Oral zinc supplements appear to be sometimes recommended for the treatment of warts or verruca. Zinc is an essential trace element that plays a role the development and integrity of the immune system. If someone is deficient in zinc, then supplementation should be considered. However, if they are not deficient any excess zinc is just excreted and the supplementation will probably have no effect as there is nowhere for the body to use it. Zinc deficiencies are rare in the western world. Any apparent benefit from taking zinc supplements for verruca or warts in those with normal levels is more likely due to the placebo effect or just the natural history as most do eventually resolve spontaneously.
There have been studies done on the use of oral zinc for verruca and they appear to show that it is helpful, but they have been done in countries that generally have a high prevalence of nutritional deficiencies, so there is a high probability the participants in the studies were zinc deficient. Zinc supplementation would probably be indicated in those populations for verruca as their immune response could be impaired.
The common doses in the studies below were 10 mg/kg up to a maximum dose of 600 mg/day.
Research on Zinc Supplementation for Verruca or Warts:
|F.T. Al-Gurairi et al, (2002)||Baghdad, Iraq||"We conclude that zinc sulphate at a dose of 10 mg kg−1 daily seems to be a highly efficacious therapeutic option for recalcitrant viral warts and proved to be safe with few adverse effects."||All participants had low zinc levels (ie zinc deficiency).
Questionable randomisation method.
Very high drop outs in both Zinc and placebo groups (>50%).
All participants in the zinc group reported nausea.
|D. R. López-García et al (2009)||Mexico||"There were no significant differences in response or clearance rates. In the placebo group, six patients had a response (24%), and in the zinc group seven patients responded (28%) (P = 0.94)."|
"Our evidence suggests that in patients without zinc
deficiency, supplementation with zinc is not superior to
placebo in the treatment of viral warts."
|"significantly more gastrointestinal side-effects in the zinc group."|
|Raza and Khan (2010)||Karachi, Pakistan||"Zinc deficiency is associated with persistent, progressive or recurrent viral warts in the studied patients."||Not a trial of zinc supplmentation, but study of levels of zinc in those with verruca compared to controls.|
|Shabaka et al (2016)||Cairo, Egypt||"There was statistically significant decrease in serum zinc level before treatment in patients than control (P < 0.001)."|
"All these types have statistically significant increase in serum zinc level after treatment"
|Case control; not randomized.
Controls included to measure zinc levels.
Did not report outcomes of verrucae from the zinc suplements.
|Iqbal et al (2019)||Multan, Pakistan||"83.3% efficacy" in the zinc group and "57.7 %" in the group applying a combination of salyclic acid and lactic acid.||No information given if randomized.
Dose of salicylic acid & lactic acid was very low strength.
Inadequte reporting of results and anlysis.
|Sadighha (2009)||Ilam, Iran||10/13 on oral zinc resolved and 1/13 resolved in the placebo group at 2 months follow up||Participants in both groups appraed to be deficencey in zinc compared to a 3rd healthy group studied.|
|Hassan et al (2013)||India||" In the patients who received oral zinc sulphate, 60.97% showed|
complete response at the end of six weeks in comparison to 6.45% partial response in the placebo group"
epigastric pain was reported by 6% of patients "
No information reported on zinc levels.
|Yaghoobi et al (2009)||Ahwaz, Iran||response rate was 78% (25 patients) in the treated group versus just 13% (3 patients out of 23) in the placebo arm||Both groups were low in zinc at start of study. Supplement group zinc levels increased.|
|Moniem et al (2016)||Alexandria, Egypt||"Serum zinc level significantly increased after treatment compared with that before treatment in group I (P=0.013); moreover, it became significantly higher than that in group II (P=0.006). The significant increase in serum zinc level in group I was associated with more clinical improvement in the warts. "||"Zinc deficiency is relatively common in our population. Oral zinc supplementation was associated with elevation of serum zinc level, which was associated with clinical improvement in the warts."|
|Mun et al (2011)||Busan, Korea||"Among the 31 patients, 18 patients showed low serum zinc levels|
(58%). Of 26 patients who completed the study (84%), 13 (50%) showed complete resolution of their warts after
2 months of treatment"
|"No serious side-effects
were reported apart from nausea (16%), mild gastric pain (3%) and itching sensation (3%)"
No control group.
Only 33% of plantar warts responded.
|Songa et al (2021)||Sichuan, China||"The use of zinc is a simple, safe, and cost-effective treatment in viral warts based on some preliminary evidence. However, more well-designed studies need to be performed to further evaluate the effect of zinc on warts."||Included studies of those who were deficient in zinc|
- Oral zinc supplementation for verrucae or warts only seems to work when there is a dietary deficiency of zinc. If zinc levels are normal, then the body just excretes the excess intake as the body has no use for it. This makes for expensive urine.
- The above studies included all types and locations of verruca. This means that very few plantar warts were included or reported. When the plantar warts were reported, they were the least responsive type of verruca to the zinc supplementation.
- A deficiency of zinc affects the immune response, but so does an excess of zinc if the body can not clear the higher levels. Using oral supplements if there is no deficiency runs a risk of decreasing the body’s immune response.
Oral Zinc for Verrucae (Podiatry Arena)
Page last updated: