Zinc is an essential nutrient for skin health, immune function, reproductive health, and metabolism. In many cases, serum zinc levels appear to correlate with the severity and type of acne lesions (Rostami Mogaddam et al., 2014). This suggests a role for zinc in PCOS and acne.

Zinc gluconate has been found effective in managing inflammatory acne. Specifically, a methionine-bound zinc complex with antioxidants appears useful in managing mild to moderate acne vulgaris (Dreno et al., 1989; Dréno et al., 2001; Meynadier, 2000; Sardana & Garg, 2010). Zinc sulfate has also been used effectively for treatment of severe acne. However, potential side effects of zinc sulfate include nausea, vomiting, and diarrhea (Bae et al., 2010; Orris et al., 1978; Weimar et al., 1978; Cunliffe, 1979).

Zinc may also be helpful in mitigating possible adverse effects of antibiotics, in terms of growing antibiotics resistance in the bacterium that causes acne, Propionibacterium acnes (James et al., 2009). This may be because zinc can enhance antibiotic absorption and may influence inflammation related to microbial infection. Zinc in PCOS and acne may also have benefits because the mineral can suppress sebum production through its antiandrogenic activity (Pierard-Franchimont et al., 1995).

In one double-blind randomised study, topical application of a zinc-antibiotic complex significantly reduced sebum (Pierard-Franchimont et al., 1995). In this study, 14 volunteers applied 4% erythromycin plus 1.2% zinc (Zineryt lotion) on one half of the face and forehead. On the other half of the face they applied a 4% erythromycin lotion. The lotions were applied twice daily for 3 months.

Researchers found that the erythromycin-zinc complex led to significant reductions in sebum excretion rate after 6 and 9 weeks, as well as a 20% reduction in total area of lipid spots (TAS).

So, while there is little research looking directly at the effects of zinc supplementation in PCOS, it may be safe to assume that improvements in acne could be a benefit of optimising zinc levels in PCOS.

Zinc in PCOS and Acne

In one study, zinc supplementation had beneficial effects on a range of symptoms of PCOS (Jamilian et al., 2016). This randomized double-blind, placebo-controlled trial involved 48 women (aged 18-40) with PCOS diagnosed according to Rotterdam criteria. For 8 weeks, half the group received 220 mg of zinc sulfate daily (providing 50 mg elemental zinc). The other group received a placebo.

After 8 weeks, the zinc group had a decrease in alopecia (41.7 vs 12.5%) and a decrease in hirsutism (-1.71 vs -0.29 on the modified Ferriman-Gallwey measure). They also had a decrease in plasma malondialdehyde (MDA) levels (-0.09 vs. +2.34 µmol/L) compared with the placebo group. MDA is a marker for oxidative stress.

The zinc group also had a trend towards reduced levels of high-sensitivity C-reactive protein (hs-CRP), a biomarker for inflammation.

In summary, zinc could offer benefits for people with PCOS and acne. Anyone who chooses to take zinc long-term should be mindful that zinc and copper are antagonistic and may wish to also supplement with copper.

Next, we will look at selenium, PCOS, and acne. References for this article series can be seen here.