Topical Zinc Oxide and Wound Healing

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Zinc in wound healing

by Aletha Tippett MD

Well, what a surprise to find that what you have been doing all along is really the right thing to do even though you didn’t know the reason. Always, over the years doing wound care, I applied a thick layer of zinc oxide ointment around the patient’s wound, then put my dressing on the wound and covered it with a topping, usually plastic wrap pressed into the zinc oxide ointment.

My rationale for dressing wounds in this manner was that the zinc oxide protected the periwound skin from moisture, preventing damage. Zinc oxide not only does that, but it also enhances healing as I found out in the most recent issue of Wounds. There was a very nice review article published in April about zinc and wound healing. I knew that my wounds healed, but was not aware of the impact of the zinc oxide.

What is Zinc Oxide?

Zinc is a trace element very abundant in the body. While it is known that zinc deficiency can cause delayed wound healing, the actual role of zinc in wound healing was not known. A number of experimental studies and clinical trials have been conducted using zinc. Results showed that topical zinc oxide had increased wound healing, increased reepithelialization, decreased rates of infection and decreased rates of deterioration of ulcers. Topical zinc oxide has shown to improve the rate of wound healing in patients, regardless of their zinc status. Oral zinc supplementation in zinc deficient patients did not have the same effect.

The animal studies reviewed showed that zinc sulfate did not enhance wound healing, but delayed it. One of the major roles for zinc in wound healing was found that zinc oxide enhances the ability of matrix metalloproteinases (MMPs) to enzymatically break down collagen fragments. There are few clinical studies, but they have all shown a positive benefit for topical zinc oxide, and of interest, especially when used for debridement in burns.

Further research on the topic of zinc in wound management has been recommended, but for now, I would say use zinc oxide whenever possible. I certainly will continue using it in my wound care practice, especially now I know it is actively helping the wound.

Reference:
Kogan S, Sood A, Granick M. Zinc and Wound Healing: A Review of Zinc Physiology and Clinical Applications.Wounds. 2017;29(4): 102-106.

About The Author
Aletha Tippett MD is a family medicine and wound care expert, founder and president of the Hope of Healing Foundation®, family physician, and international speaker on wound care.

The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.

Comments

Thank you Dr. Tippett for sharing this important information about Zn and Zinc Oxide in relation to wound healing. The Wounds review article you mention is really good. At Viniferamine, we also believe in the power of Zn and ZnOxide in wound healing. Our SkinMineralZ includes Zinc Oxide along with 3 French clays to help restore and detoxify skin. It nourishes macerated and inflamed skin and can be used in many wound healing applications. SkinMineralZ also includes other important nutrients for skin health including antioxidants and vitamins. Zinc and Zinc Oxide are amazing. Thanks again for sharing.

That is good to now. Today the zinc oxide given in a diferent % and this very convenient in the diferent uses. Is very important have be careful in the sensitive skin in old patient.

would you ever use it in the wound bed for debridement? I have only used it on the periwound.

I just wanted to ask if this treatment is recommended with patients that have ulcers due to PVD or diabetes ? Further information and reading would be appreciated

Thanks 4 information. Do you have to apply sterile zinc oxide on wound, or OTC zinc oxide will do?

There seems to be significant amnesia regarding the most basic fundamental principles of magnetism. Everyone should remember that positive and negative attract and that positive and positive rappel, as do negative and negative. Zinc oxide has a positive charge based on the plus one charge of the Zinc. It is formulated to adhere and protect the skin which has a negative charge. Positive zinc oxide skin cream will stick to negatively charged skin. Loss of the skin now it exposes the subcutaneous tissue which has a positive charge. That is why our bodies stick together because the positive skin adheres to the negative soft tissues. Were the soft tissues also negatively charged, we would explode like overripe watermelons. And so, attempts to apply a positively charged skin cream into a positively charged open wound just isn't going to happen. As an aside, I have taught for years that zinc oxide is an excellent way to measure wounds since it will stick only to epithelium and not to open wounds and so you simply measure from the white edge to the white edge and that is your wounds length and width. Again, if you have any recollection of the elementary school magnetism, forget about putting zinc based creams into the wound. As far as the effects of zinc on the periwound intact skin, and what that does to healing, why not go with the oral ZInc Sulfate since that suppies it to all the skin, not just the area of concern at that time ? the only issue is will using the cream on the peri-wound reduce adherence of your adhesive dressings ? The eternal battle between solid science and "whattya think about".

All substances foreign to the extracellular matrix are potentially inflammatory, increase metalloproteases. But we all agree that it is these proteins, among other substances, that chronify the wounds. Best regards

Zinc oxide provides a moist wound environment, and moist wound environments support rapid wound healing. The zinc from zinc oxide leaches into the woundbed, as well, correcting deficiencies and decreasing inflammation. However, because zinc is absorbed systemically (even through intact skin), zinc toxicity is a concern. Allergic reactions (including anaphylaxis) can occur, but are not common and are usually related to high systemic zinc levels due to absorption of zinc through the skin over time. The FDA warns that topical zinc is not recommended during pregnancy. Podiatry Today published a summary of research on the use of zinc oxide in open wounds back in 1990. http://www.podiatrytoday.com/article/1894

Great comments. Thanks to everyone. Zinc oxide ointment is used on the periwound, not the wound. OTC is fine. I have never used it for debridement.

The main mistake in therapy of chronic wounds. with extremely low outcome is the attitude to the wound as an organ disease and attempts to treat it at any cost. Try to look at the wound as a dead tissue, which is ridiculously to cover with honey, silver, to through out the exudation, has produced by immune system for dead or harmed tissue restoring discharge to clean it, putting into high-pressure chambers to breath the oxygen and a lot of other ridiculous and absurd manipulations with dead and non-viable tissue devoid of biological communication with the rest of the body, that does not see it and does not want to fight it.

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