zinc deprivation has been shown to result in moderate to severe
dermatitis because zinc-based enzymes and proteins play an integral
role in epidermal renewal.7 Zinc is especially important in
wound healing and inflammation reduction, and oral zinc supplements
and topical zinc applications have been shown to accelerate
the processes of wound healing and inflammation reduction.7
In a double-blind trial, Dreno and colleagues randomized 66
AV patients to receive either oral zinc gluconate (200 mg/
day) or placebo for 3 months.8 Inflammatory scores based on
the number of lesions—papules, pustules, and nodules—significantly
improved in the group that received zinc gluconate
compared with the placebo group (P<.02).8 The investigators
concluded that the efficacy of zinc gluconate for the treatment
of AV could be explained by the action of zinc on inflammatory
cells, especially granulocytes.8
Sardena and Garg administered oral zinc methionine plus antioxidants
to 48 mild to moderate AV patients 3 times a day for 3
months, followed by a 4-week treatment-free period.9 The subjects
had a significant reduction in pustules at 8 weeks (P<.05)
and 12 weeks (P<.001), and papules and closed comedones at 8
weeks (P<.05) and 12 weeks (P<.001).9 At the end of the 3-month
treatment period, the study’s subjects had a statistically significant
improvement in their global acne count (P<.05), which
began after 8 weeks (P<.05).9 Nearly 79% (38/48) of the subjects
had 80% to 100% improvement.9 Sardena and Garg concluded
that zinc methionine for mild to moderate facial AV is efficacious
and well tolerated.9
Topical zinc has also demonstrated a sebosuppressive effect.
In a double-blind, randomized trial, 14 volunteers applied a 4%
erythromycin plus 1.2% zinc topical formulation on half of their
foreheads, and a 4% erythromycin lotion on the other half of
their foreheads twice daily for 3 months.
Evaluations of the subjects’ casual level of sebum and sebum
excretion rate were made with a Sebumeter, and their total area
of lipid spots was measured by Sebutape® (Cuderm Corporation,
Dallas, Texas) at 3-week intervals. Significant reductions
in subjects’ casual level of sebum, sebum excretion rates, and
total area of lipid spots were observed for the erythromycinzinc
formulation compared with the erythromycin control lotion
at 6 and 9 weeks.10 One of the molecular mechanisms for zinc’s
reported therapeutic efficacy in the treatment of AV may be its
antiandrogen activity through an inhibition of 5α-reductase.11
Broad-Spectrum Photoprotection With Oleosome Technology
Patients with AV are frequently prescribed topical retinoids, oral
tetracyclines, BPO–containing formulations, etc, that necessitate
photoprotection; and Cetaphil DermaControl Moisturizer
SPF 30 incorporates patented Oleosome Technology™ which
is an innovative delivery system that provides UV protection
with fewer UV filters.12 Oleosomes are found on oil-bearing
plant seeds, and they are between 0.6 μm and 2 μm in diameter.
13 At the core of an olesosome are emollient plant oils and
vitamin E, which are surrounded by a phospholipid membrane
and stabilized by a protein coat.12 Olesosomes mimic the cell
