Acne, pregnant women and zinc salts: A literature review

Background. - Acne in adult women is a common reason for dermatological consultation. Dermatologists are occasionly confronted with the problem of treating acne in women who are either pregnant or seeking to become pregnant, or in breast-feeding women, in whom zinc salts are the only form of systemic treatment that may be envisaged. Patients and methods. - The purpose of our study was to provide an overview of existing data concerning the use of the zinc salts in pregnant and breast-feeding women based on a Literature review, a survey of prescription of zinc gluconate by French dermatologists, and finally, analysis of French pharmacovigilance data. Results. - There are many studies involving the use of zinc supplements during pregnancy. In these studies, more than 2500 pregnant women were given zinc at different doses. None of these studies described any abnormalities, congenital malformation, harmful effects or risk for the foetus associated with the use of zinc during pregnancy at doses below 75 mg/day. Although there are fewer studies of the use of zinc supplements in breast-feeding women, no abnormalities associated with use of zinc during breast-feeding have been reported. According to the results of the prescription survey, around 10,000 pregnant women and 2000 breast-feeding women are treated each year for acne using zinc gluconate, with only four serious adverse events involving zinc being reported since the initial introduction of the product, and with zinc having a doubtful causal relationship. Discussion. - Zinc plays a key role in our body's physiology, since it is involved in the activities of many enzymes. In addition, zinc requirements increase during pregnancy, mainly because of its utilisation during embryogenesis and fetal development. This literature review shows that use of zinc salts in pregnant women is beneficial in those with zinc deficiency but that it has no harmful effects in those without zinc deficiency. (c) 2008 Elsevier Masson SAS. Tous droits reserves.