Usage of zinc to manage skin exudation during Topical Steroid Withdrawal

Benefits of Zinc for Wound Healing in Topical Steroid Withdrawal

Zinc can be in effective treatment in wound healing, skin protection and managing the oozing involved in topical steroid withdrawal.

Wound healing involves a cascade of events that begin the moment the skin’s barrier is breached by a cut, burn or wound. Wound healing takes place in several steps;
The first is the inflammatory step. During this period, cytokines are released, neutrophils and macrophages migrate to the site of injury to phagocytose both bacteria and damaged tissue.

The next stage involves the proliferation of fibroblasts and other endothelial cells to form a granulation tissue that blocks the cut or wound.

The final stage is the remodelling stage, where new cells are created as the aggregated platelets and clots are gradually dissolved. This stage is the most sensitive of the three, as any deficiencies of trace minerals may slow down the healing process, encourage the formation of lesions and fibrous scarring.

Zinc, a trace element, can contribute to proper and speedy wound healing. Although zinc seems to be most prominent in the third stage of wound healing, recent studies show that zinc can be utilised in every step of the wound healing process. (1)

 

What is Zinc and Zinc Oxide?

Zinc is a trace element needed by the body to regulate some metabolic processes such as immune responses, wound healing, and blood clotting. Zinc also influences vision and thyroid function. Zinc therapy is commonly used to treat electrolyte imbalance associated with diarrhoea or vomiting. (2)
Zinc oxide is a drug that relieves minor skin irritations, burns, and rashes. In some cases. Zinc oxide is used as a sunscreen, to absorb the harmful, oxidizing rays of the sun.
As an anti-irritant, Zinc oxide forms a protective coat over the skin, preventing contact with irritants and moisture which may cause a rash.
As a sunscreen, Zinc Oxide reflects, absorbs, and scatters incident rays of the sun. Finally, as a bactericide, Zinc oxide prevents bacterial infections by initiating oxidation of bacterial DNA, after permeating the cell membrane.

zinc for tsw

 

How does Zinc Work on the Skin?

About 50mg/kg of Zinc is sufficient for therapeutic effects. Surprisingly, of all tissues, the skin possesses the third-highest abundance of Zinc on the body. To be specific, of the four layers of skin, the epidermis of the skin contains the highest concentration of zinc.
This high amount of zinc is in tandem with a high concentration of ZIP4 transporters, which move Zinc in and out of cells, and keratinocytes.
This may lead us to suspect that Zinc plays a significant role in the production of keratin. Many studies support this notion. (3)
Zinc is also an antioxidant. When used as a topical formulation, it protects the skin from photo-oxidative stress. This delays wrinkling, formation of smile lines, and most importantly, skin cancers.

 

zinc cream for topical steroid withdrawal

Benefits of Topical Zinc

The effects of topical zinc are often under estimated. According to research, topical zinc is more effective than its systemic counterpart in precipitating wound healing. Furthermore, many skin disorders have been associated with zinc deficiency. Examples include Acrodermatitis enteropathica and some kinds of alopecia (4).
Topical zinc therapy proves effective in the following cases:

 

1. Wound healing

Zinc plays a part in all stages of wound healing. When the skin is cut or scratched, bleeding occurs and this reduces ECF volume. Zinc mediates an instant aggregation of the platelet. Patients with decreased serum zinc levels experienced longer bleeding times.
Topical zinc makes for an excellent post-surgical adjuvant because it improves wound healing while offering some anti-infective properties (5). Its cosmetic advantage is also worth noting. Zinc encourages the proliferation and differentiation of keratinocytes, the cells responsible for producing the structural protein keratin. Keratin in turn reduces the risk of scarring.
In other words, topical zinc therapy encourages fast wound healing and often promotes little or no scar formation.
Deficiencies of Zinc have been associated with pellagra and necrolytic migratory erythema. Also, low serum zinc levels may impair vitamin B metabolism (6).

2. Eczema

Eczema is characterized by frequent outbreaks of rash, severe itching, and redness. To a great extent, outbreaks of atopic dermatitis (eczema) are mediated by irregularities of the immune system. In a study it was discovered that the serum zinc levels of children with atopic dermatitis fell below that of an average child within the same weight/height range (7).
Unfortunately, oral supplementation seems to have few benefits in the treatment of eczema and other similar conditions. (8)
Topical zinc (zinc applied on the skin), however, may be the beacon of advancement in eczema treatment. Its anti-infective properties can mitigate flare ups by forming a protective layer.
Lastly, UV rays from the sun can aggravate any existing skin irritations. By deflecting these rays, zinc and zinc oxide will reduce oxidative stress to facial tissue and hold further reddening at bay.

3. Oozing/Weeping Associated with Topical Steroid Withdrawal

Both eczema and its medically suggested treatment option, topical steroids, may cause painful, fluid-filled blisters to form on your face and sensitive skin. Zinc oxide has long been used to soothe discomfort and itching. Various products with differing formulations of zinc within their mixtures, are used not just in Topical Steroid Withdrawal, but also in eczema, measles, chickenpox, and all other forms of skin irritations.
It serves as an anti-irritant and an anti-infective agent. In topical zinc products and calamine lotion, zinc oxide is suspended in a flocculated system. When it is applied, it dries up quickly, giving a cooling sensation. Doing this can dry up blisters and ooze associated with topical steroid withdrawal.

4. Acne

Many zinc preparations have been used to combat acne. Over the years, people who took zinc supplements experienced a reduction in the severity of acne breakouts. Acne lesions and wounds were reported as more mild.
This is due to the anti-inflammatory action of Zinc, ably supported by its wound-healing abilities.

 

Conclusion

Zinc is a trace element crucial for wound healing, immune response, thyroid function, and vision. It promotes swift wound healing and can be used as an antibacterial agent, an anti-irritant, or as a sunscreen.

The most common zinc preparation used for skin irritation is Zinc oxide, the active ingredient in Calamine lotion and other various zinc topical creams, that is trending in efficacy in managing the skin exudation (oozing) present during topical steroid withdrawal.

 

References

  1. https://www.woundscanada.ca/docman/public/wound-care-canada-magazine/2016-14-no3/126-the-role-of-zinc-in-wound-healing/file
  2. https://www.webmd.com/vitamins/ai/ingredientmono-982/zinc
  3. https://www.sciencedirect.com/science/article/abs/pii/S0003986116301898
  4. https://www.sciencedirect.com/science/article/abs/pii/S0003986116301898
  5. https://www.cureus.com/articles/26202-the-effect-of-zinc-on-post-neurosurgical-wound-healing-a-review
  6. https://www.mdpi.com/2072-6643/10/2/199
  7. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2133.1984.tb06630.x
  8. https://europepmc.org/article/med/1782922

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