Zinc and hidradenitis suppurativa: what the studies actually show

Zinc is the most-studied supplement in HS. That says more about supplements than about zinc.

Zinc comes up in every HS community, usually as a success story or a shrug. Both are real: the research signal is genuinely interesting, and genuinely unproven. Here is every study, what it found, and where its limits are, so you can have an informed conversation with your dermatologist instead of a leap of faith.

Small interventional studies · low certainty

What the studies actually did

The reference study is Brocard 2007: an open-label pilot where 22 people with HS received zinc gluconate at 90 mg per day. The reported outcome was striking for a supplement: 8 complete and 14 partial remissions, mostly in people at earlier Hurley stages. Striking, and fragile: no placebo group, no randomization, 22 people.

A retrospective series (Hessam 2016, 66 people) combined oral zinc gluconate with a topical triclosan wash and observed fewer nodules and flares and better quality-of-life scores, but no effect on fistulas or pain. Because two treatments were combined, zinc's individual contribution cannot be isolated.

Systematic reviews of non-pharmacologic approaches (Hendricks 2019, and the micronutrient review by Weir 2023) reach the same verdict: a consistent, promising signal built entirely on small, non-randomized studies.

Sources

Hidradenitis suppurativa and zinc: a new therapeutic approach(2007, interventional study; 22 people with HS, open-label pilot, zinc gluconate 90 mg/day)
Combination of oral zinc gluconate and topical triclosan: An anti-inflammatory treatment modality for hidradenitis suppurativa(2016, case series; 66 people with HS, retrospective)
Non-pharmacologic approaches for hidradenitis suppurativa - a systematic review(2019, review; Systematic review of CAM therapies in HS)
Hidradenitis Suppurativa and Five Key Vitamins and Minerals(2023, review; Narrative review of micronutrients in HS)

What we don't know

There is no randomized placebo-controlled trial of zinc in HS. That means we cannot separate zinc's effect from the placebo effect, from regression to the mean (people enroll in studies when they're at their worst), or from everything else patients change when they start caring for a condition. The doses used in studies are far above nutritional needs, which moves zinc from "supplement" into "pharmacological intervention" territory.

Safety and context

The studies themselves flag the cost of high-dose zinc over time: gastrointestinal effects and, more quietly, copper deficiency, because zinc and copper compete for absorption. Copper deficiency creeps in over months and can cause anemia and neurological symptoms. This is exactly the kind of intervention to run with your doctor and a blood test, not from a forum post: which form, whether at all, and what to monitor are clinical decisions that depend on your labs, your medications and your stage.

For the broader picture of micronutrients in HS (vitamin D included, where deficiency is remarkably common), start from the supplements overview and the vitamin D article.

The only test that counts

Evidence tells you where to look. Your body tells you what's true.

Everything on this page is a map of what's been studied, not a list of rules. The way I found my own triggers was an elimination and reintroduction protocol: one change at a time, a defined window, notes on everything. The full method, and the journal I used to track it, are in the book.

How I tested mine → the book The reintroduction method (free)

← All triggers

I am not a doctor: this page gathers published research and patient-reported information for informational purposes. It is not medical advice, and it is not a recommendation to start, stop or change any treatment, diet or product. Decisions about your health belong in a conversation with your doctor.