The Role of Blood Lead, Cadmium, Zinc and Copper in Development and Severity of Acne Vulgaris in a Nigerian Population

Abstract

Acne vulgaris is a very common skin disorder affecting human beings. There is a paucity of report on the role of heavy metals-lead (Pb) and cadmium (Cd)-globally, and trace metals-zinc (Zn) and copper (Cd)-particularly in Nigeria in the development/severity of acne vulgaris. This study is aimed to determine the blood levels of some heavy metals-cadmium and lead-and trace metals-zinc and copper-in acne vulgaris sufferers in a Nigerian population. Venous blood samples were collected from a total number of 90 non-obese female subjects consisting of 30 mild, 30 moderate and 30 severe acne vulgaris sufferers for blood Cd, Pb, Cu and Zn determination. They were age-matched with 60 females without acne vulgaris who served as the control subjects. Acne sufferers had significantly higher blood Cd and Pb (P = 0.0143 and P = 0.0001 respectively) and non-significantly different blood levels of Cu and Zn (P = 0.910 and P = 0.2140 respectively) compared to controls. There were significant progressive increases in blood levels of Cd and Pb (P = 0.0330 and P = 0.0001 respectively) and non-significant differences in the mean blood level of Cu and Zn (P = 0.1821 and P = 0.2728 respectively) from mild to moderate and severe acne vulgaris sufferers. Increases in blood Cd and Pb may play critical roles in the pathogenesis/severity of acne vulgaris, while Cu and Zn seem to play less significant roles in the development of this disorder in this environment.

Serum zinc levels and efficacy of zinc treatment in acne vulgaris: A systematic review and meta‐analysis

“…There were 12 randomized controlled trials and 13 prospective observational studies from 13 countries in Europe, Asia, the Middle East, Africa, and the United States. A total of 12 studies provided data regarding mean serum zinc levels in acne and controls (Table 1), [8][9][10][11][12][13][14][15][16][17][18][19] while 13 studies provided data regarding the efficacy of zinc therapy compared to placebo [20][21][22][23][24][25][26] or active interventions such as topical clindamycin with benzoyl peroxide, 27 topical benzoyl peroxide alone, 28 topical erythromycin, 29,30 topical minocycline, 31 or tea extract ( Table 2). 32 Seven studies 20,[22][23][24][25][26]31 used oral formulations of zinc sulphate 137 to 300 mg 2 to 3 times daily or gluconate daily.…”

Association of serum zinc and vitamin E levels with Acne vulgarisin Bangladeshi acne patients

“…Despite the high prevalence of acne and the known relevance of nutrition with acne, studies on their association are relatively scarce. A limited number of nutritional studies has found with a number of nutrients including vitamin E, zinc, vitamin A (Ozuguz et al, 2014;El-Akawi et al, 2006), selenium (Michaëlsson, 1990), and copper (Ikaraoha et al, 2017) deficient in acne patients. This deficiency could either partly play a role in triggering acne or be the effect of acne pathogenesis.…”

“…Unlike vitamin E studies, there are a good number of studies on zinc level in acne patients though the findings varied (Ozuguz et al, 2014;Ikaraoha et al, 2017;Nasiri et al, 2009;Mogaddam et al, 2014;Kaymak et al, 2007;Michaëlsson and Ljunghall, 1990;Michaëlsson, 1990). While both of the studies on the Turkish population found significant zinc deficiency in acne patients (Ozuguz et al, 2014;Kaymak et al, 2007), other studies on patients from Iran (Nasiri et al, 2009;Mogaddam et al, 2014) and Nigeria (Ikaraoha et al, 2017) found no significant difference when compared to the healthy volunteers in coherence to this study. The study of El-Dibany and Elhassi (2019) also reported no correlation between serum zinc level and severity of acne.…”

“…Reactive oxygen species produced by neutrophils participate in the inflammatory progression of acne; thus, antioxidants are suspected of playing an important role in acne treatment. Studies have shown various patterns of association of nutritional factors, including vitamins and minerals, such as vitamin A and E, zinc, selenium, and copper, in the pathogenesis of acne in a different population (Kucharska et al, 2016;Ozuguz et al, 2014;Ikaraoha et al, 2017). To understand the association of various nutrients on acne pathogenesis, from the literature, we narrowed down zinc and vitamin E to be two of the most potential candidates and studied their serum levels in acne patients.…”

“…It accentuates the immune system, protects skin against UV radiation, and preserves the membranes from peroxidation. The role of zinc in acne pathogenesis is the most studied of all nutrients, although studies have shown variation in results regarding the association of zinc with acne pathogenesis (Ozuguz et al, 2014;Ikaraoha et al, 2017;Nasiri et al, 2009;Mogaddam et al, 2014;Kaymak et al, 2007;Michaëlsson and Ljunghall, 1990).…”