Zinc oxide is a topical mild astringent with weak antiseptic properties. It is used to treat dermatologic conditions such as abrasions, burns, chafing, diaper rash (diaper dermatitis), insect bites, and minor skin irritations. In the US, zinc oxide is available in a topical cream, ointment, or paste. Zinc oxide topical paste is commonly used for weeping and oozing associated with poison ivy (Toxicodendron radicans ), poison oak (Toxicodendron diversilobum,Toxicodendron quercifolium), and poison sumac (Toxicodendron vernix ). Combined with titanium dioxide, zinc oxide is also used as a sunscreen agent (see separate monograph). In Europe, a zinc oxide tape (MeZinc) is available for treating diabetic foot ulcers. Zinc oxide has been available since before 1938.
General Administration Information
For storage information, see the specific product information within the How Supplied section.
Route-Specific Administration
Topical Administration
-Zinc oxide is for topical dermatologic use only; do not take by mouth.
-Avoid contact with eyes and mucous membranes.
Cream/Ointment/Lotion Formulations
-Apply zinc oxide liberally as often as necessary to affected area.
-Do not use on large areas of blistered/broken skin.
-For diaper rash: Change wet and soiled diapers promptly, cleanse the diaper area, and allow to dry. Apply liberally as often as necessary, with each diaper change, especially at bedtime or anytime when exposure to wet diapers may be prolonged.
There have been no adverse reactions reported with the use of topical zinc oxide products.
There are no contraindications associated with the use of topical zinc oxide products. However, type 4 or delayed hypersensitivity reactions may occur in patients with latex hypersensitivity who use zinc oxide topical products concomitantly. This occurs as a result of the chemicals used in the manufacture of latex chemically reacting in the presence of zinc oxide. These chemicals have been documented to cause allergic contact dermatitis.
No problems would be expected with appropriate use of topical zinc oxide during pregnancy (see Zinc Salts monograph).
No problems would be expected with appropriate use of topical zinc oxide during breast-feeding (see Zinc Salts monograph).
For the prevention or treatment of minor skin irritations such as burns, contact dermatitis, Rhus dermatitis due to poison ivy, poison oak, or poison sumac, diaper rash (diaper dermatitis), insect bites or stings, and skin abrasion or cuts:
Topical dosage:
Adults and Children: Apply liberally as often as necessary to affected area.
Infants: For diaper rash apply liberally as often as necessary with each diaper change, especially at bedtime or anytime when exposure to wet diapers may be prolonged.
For the treatment of diabetic foot ulcer*:
Topical dosage (MeZinc brand medicated tape):
Adults and Children: Cleanse wound with normal saline. Dry surrounding skin. Cut adhesive zinc oxide tape to extend 0.5 cm beyond wound margin and apply to the wound; anchor tape with steri-strips. Cover with absorbent pad and tape. Wound should be observed daily. Tape may stay in place for up to 5 days. Remove exudate from surrounding skin with dry gauze until full dressing change. One study reports that use of MeZinc improved necrotic foot ulcers more effectively than using an adhesive occlusive hydrocolloid dressing (DuoDerm).
Maximum Dosage Limits:
-Adults
No maximum dosage information is available.
-Elderly
No maximum dosage information is available.
-Adolescents
No maximum dosage information is available.
-Children
No maximum dosage information is available.
Patients with Hepatic Impairment Dosing
Specific guidelines for dosage adjustments in hepatic impairment are not available; it appears that no dosage adjustments are needed.
Patients with Renal Impairment Dosing
Specific guidelines for dosage adjustments in renal impairment are not available; it appears that no dosage adjustments are needed.
*non-FDA-approved indication
There are no drug interactions associated with Zinc Oxide products.
Topically administered zinc acts as an astringent and weak antiseptic. These actions are thought to be mediated by precipitation of proteins by zinc ions. In the treatment of leg ulcers, zinc enhances reepithelialization, decreases inflammation, and reduces bacterial growth. Zinc oxide also acts as a physical sunscreen agent by blocking ultraviolet radiation.
Zinc oxide is administered topically. Absorption of zinc into the skin does occur, however, the extent of absorption is not known. Once in the systemic blood circulation, zinc is primarily bound to albumin. The liver extracts some zinc from the circulation and stores it. In the plasma, zinc is localized in erythrocytes and leukocytes. Plasma concentrations tend to correspond with dietary intake and physiologic factors (i.e., injury or inflammation). Plasma levels can drop by 50% during the acute phase response to injury probably due to the sequestering of zinc by the liver. Tissue distribution of zinc is highest for the liver, pancreas, kidney, bone, and voluntary muscles. Significant concentrations also occur in parts of the eye, skin, hair, fingernails, toenails, prostate gland, and spermatozoa. Up to 25% of the daily loss is via biliary and pancreatic secretions.
-Route-Specific Pharmacokinetics
Topical Route
Following application of topical zinc oxide, absorption of zinc into the skin does occur; however, the extent is not known.