Study assesses safety and efficacy of oral zinc and low-dose isotretinoin for acne vulgaris

A study recently published in the Journal of Clinical and Aesthetic Dermatology aimed to assess the safety and efficacy of combining oral zinc with low-dose isotretinoin in patients with acne vulgaris (AV). The overall results showed that oral administration for more low-dose isotretinoin resulted in satisfactory improvement in AV patients and with fewer adverse effects. The study author believes that further studies are recommended to compare the effectiveness of other zinc preparations when combined with systemic isotretinoin at different concentrations.

The study recruited 60 patients with moderate to severe VA, according to the Global Acne Grading System (GAGS). The patients were divided into 2 groups; Group A received oral zinc sulfate plus low dose isotretinoin and group B received the standard dose of isotretinoin. Acne severity, pictures, adverse effects, and patient-reported satisfaction were recorded at each visit.

In the 2 groups, there was no significant difference in the reduction of the number of lesions and GAGS scores. The frequency of treatment-related side effects was 20% in group A and 76.7% in group B. There was no difference in relapse rates between the two groups (p>0.05 ). Finally, patient satisfaction rates did not differ between the 2 groups.

Group A consisted of 15 men and 15 women with a median age of 23.5 years. Group B consisted of 15 men and 15 women with a median age of 25 years. There was no statistically significant difference between the 2 groups studied regarding the reduction in the number of comedonal and non-comedonic lesions, as well as the GAGS assessment at baseline and monthly follow-up visits, except at the fourth visit. At the fourth follow-up visit, group B showed more significant improvement in GAGS than group A, however, the difference became insignificant at the fifth visit.

In this study, oral zinc combined with a low dose of isotretinoin demonstrated satisfactory improvement in AV patients with fewer adverse effects. Another benefit of this combination is the cost of treatment, as systemic isotretinoin products are known to be expensive compared to over-the-counter oral zinc supplements.

Oral zinc is an inexpensive, adjuvant, and sparing treatment to systemic isotretinoin in VA. Additionally, oral zinc minimizes the adverse effects of isotretinoin. However, the treatment relapse rate is similar to higher dose isotretinoin monotherapy. Further studies are recommended to evaluate the use of other zinc preparations and higher zinc doses with different isotretinoin regimens to determine the best combination.


  1. Salah E. Oral Zinc as a New Adjuvant and Sparing Therapy for Systemic Isotretinoin in Acne Vulgaris: A Preliminary Comparative Study. J Clin Esthet Dermatol. 2022;15(10):58–61.

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