Hair Zinc Levels and the Efficacy of Oral Zinc Supplementation in Patients with Atopic Dermatitis

Abstract

Zinc deficiency in patients with atopic dermatitis (AD) and the use of zinc supplementation is still controversial. We measured hair zinc levels in 58 children with AD and 43 controls (age range 2-14 years). We also investigated the efficacy of oral zinc supplementation in AD patients with low hair zinc levels by comparing eczema assessment severity index (EASI), transepidermal water loss (TEWL), and visual analogue scales for pruritus and sleep disturbance in patients receiving zinc supplementation (Group A) and others not receiving supplementation (Group B). At baseline, the mean zinc level was significantly reduced in AD patients (113.1 μg/g vs. 130.9 μg/g, p = 0.012). After 8 weeks of supplement, hair zinc level increased significantly in Group A (p < 0.001), and EASI scores, TEWL, and visual analogue scales for pruritus improved more in Group A than in Group B (p = 0.044, 0.015 and < 0.001, respectively). Thus, oral zinc supplementation may be effective in AD patients with low hair zinc levels.

Erythrocyte zinc level in patients with atopic dermatitis and its relation to SCORAD index

“…It seems that normalized zinc levels lead to balance inversion between cell-mediated (Th1) and humoral (Th2) immunity in favor of the Th1 response. Furthermore, a recent study investigating the efficiency of oral zinc supplementation in AD demonstrated favorable effects on AD supporting the abovementioned study results [20]. …”

“…It has been shown that increased oxidative stress (OxS) plays a role in the pathophysiology of childhood AD and the use of an antioxidant agent might be a useful strategy for the treatment of AD [19]. A low zinc level could cause the membrane barriers’ problem and this problem could increase transepidermal water loss (TEWL), which makes the skin dry clinically, and the penetration of allergens could be easier [20]. This can affect the severity of the disease.…”

“…However, being influenced by a variety of factors, such as infection, stress, hormonal changes, low albumin levels, and growth rate, its diagnostic value is limited [20]. It has also been found that 99% of this trace element is being located intracellularly [21].…”

Zinc Regulates Lipid Metabolism and MMPs Expression in Lipid Disturbance Rabbits

“…It plays a key pathophysiological role in diseases such as diabetes, cardiovascular diseases, and cancer [16]. Zn deficiency is observed in patients with inflammatory diseases such as atopic dermatitis [17], asthma [18], and Crohn's disease [19]. Zn supplement can decrease oxidative stress in isolated mononuclear cells and can also decrease the expression of genes encoding inflammatory cytokines which are known to generate reactive oxygen species (ROS) [20].…”

Hair Mineral Analysis in Children with Atopic Dermatitis

“…Previous studies have hypothesized that AD is associated with a non-specific decrease concerning trace metals34. Furthermore, we previously reported that zinc (Zn) supplementation led to clinical improvement in AD patients with low hair Zn levels5. However, there is little data on other hair mineral levels in AD.…”