Promoting wound healing with zinc oxide
Zinc is a chemical element that is an essential nutrient for the human body and is involved in growth, immune function, tissue maintenance, skin integrity and wound healing (Kogan et al, 2017; Al-Khafaji et al, 2022). Zinc deficiency is associated with older age, poor dietary intake and comorbidities, which are common features of both MASD and PUs (Kogan et al, 2017; Arribas Lopez et al, 2025). Figure 1 outlines the crucial role of zinc at each stage of wound healing.
Zinc oxide is a chemical compound prepared by combining zinc and oxygen. It is a white powder that is poorly absorbed by the body and a good candidate for topical application. Historical evidence exists for topical zinc oxide applications in managing chronic dermatological conditions and lower limb ulceration where an open wound has occurred due to compromised skin integrity (Davies, 2026). A recent systematic review and meta-analysis concluded that zinc treatment is associated with accelerated wound healing (Arribas Lopez et al, 2025). Zinc oxide paste-impregnated cotton dressings have demonstrated improved outcomes in patients with venous leg ulcers (VLUs), particularly when acute inflammation occurs along with generalised skin involvement, such as stasis dermatitis or eczema (Davies, 2026). When used alongside compression therapy, zinc oxide has demonstrated significantly greater healing improvement than compression therapy alone (Beckert et al, 2006). A systematic review recommended that healthcare professionals (HCPs) consider zinc oxide treatment for patients with PUs (Song et al, 2020). As zinc oxide-based treatments, such as medicated dressings, are inexpensive and easy to apply, they may provide a reliable wound care option for patients, HCPs and healthcare systems (Davies, 2026).
Viscopaste™ and Ichthopaste™ (Evolan Pharma) are zinc oxide medicated dressings that have demonstrated benefits in the treatment of patients with VLUs and other skin complications (see Table 1 for a summary of their features and product characteristics). In addition to zinc oxide, Ichthopaste contains ichthammol, an ammonium salt derived from sulphonated shale oil. Due to its reported anti-inflammatory, antibacterial and antifungal properties, ichthammol has historically been used to treat skin conditions such as eczema, psoriasis and boils (Boyd, 2010; National Library of Medicine [NLM], 2026).
As stated in the Instructions for Use (IFU) for Viscopaste and Ichthopaste, the products should not be used in individuals with a known sensitivity to zinc oxide or any other listed ingredient. If a reaction occurs, remove the product, cleanse the affected area with warm water and an emollient, gently pat the area dry and seek medical assistance.
Supporting patients with MASD and/or category 1 or 2 PUs
Skin deterioration and open wounds associated with MASD and pressure damage can severely affect patients’ quality of life. The wound healing mechanisms promoted by zinc oxide in MASD- and pressure-related wounds may be similar to those observed in VLUs (see Figure 1), supporting the use of zinc oxide medicated dressings to promote healing in MASD and category 1 or 2 PUs. Zinc oxide may be a suitable treatment for superficial wounds but not those with exposed bones, tendon or other structures (e.g. in high-category PUs).
Appropriate identification and prompt treatment can help improve patient outcomes. Therefore, HCPs should understand the assessment, diagnosis and management of MASD and PUs and the role of evidence-based zinc treatments (Arribas Lopez et al, 2025).
Table 2 summarises and differentiates MASD and PU characteristics and presentation. It is important to remember that MASD and PUs may coexist, particularly in elderly patients (Wounds UK, 2025; Beeckman et al, 2026).
The general principles of care for MASD and PUs are similar, including:
- Optimisation of patient’s health
- Alleviation of the cause of the wound
- Timely screening and identification via validated tools
- Comprehensive skin care regimen
- Reduction of mechanical and environmental stress
- Promotion of wound healing and skin protection
- Appropriate documentation
- Prompt referral/escalation, where needed.
Given the beneficial role of zinc oxide in wound healing, early intervention with zinc oxide medicated dressings
may improve outcomes in patients with MASD and category 1 and 2 PUs.
Steps and considerations for using zinc oxide medicated dressings
Patch testing is always recommended 48 hours prior to initial use, particularly if zinc oxide sensitivity is suspected. Table 3 (page 3) outlines steps and considerations for using zinc oxide medicated dressings for patients with MASD and/or superficial PUs. Figure 2 shows examples of these medicated dressings.
Conclusion
Despite advances in wound care, improving outcomes for patients with MASD and PUs remains a challenge in practice. Zinc oxide medicated dressings protect fragile skin, reduce inflammation and support compression therapy where needed. Viscopaste and Ichthopaste remain effective, clinically relevant options within holistic, patient-centred community and tissue viability care.
