Zinc is a trace mineral contained in the snail secretions and plays an important role in wound healing & acne lesions

Zinc is an essential trace element in the human body and its importance in skin health and in disease is recognized. It serves as a cofactor in numerous transcription factors and enzyme systems including zinc-dependent matrix metalloproteinases that increase autodebridement and keratinocyte migration during wound repair.

Zinc confers resistance to epithelial apoptosis through cytoprotection against reactive oxygen species and bacterial toxins possibly through antioxidant activity of the cysteine-rich metallothioneins. Zinc deficiency of hereditary or dietary cause can lead to pathological changes and delayed wound healing. Oral zinc supplementation may be beneficial in treating zinc-deficient leg ulcer patients, but its therapeutic place in surgical patients needs further clarification.

Topical administration of zinc appears to be superior to oral therapy due to its action in reducing superinfections and necrotic material via enhanced local defense systems and collagenolytic activity, and the sustained release of zinc ions that stimulates epithelialization of wounds in normozincemic individuals. Zinc oxide in paste bandages (Unna boot) protects and soothes inflamed peri-ulcer skin. Zinc is transported through the skin from these formulations, although the systemic effects seem insignificant.

We present here the first comprehensive account of zinc in wound management in relation to current concepts of wound bed preparation and the wound-healing cascade. This review article suggests that topical zinc therapy is underappreciated even though clinical evidence emphasizes its importance in autodebridement, anti-infective action, and promotion of epithelialization.

Zinc is a transitional metallic element known from ancient times. It is widely distributed in the human environment, being found in water, air, and virtually all foodstuffs. The medicinal properties of zinc in the form of calamine were documented more than 3,000 years ago in the Ebers Papyrus and in ancient Ayurvedic manuscripts in early Indian medicine, but the observation by Raulin in 1869 that the mold Aspergillus niger would not grow on a zinc-deficient medium was fundamental in establishing the importance of zinc in biological systems.

Subsequent research has shown that zinc is present, albeit in minute concentrations, in all living plant and animal cells, mainly in the form of cofactors or structural components in key enzyme systems in cell replication, protein synthesis, and repair systems following injury. In 1941, Keilin and Mann identified the first metalloenzyme, carbonic anhydrase, with zinc as an essential cofactor, but more recently zinc has been identified in more than 300 different enzymes, of which alcohol dehydrogenase, alkaline phosphatase, angiotensin-converting enzyme, matrix metalloproteinases (MMPs), reverse transcriptase, RNA and DNA polymerases, and superoxide dismutase are well documented.

In addition to its role in nucleic acid and protein synthesis, carbohydrate metabolism, and oxygen transport, zinc is now known to be instrumental in stabilizing cellular membranes. Zinc-finger proteins are a family of more than 2,000 transcription factors that bind specifically to DNA and activate transcription of growth factors, cytoprotective proteins, and are regulators of adult hematopoietic stem cells. Apart from its importance in protein complexes, the zinc ion is closely involved in intracellular signaling and neurotransmission.

Zinc is second only to iron in being the most abundant trace element in the human body, but its nutritional significance came to light only in the 1960s following reports of zinc-responsive growth failure in infants in rural Egypt and Iran.

Because of new clinical evidence presented at the World Union of Wound Healing Societies' meeting in Paris 2004, it is timely to re-evaluate the potential benefits offered by zinc therapy in wound management. Although numerous clinical trials claim to show the benefits of using oral or topical zinc therapy in wound management, variations in treatment regimen and zinc formulations used have obscured the true efficacy of the protocols. In keeping with the early studies on supplementary zinc therapy in pilonidal sinus management, evidence is now available to show that not only is zinc beneficial in the healing profile but that it provides an effective level of anti-infective action. Furthermore, a young boy with Hirschsprung's disease with symptoms of zinc deficiency successfully treated with zinc following gastrointestinal surgery provides further irrefutable evidence for the value of zinc in wound healing.

This review: Zinc in wound healing: Theoretical, experimental, and clinical aspects summarizes the knowledge on regulation of zinc homeostasis, nutritional role, and metabolism of the trace element, zinc deficiency and diagnosis, and zinc in skin physiology. It also provides an extensive summary of experimental and clinical studies on the physiological and pharmacological roles of zinc in the wound-healing process.

This link provides more information on topical zinc and on dietary sources of zinc: Topical Zinc & Zinc in Diet for Skin Health

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