Unknown	The disorder can be managed with oral zinc gluconate alone or in combination with topical triclosan.	[188,189]
Jock itch	Trichophyton rubrum Trichophyton mentagrophytes	A cream formulated with 20% zinc undecylenate has effectively cleared the skin.	[166,190]
Leprosy	Mycobacterium leprae	Combining oral zinc with dapsone was found to enhance the therapy’s effectiveness through bacterial clearance and rapid conversion of lepromin.	[191,192,193]
		Topical application of phenytoin sodium zinc oxide paste showed a significant clearance of the bacterial load of trophic ulcers.
Melasma	UV exposure	Topical 10% zinc sulphate resulted in a significant decrease in MASI* scores.	[194,195,196,197,198,199]
		Zinc oxide in sunscreen formulations is used in the management of melasma owing to its photoprotection properties.
Necrolytic acral erythema	Associated with hepatitis C	The condition was treated with oral zinc supplementation.	[200,201,202]
Necrolytic migratory erythema	Associated with pancreatic glucagonoma	Oral zinc sulfate has been shown to improve the condition.	[203]
Oral aphthous stomatitis	Unknown	Oral zinc sulphate lowered the risk of relapse in recurrent aphthae and provided both curative and preventative effects.	[204,205,206,207,208]
		Zinc sulphate-containing mouth rinse decreased the frequency of recurring ulcers.
Oral lichen planus	Unknown	0.2% zinc mouthwash in combination with fluocinolone helped diminish irritability, pain, and lesion surface area.	[209,210]
		Administration of oral zinc acetate showed favorable clinical improvement.
Pityriasis versicolor	Malassezia	Zinc pyrithione 1% in shampoo formulations was found effective in the treatment of pityriasis versicolor.	[211,212,213,214]
		Topical 15% zinc sulphate was effective in the treatment of pityriasis versicolor.
Psoriasis	Unknown	Topical 0.25% zinc pyrithione was found effective for localized plaque psoriasis.	[215]
Psoriatic arthritis	Unknown	Psoriatic arthritis can be effectively treated with oral zinc sulphate.	[148,216]
Seborrheic dermatitis	Malassezia	Zinc pyrithione 1% in a shampoo formulation is a therapeutic choice for reducing inflammations and scaling.	[215]
Ulcers	Poor blood flow	Topical zinc oxide formulations have been used in the treatment of arterial and venous leg ulcers, pressure ulcers, and diabetic foot ulcers.	[6,217,218,219,220]
		Zinc iontophoresis was demonstrated to be beneficial in the treatment of ischemic skin ulcers.
Vitiligo	Melanocyte decrement in relation to genetic and non-genetic factors	Oral zinc sulphate in combination with topical corticosteroids showed a higher response rate than Topical corticosteroids alone in the treatment of vitiligo.	[221]
Warts	Human papillomavirus	Topical 10% zinc sulfate was found effective for the treatment of plane warts	[222,223,224,225,226]
		Oral zinc sulfate can be used in the treatment of different types of warts.
		Topical 20% zinc oxide is considered an effective and safe therapeutic method.
		Zinc acetate coformulated in a carrageenan gel demonstrated anti-HIV and anti-human papillomavirus activity.

MASI*: melasma area and severity index.