Oral Zinc Supplementation in Acne Vulgaris and Hidradenitis Suppurativa: An Updated Comprehensive Review

Oral zinc supplementation has emerged as a potential ⁠adjunctive strategy in inflammatory follicular disorders, including ⁠acne vulgaris and hidradenitis suppurativa. Beyond its role as an essential micronutrient, zinc modulates several pathways and biological processes directly ⁠relevant to these diseases, including innate immunity, oxidative stress, neutrophil-driven inflammation, antimicrobial defense, wound repair, and possibly sebaceous gland activity and androgen metabolism. In acne, available data support a potential clinical benefit, mainly on inflammatory lesions, with ⁠potential relevance in antibiotic-sparing approaches. In hidradenitis suppurativa, the evidence remains more limited and is largely based on small observational or uncontrolled studies, although a possible adjunctive role has been suggested in mild-to-moderate disease and maintenance therapy. However, differences across studies in zinc formulation, ⁠dose, treatment duration, baseline zinc assessment, and outcome measures make it difficult to draw firm conclusions, and further randomized controlled trials are needed to identify which patients are most likely to benefit. Considering the available evidence, zinc represents an accessible and clinically attractive adjunct in acne vulgaris and hidradenitis suppurativa. This review critically appraises the evidence ⁠on oral zinc in acne vulgaris and hidradenitis suppurativa, with particular attention to biological plausibility, clinical effectiveness, dosing and safety.