From the Guidelines
Selenium and zinc supplements should not be considered as primary treatments for acne, as the current evidence is insufficient to support their use, and traditional acne treatments have stronger recommendations. The most recent guidelines for the management of acne vulgaris, published in the Journal of the American Academy of Dermatology in 2024 1, provide strong recommendations for benzoyl peroxide, topical retinoids, topical antibiotics, and oral doxycycline, as well as oral isotretinoin for severe cases.
Key Points to Consider
- The guidelines examined various complementary and alternative therapies, including botanical agents, vitamins, and minerals like zinc, but found the evidence to be insufficient to develop a recommendation for their use in acne treatment 1.
- Traditional acne treatments, such as topical and oral antibiotics, retinoids, and hormonal agents, have a stronger evidence base and are recommended as first-line treatments.
- While selenium and zinc may have antioxidant and anti-inflammatory properties, their use in acne treatment is not supported by the current evidence, and they should not be relied upon as primary treatments.
- Patients with acne should consult with a healthcare provider to determine the best course of treatment, which may include a combination of topical and oral therapies, as well as lifestyle modifications.
Important Considerations for Treatment
- Combining topical therapies with multiple mechanisms of action, limiting systemic antibiotic use, and adding intralesional corticosteroid injections for larger acne lesions are recommended as good practice statements 1.
- Oral isotretinoin is strongly recommended for acne that is severe, causing psychosocial burden or scarring, or failing standard oral or topical therapy 1.
- Conditional recommendations are made for topical clascoterone, salicylic acid, and azelaic acid, as well as for oral minocycline, sarecycline, combined oral contraceptive pills, and spironolactone 1.
From the FDA Drug Label
Zinc is an essential nutritional requirement and serves as a cofactor for more than 70 different enzymes including carbonic anhydrase, alkaline phosphatase, lactic dehydrogenase, and both RNA and DNA polymerase. Zinc facilitates wound healing, helps maintain normal growth rates, normal skin hydration, and the senses of taste and smell Zinc resides in muscle, bone, skin, kidney, liver, pancreas, retina, prostate and particularly in the red and white blood cells. Providing zinc helps prevent development of deficiency symptoms such as: Parakeratosis, hypogeusia, anorexia, dysosmia, geophagia, hypogonadism, growth retardation and hepatosplenomegaly. At plasma levels below 20 mcg zinc/100 mL dermatitis followed by alopecia has been reported for TPN patients.
The FDA drug label does not answer the question about the use of selenium and zinc for acne. The label discusses the importance of zinc in various bodily functions, including skin health, but does not provide information on its use for treating acne, nor does it mention selenium. 2
From the Research
Selenium and Zinc for Acne
- There is no direct evidence regarding the use of selenium for acne treatment in the provided studies.
- However, several studies discuss the role of zinc in acne treatment:
- A systematic review and meta-analysis found that acne patients have decreased serum zinc levels and that zinc is effective for the treatment of acne, particularly at decreasing the number of inflammatory papules 3.
- Another review highlights the various dermatological uses of zinc, including its use in treating acne vulgaris 4.
- A systematic review of the literature found that zinc has antibacterial and anti-inflammatory effects and may decrease sebum production, with a strength of recommendation of B for both oral and topical zinc 5.
- A review of the literature evaluates the effectiveness and side-effect profiles of various formulations of zinc used to treat acne, suggesting that zinc is a promising alternative to other acne treatments due to its low cost, efficacy, and lack of systemic side effects 6.
- A review of acne vulgaris management does not specifically mention zinc or selenium as treatment options, but discusses various other topical and systemic therapies 7.