Acne vulgaris is a common chronic inflammatory skin disorder affecting adolescents and young adults. It involves the pilosebaceous units and is characterized by comedones, papules, pustules, and nodules. The pathogenesis of acne is multifactorial, including increased sebum production, follicular hyper keratinization, microbial colonization, and inflammation (6). In recent years, attention has been directed toward the role of micronutrients, particularly zinc, in the development and severity of acne.

Zinc is an essential trace element that plays a critical role in immune function, wound healing, and inflammatory response. It is also known for its antibacterial and anti-inflammatory properties, which are relevant in acne pathogenesis (4,5). Several studies have suggested that zinc deficiency may contribute to the development and progression of acne vulgaris.

Clinical studies have demonstrated a significant association between serum zinc levels and acne severity. Research indicates that patients with acne tend to have lower serum zinc levels compared to healthy individuals (1,7,9). Moreover, studies have reported that reduced zinc levels are correlated with increased severity of acne lesions (2,8). Zinc is believed to inhibit the growth of acne-causing bacteria and reduce inflammation, thereby improving clinical outcomes.

In addition, dietary intake and biochemical levels of zinc have been shown to influence acne severity. Observational studies have highlighted that inadequate zinc intake may exacerbate acne, while sufficient levels may have a protective effect (3,10). Given the importance of zinc in skin health, it is increasingly being considered as a potential therapeutic option in acne management.

Despite growing evidence, the relationship between serum zinc levels and acne severity remains inconsistent across different populations and study designs. Therefore, this study aims to evaluate the biochemical association between serum zinc levels and acne severity among young adults.

Study Design and Setting

This was a cross-sectional observational study conducted to assess Biochemical Association of Serum Zinc Levels with Acne Severity among Young Adults. The study was carried out Conducted at The Department Of   Biochemistry, dermatology and   Community   Medicine Muhammad College of Medicine, Peshawar   From 1st  Sep   2024  To 30th    Nov     2025.

Study Population: A total of 300 participants aged 18–30 years were included. Both male and female patients presenting with acne were recruited from dermatology outpatient departments.

Sampling Technique : A non-probability convenience sampling technique was used.

Inclusion Criteria

• Patients aged 18–30 years
• Clinically diagnosed acne vulgaris
• Willing to participate

Exclusion Criteria

• Patients on zinc supplementation
• Individuals with chronic systemic diseases
• Patients on long-term antibiotics or retinoids
• Pregnant or lactating females

Data Collection Procedure

1. Sociodemographic Data: Age, gender, and lifestyle information were recorded using a structured questionnaire.
2. Assessment of Acne Severity: Acne severity was assessed using the Global Acne Grading System (GAGS) and categorized as:

• Mild
• Moderate
• Severe

3. Measurement of Serum Zinc Levels: Blood samples (5 ml) were collected under aseptic conditions. Serum zinc levels were measured using standard laboratory techniques and categorized as:

• Low Zinc: <70 µg/dL
• Normal Zinc: 70–120 µg/dL

Statistical Analysis: Data were analyzed using SPSS version 21.Frequencies and percentages were calculated. The Chi-square test was applied to assess association between zinc levels and acne severity.

A p-value ≤ 0.05 was considered statistically significant.

A total of 300 participants with acne vulgaris were included in the study. The mean age of participants was 23.6 ± 3.1 years. Among them, 172 (57.3%) were females and 128 (42.7%) were males. The majority of participants belonged to the 21–25 years age group (48%), followed by 18–20 years (32%) and 26–30 years (20%). Based on the Global Acne Grading System (GAGS), acne severity was categorized into mild, moderate, and severe forms. It was observed that 126 (42.0%) participants had moderate acne, which was the most common presentation. This was followed by 102 (34.0%) with mild acne and 72 (24.0%) with severe acne. Serum zinc levels were assessed in all participants. A total of 162 (54.0%) individuals were found to have low serum zinc levels, while 138 (46.0%) had normal zinc levels. A clear association was observed between serum zinc levels and acne severity. Among participants with low zinc levels, a higher proportion had moderate to severe acne. Specifically, 72 participants with low zinc levels had moderate acne, and 54 had severe acne, whereas only 36 participants with low zinc levels had mild acne. In contrast, among participants with normal zinc levels, the majority had mild acne (66 participants), while fewer had moderate (54 participants) and severe acne (18 participants). Statistical analysis using the Chi-square test demonstrated a highly significant association between serum zinc levels and acne severity (χ² = 21.36, p < 0.001). These findings indicate that lower serum zinc levels are associated with increased severity of acne.

Overall, the results suggest a strong inverse relationship between serum zinc levels and acne severity, with zinc deficiency being more common in patients with severe forms of acne.

Table 1: Sociodemographic Characteristics (n = 300)

Table 2: Distribution of Acne Severity

Table 3: Serum Zinc Levels among Participants

Table 4: Association Between Serum Zinc Levels and Acne Severity

Table 5: Statistical Association

The present study demonstrated a significant association between serum zinc levels and acne severity, with lower zinc levels observed in patients with more severe forms of acne. These findings are consistent with previous research indicating that zinc plays an important role in the pathogenesis and progression of acne.

Zinc has well-established anti-inflammatory and antibacterial properties, which contribute to its beneficial effects in acne management. Clinical trials have shown that oral zinc therapy can significantly reduce acne lesions, supporting its therapeutic role (11,12). Additionally, zinc has been found to reduce inflammation by inhibiting pro-inflammatory cytokines, thereby improving acne severity (14).

The inverse relationship between serum zinc levels and acne severity observed in this study is supported by previous findings. Studies have demonstrated that patients with severe acne often have significantly lower zinc levels compared to those with mild or moderate disease (16,17). Furthermore, zinc deficiency has been linked with increased sebum production and bacterial colonization, both of which are key factors in acne development (18).

Zinc supplementation has also been shown to improve clinical outcomes in acne patients. Several studies have reported that oral zinc sulfate therapy leads to a reduction in inflammatory lesions and overall disease severity (13). These findings suggest that zinc may be an effective adjunct therapy in acne management.

The role of zinc in immune function further supports its importance in acne. Zinc is essential for maintaining proper immune responses, and its deficiency can lead to increased susceptibility to infections and inflammatory conditions (20). Recent studies have also highlighted the potential inverse relationship between serum zinc levels and acne severity, indicating that lower zinc levels are associated with more severe disease (19).

Overall, the findings of this study are in agreement with existing literature, confirming that serum zinc levels are an important biochemical factor influencing acne severity. However, some variability exists due to differences in dietary habits, genetic factors, and study methodologies.

This study concludes that there is a significant inverse relationship between serum zinc levels and acne severity among young adults. Lower serum zinc levels are associated with increased severity of acne. These findings suggest that zinc plays an important role in acne pathogenesis and may serve as a useful adjunct in its management. Further studies are recommended to establish standardized guidelines for zinc supplementation in acne treatment.

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