The Association between Serum Zinc Levels and Zinc Supplementation in Topical Retinoids Treated Acne Vulgaris Patients: A Randomized, Double-Blind, Placebo-Controlled Trial

Background: The association between serum zinc levels and zinc supplementation, with topical retinoids treatment in acne vulgaris patients presents a multifaceted interplay involving both physiological and therapeutic aspects. Objective: To evaluate the association between serum zinc levels and zinc supplementation with topical retinoid-treated in acne vulgaris patients. Method: A clinical trial was carried out at the Department of Pharmacology and Department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University, spanning from March 2020 to January 2022, with participant enrollment commencing in April 2021. This study encompassed 122 recently diagnosed mild to moderate acne vulgaris (AV) patients who received 20 mg of zinc sulfate or 20mg of placebo tablet twice daily orally with topical retinoid treatment. Notably, nine participants withdrew from the study for various reasons, resulting in a cohort of 113 individuals for per-protocol (PP) analysis. The investigation featured both baseline and after 8-week follow-up assessments, scrutinizing GAGS acne severity scores and serum zinc levels. Results: After 8 weeks of intervention, serum zinc levels in the intervention arm significantly increased from the baseline (100.39 ± 22.26 vs. 59.03 ± 15.76, P = 0.00), and they were also significantly higher than in the control arm. Likewise, the GAGS score in the intervention arm significantly decreased after 8 weeks compared to the baseline (12.03 ± 5.39 vs. 16.74 ± 6.09, P = 0.00) and was significantly lower than in the control arm. Also shows a correlation between serum zinc level and GAGS score which was observed after 8 weeks of intervention. Conclusion: Our study suggests that combining zinc supplementation with topical retinoids for acne treatment depends on factors like patient traits, baseline zinc levels, formulations, and duration. While findings vary, there's an overall trend toward better outcomes with this combination. Zinc's .......