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Skin Health Protocol

Inflammatory and Noninflammatory Lesions

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Dr. Alex Keller, ND
Protocols Fullscript Protocols
Inflammatory and Noninflammatory Lesions

Protocol development in integrative medicine is not typically a simple process. Individuals require individualized care, and what works for one patient may not work for another.

To establish these protocols, we first developed a Rating Scale that could be used to discern the rigor of evidence supporting a specific nutrient’s therapeutic effect.

The following protocols were developed using only A through C-quality evidence.

Systematic review or meta-analysis of human trials
RDBPC human trials
2+ studies and/or 1 study with 50 + subjects
RDBPC human trials
1 study

Skin Health – Inflammatory and Noninflammatory Lesions


Skin lesions affect a large portion of the population. Teenagers between the ages of 13 to 18 experience the highest rates, with skin lesions affecting approximately 80% of individuals.1 Some studies cite the prevalence in adolescents as high as 85%. 2 Additionally, skin lesions continues to affect 3% of men and 12% of women over 25 years of age.1

Addressing the underlying mechanisms involved in the development of skin lesions is vital to integrative treatment plans. Certain topical and dietary supplement therapies show promising results. For example, decreasing sebum production may play a role in improving total lesion count.2,3 Other interventions suggest that inducing anti-inflammatory mechanisms via the suppression of NF-κB and AP-1 pathways may subsequently decrease the number of inflammatory lesions.2

Based on the research findings, the ingredients presented in the protocol below have demonstrated efficacy in alleviating skin lesions.

Zinc gluconate

30 mg elemental zinc from zinc gluconate, once per day, 6-12 weeks4,5

  • A decrease in inflammatory score demonstrated by the number of inflammatory lesions was observed in individuals receiving zinc gluconate supplementation when compared to placebo5,4,3
  • Compared to baseline, zinc sulfate supplementation resulted in a decreased number of papules, pustules, infiltrates, and cysts in 58% of patients6,7
  • Overall improvement in lesion counts following zinc sulfate supplementation when compared to placebo, with improved efficacy over the duration of 12 weeks8,9
Zinc gluconate in the Fullscript catalog

Tea tree oil (Melaleuca alternifolia)

5% tea tree oil gel applied topically, 1-2 times per day, 45 days to 12 week10,11,12

Disclaimer: It is suggested to dilute tea tree essential oil with a carrier oil (e.g., olive oil) to avoid skin irritation13

  • Application of tea tree oil decreased total number of inflamed and non-inflamed acne lesions by 43.64% according to mean total acne lesions count10,11,12
  • Fewer side effects observed in those treated with tea tree oil gel when compared with benzoyl peroxide lotion10
  • Tea tree oil decreased total lesion counts by 45.64% and acne severity index by 40.49% compared to placebo11
Tea tree oil in the Fullscript catalog

Green tea extract (Camellia sinensis)

1500 mg green tea extract with standardized EGCG of 856 mg, once per day, 4 weeks, or 1-5% tea catechin gel, applied topically 1-2 times per day, 8 weeks14,2,15

  • Decreased revised Leeds score, which assesses inflammatory and noninflammatory acne lesions such as papules, pustules, nodules, cysts, and comedones, following topical application of both 1% and 5% EGCG2
  • Lesion count of acne vulgaris decreased following EGCG supplementation or green tea topical application compared to baseline and placeb2,15
  • Reduced number of facial inflammatory lesions on the nose, perioral area, and chin, when compared to baseline in women with post-adolescent acne14
  • EGCG regulated the AMPK-SREBP-1 signaling pathway, inhibited NF-κB and AP-1 signaling pathways and caused cytotoxicity of SEB-1 sebocytes, thereby reducing inflammation, sebum production and P. acnes2
Green tea extract in the Fullscript catalog


The Fullscript Integrative Medical Advisory team has developed or collected these protocols from practitioners and supplier partners to help health care practitioners make decisions when building treatment plans. By adding this protocol to your Fullscript template library, you understand and accept that the recommendations in the protocol are for initial guidance and may not be appropriate for every patient.

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Systematic review or meta-analysis of human trials
Systematic review or meta-analysis of human trials
Systematic review or meta-analysis of human trials

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