Four clinical studies have tested zinc supplementation specifically in HS patients. The most cited, Brocard et al. (2007), found partial or complete remission in all 22 participants taking 90mg zinc gluconate daily for four months. The evidence base is small and limited to mild-to-moderate disease. But it is the most consistent supplement evidence in HS by a significant margin.
What the four zinc studies actually found
Zinc is the only supplement with direct HS-specific interventional trial data. The four foundational studies span 2007 to 2020, and they tell a consistent story.
Brocard et al., 2007 (Dermatology): 22 patients with Hurley Stage 1-2 HS received 90mg oral zinc gluconate daily for four months. All 22 showed response: 8 achieved complete remission, 14 achieved partial remission. This is the most cited zinc-HS study and is referenced in European clinical guidelines.
Dréno et al., 2012: Zinc gluconate was compared head-to-head against tetracycline in mild-to-moderate HS. Both were effective. Zinc had fewer antibiotic-associated side effects. This finding positions zinc as clinically comparable to a first-line treatment for mild disease.
Hessam et al., 2016 (Journal of Dermatological Science): 66 HS patients received oral zinc gluconate combined with topical triclosan. After three months, participants reported improved quality of life, reduced redness, fewer inflamed nodules, fewer new boils, and fewer flares.
Molinelli et al., 2020 (JAAD): Zinc combined with nicotinamide as maintenance therapy in mild-to-moderate HS. 47 participants on the supplement had longer symptom-free periods and fewer, shorter flares compared to 45 in the placebo group. This is the most recent controlled study and addresses long-term maintenance, not just acute reduction.
These are small studies. None of them is a large-scale randomised controlled trial. But the consistency across four independent studies in different patient populations over 13 years is meaningful.
Why zinc may affect HS: the biological mechanism
Zinc plays three roles that are directly relevant to HS pathophysiology.
The first is immune modulation. Zinc regulates the activity of T cells and neutrophils, the exact immune cells that are chronically dysregulated in HS. It also modulates TNF (tumour necrosis factor), a key cytokine involved in HS. Adalimumab (Humira), the first FDA-approved biologic for HS, works by inhibiting TNF. Zinc influences this same pathway, at a much more modest level and through a different mechanism.
The second is wound healing and tissue repair. HS creates repeated cycles of skin damage. Zinc is essential for keratinocyte regeneration and tissue repair. People with HS lose zinc through wound exudate, which partly explains why deficiency is so prevalent in this population.
The third is inflammatory regulation. Zinc inhibits NF-kB signalling, one of the key pro-inflammatory mechanisms implicated in HS.
Zinc deficiency in HS: how prevalent is it?
One study of 122 HS patients found significantly lower serum zinc levels compared to participants without HS. Broader research suggests hypozincemia appears in somewhere between 65% and 84% of HS patients across case-control studies.
Several factors explain this. Chronic inflammation increases the body's zinc requirements. Repeated wound drainage causes ongoing zinc loss through exudate. The data doesn't establish that deficiency is the sole driver of disease severity. But it does mean that many HS patients are starting from a depleted baseline before they consider supplementation at all.
Why form matters more than most people realize
All four zinc-HS clinical studies used zinc gluconate. But the form of zinc you take determines how much your body actually absorbs, and gluconate is not the most bioavailable option available today.
Zinc oxide, in most budget supplements and multivitamins, absorbs at around 10-15%. Zinc gluconate, the form used in the HS trials, absorbs at approximately 20-30% and is generally well tolerated. Zinc bisglycinate, bound to two glycine molecules that act as a transport vehicle across the intestinal wall, absorbs at approximately 30-40% with minimal gastrointestinal side effects.
The practical implication: if you take zinc oxide or a poorly absorbed form, you may see nothing and conclude zinc doesn't work. The problem in most cases is form, not the ingredient itself.
Who zinc may help, and who it may not
The zinc-HS trials recruited patients with mild-to-moderate disease, predominantly Hurley Stage 1-2. This is where the evidence base sits. At Hurley Stage 3, zinc is not the primary lever to pull. Biologics, surgery, and specialist-led management are the appropriate interventions at that level.
There is also an individual component. Responses in the studies were not uniform. Some patients showed no improvement. Others saw significant change. This is consistent with HS generally.
What zinc cannot do
Zinc is not a treatment for HS. The North American Clinical Management Guidelines include zinc as an alternative or adjunctive option, not a primary treatment.
It will not work in two weeks. The clinical studies used evaluation windows of three to four months.
It does not replace prescribed medical care. Biologics, antibiotics, hormonal therapy, and surgery address HS through mechanisms zinc cannot match.
There is also an important interaction note: zinc can reduce the absorption of certain oral antibiotics, particularly tetracyclines and quinolones, when taken at the same time. Separating doses by at least two hours eliminates this.
Copper and the zinc-copper balance
Long-term zinc supplementation can gradually deplete copper. Zinc and copper compete for absorption through the same intestinal transporter. Copper deficiency is associated with anaemia, neurological symptoms, and immune dysfunction. Including a small amount of supplemental copper (typically 1-2mg) alongside zinc prevents this depletion from occurring.
What to discuss with your dermatologist
Zinc supplementation at doses relevant to the HS evidence base is generally considered safe when used appropriately. It's worth asking about your current zinc and vitamin D status, as both are frequently depleted in HS populations.
HS Daily includes zinc bisglycinate (20mg elemental) alongside copper bisglycinate (2mg), formulated to support the zinc-copper balance during long-term use. The formula was reviewed by dermatologists who work with HS patients. It is not a treatment for HS. It is nutritional support designed to sit alongside whatever your dermatologist has prescribed.
For more on how the different supplement ingredients in HS research compare, see our overview of what supplements actually help hidradenitis suppurativa (add URL when Post #10 publishes)
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Frequently asked questions
How long does zinc take to work for HS?
The clinical studies used three-to-four month evaluation windows. This is the minimum timeframe to assess whether zinc is having any effect. Two weeks is not long enough. If there is no improvement after 12 weeks of consistent supplementation at an appropriate dose, it's worth reviewing with your dermatologist.
Is zinc safe to take with biologics like Humira or Cosentyx?
Zinc at supplemental doses is not known to interact meaningfully with the biologics approved for HS. There is no documented interaction between zinc supplementation and adalimumab or secukinumab. Always confirm with your prescribing clinician when adding anything to your regimen.
Can you get enough zinc from food for HS?
The richest dietary sources are red meat, shellfish (particularly oysters), legumes, and pumpkin seeds. Most people with HS who have documented deficiency are unlikely to correct it through diet alone, particularly given the ongoing loss through wound exudate.
What zinc dose is in HS Daily?
HS Daily contains 20mg elemental zinc as zinc bisglycinate. This uses a highly bioavailable form and reflects current evidence on dose ranges for adjunctive use in HS.
Is zinc bisglycinate better than zinc gluconate for HS?
The studies used zinc gluconate. Zinc bisglycinate has not been specifically tested in HS trials. But it has higher documented bioavailability (approximately 30-40% vs 20-30% for gluconate) and fewer gastrointestinal side effects.
This article is for educational purposes only. It is not a substitute for medical advice. If you have hidradenitis suppurativa, work with a board-certified dermatologist to build a treatment plan.
References
- Brocard A, Knol AC, Khammari A, Dréno B. Hidradenitis suppurativa and zinc: a new therapeutic approach. Dermatology. 2007;214(3):325-327. https://doi.org/10.1159/000100883
- Hessam S, Sand M, et al. Combination of oral zinc gluconate and topical triclosan. J Dermatol Sci. 2016;84(2):197-202. https://doi.org/10.1016/j.jdermsci.2016.08.010
- Molinelli E, et al. Zinc and nicotinamide in hidradenitis suppurativa. JAAD. 2020.
https://pubmed.ncbi.nlm.nih.gov/32339699/ - Dréno B, et al. Zinc gluconate versus tetracycline in HS. 2012.
https://www.researchgate.net/publication/6369615_Hidradenitis_Suppurativa_and_Zinc_A_New_Therapeutic_Approach?utm_source=chatgpt.com&__cf_chl_tk=bRGWmbUZz.atVUBd1B_YuEW1GIn3mJIx3KQ3axc67_8-1779175788-1.0.1.1-cye_6eiO6O2Wyvmd_TosT9hKAeMfRSevo7we0JcLcUc
Published by HS Daily.
