Effects of Oral Zinc and Vitamin A in Acne

Michaëlsson, G

doi:10.1001/archderm.1977.01640010033003

Cited by 113 publications

(54 citation statements)

References 16 publications

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“…Despite these inconsistencies, none detected a difference in efficacy between the two drugs. The earliest trial [33] found no difference in acne severity score between spironolactone (100 mg/day) and cimetidine (1.6 g/day) [MD −4.20, 95% CI −17.48 to 9.08; p = 0.54] using the Michaëlsson scale [78]. Similarly, the second study [38] found no difference between the same dose of spironolactone and cimetidine 1.4 g/day, using reduction in inflamed and non-inflamed lesions as the outcome measure.…”

Section: Resultsmentioning

confidence: 99%

Oral Spironolactone for Acne Vulgaris in Adult Females: A Hybrid Systematic Review

et al. 2017

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BackgroundThe management of acne in adult females is problematic, with many having a history of treatment failure and some having a predisposition to androgen excess. Alternatives to oral antibiotics and combined oral contraceptives (COCs) are required.ObjectiveOur aim was to conduct a hybrid systematic review of the evidence for benefits and potential harms of oral spironolactone in the management of acne in adult females.MethodsThe review was conducted according to a previously published protocol. Three reviewers independently selected relevant studies from the search results, extracted data, assessed the risk of bias, and rated the quality of the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.ResultsTen randomized controlled trials (RCTs) and 21 case series were retrieved. All trials were assessed as being at a ‘high risk’ of bias, and the quality of evidence was rated as low or very low for all outcomes. Apart from one crossover trial that demonstrated statistical superiority of a 200 mg daily dose versus inflamed lesions compared with placebo, data from the remaining trials were unhelpful in establishing the degree of efficacy of lower doses versus active comparators or placebo. Menstrual side effects were significantly more common with the 200 mg dose; frequency could be significantly reduced by concomitant use of a COC. Pooling of results for serum potassium supported the recent recommendation that routine monitoring is not required in this patient population.ConclusionThis systematic review of RCTs and case series identified evidence of limited quality to underpin the expert endorsement of spironolactone at the doses typically used (≤100 mg/day) in everyday clinical practice.Electronic supplementary materialThe online version of this article (doi:10.1007/s40257-016-0245-x) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Oral Spironolactone for Acne Vulgaris in Adult Females: A Hybrid Systematic Review

et al. 2017

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“…Patients with acne were reported to have low levels of serum zinc. 82,83 Subsequently, randomized double-blind placebo-controlled trials [84][85][86][87][88][89] and a randomized double-blind trial of zinc versus minocycline 90 showed that oral zinc was effective in the treatment of severe and inflammatory acne, more so than mild or moderate acne. 91,92 These trials did not control for other dietary factors.…”

Section: Zinc and Acnementioning

confidence: 99%

Diet and acne

Bowe

Joshi

Shalita

2010

Journal of the American Academy of Dermatology

136

120

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“…Zinc salts have also been used in the treatment of gastric ulcers (Frommer, 1975), rheumatoid arthritis (Simkin, 1976), and acne (Michaelsson et al, 1977). These applications await further evaluation and the consequences of prolonged oral zinc administration (see below) indicate that such use of zinc should be undertaken cautiously.…”

Section: Treatment Of Deficiency Statesmentioning

confidence: 99%