Zipzoc Medicated Stocking: Uses, Dosage & Side Effects
A zinc oxide-impregnated medicated stocking used as an inner bandage layer for the treatment of chronic venous leg ulcers, venous insufficiency, and post-surgical wound care
Zipzoc Medicated Stocking is a zinc oxide-impregnated elastic viscose stocking designed for the management of chronic venous leg ulcers and related conditions of the lower limbs. The stocking serves as the inner layer in a dual-bandage compression system: it delivers continuous soothing zinc oxide ointment directly to the skin while preventing the adhesive outer compression bandage from sticking to the wound or surrounding skin. Zipzoc is widely used in wound care clinics, community nursing, and hospital settings across Europe. It is classified as an over-the-counter product but is most commonly applied by trained healthcare professionals as part of a comprehensive leg ulcer management plan. The zinc oxide provides a protective, anti-inflammatory barrier that supports the natural wound healing environment.
Quick Facts: Zipzoc Medicated Stocking
Key Takeaways
- Zipzoc Medicated Stocking is a zinc oxide-impregnated viscose bandage stocking that forms the inner layer of a dual-bandage compression system for treating chronic venous leg ulcers and venous insufficiency of the lower limbs.
- The stocking is pulled onto the lower leg from the base of the toes to the knee crease, smoothed flat, and then covered with a suitable compression bandage; the combination is typically changed once per week.
- Zinc oxide (200 mg/g) provides a soothing, protective barrier with mild anti-inflammatory and astringent properties, promoting moist wound healing and preventing adhesion of the outer bandage to the skin.
- Zipzoc must not be used in patients with arterial insufficiency of the lower limbs, and an ankle-brachial pressure index (ABPI) assessment should be performed before initiating compression therapy.
- Common side effects are limited to mild local skin reactions (rash, redness, itching, wound edge softening); no known risks during pregnancy or breastfeeding have been identified.
What Is Zipzoc Medicated Stocking and What Is It Used For?
Zipzoc Medicated Stocking consists of a tubular, knitted viscose fabric that has been uniformly impregnated with a zinc oxide-based ointment. The stocking is 80 cm in length and is designed to cover the entire lower leg from the base of the toes up to the knee crease. When applied, it provides continuous, even contact between the medicated ointment and the skin surface, delivering the therapeutic benefits of zinc oxide directly to the affected area.
The zinc oxide ointment within the stocking has well-established soothing and protective properties. Zinc oxide has been used in dermatology and wound care for centuries due to its mild astringent, antiseptic, and anti-inflammatory effects. When applied to damaged or ulcerated skin, it creates a physical barrier that protects the wound bed from external irritants, reduces local inflammation, and supports the natural processes of tissue repair. The ointment base (consisting of liquid paraffin and white petrolatum) further contributes to maintaining a moist wound healing environment, which is recognized by international wound care guidelines as optimal for granulation tissue formation and epithelialization.
One of the critical functions of Zipzoc Medicated Stocking is to serve as a non-adherent interface between the skin and the outer compression bandage. In the management of venous leg ulcers, compression therapy is the cornerstone of treatment. However, applying a compression bandage directly to an ulcerated or fragile leg can cause the bandage to adhere to the wound surface, leading to pain and tissue damage during dressing changes. By placing the Zipzoc stocking as the inner layer, the zinc oxide ointment prevents this adhesion. The dual-bandage system (Zipzoc plus compression bandage) can remain in place for extended periods, typically up to one week, reducing the frequency of painful dressing changes and allowing the wound to heal undisturbed.
Zipzoc Medicated Stocking is indicated for the following conditions:
- Chronic venous insufficiency (CVI): A condition in which the veins of the lower legs cannot efficiently return blood to the heart, leading to swelling, skin changes, and ultimately ulceration. CVI affects an estimated 2–5% of the adult population in Western countries. The zinc oxide stocking, combined with compression, helps manage the associated skin inflammation, edema, and tissue breakdown.
- Chronic venous leg ulcers (ulcus cruris): Open wounds on the lower leg caused by chronic venous hypertension. Venous leg ulcers are the most common type of chronic lower-extremity wound, accounting for approximately 70–80% of all leg ulcers. They can be persistent and difficult to heal, often requiring months or even years of treatment. Zipzoc provides an ideal inner dressing layer as part of the standard compression bandage regimen.
- Post-operative bandaging: After surgical procedures on the lower limbs, particularly varicose vein operations (such as stripping, phlebectomy, or endovenous ablation), the Zipzoc stocking is used under compression wrapping to protect the surgical sites, reduce inflammation, and prevent the outer bandage from adhering to the incisions or wounds.
The dual-bandage system is a well-established approach in venous leg ulcer management. The inner layer (Zipzoc Medicated Stocking) provides the medicated contact with the skin, while the outer layer (compression bandage) delivers the therapeutic compression needed to counteract venous hypertension. Together, they create an effective treatment system that can be left in place for up to a week, minimizing wound disturbance and supporting continuous healing. Clinical studies have demonstrated that this approach significantly improves ulcer healing rates compared to non-compression regimens.
The zinc ion itself plays an important role in wound healing at the cellular level. Zinc is a cofactor for more than 300 enzymes involved in cell division, immune function, protein synthesis, and DNA repair. Topical zinc oxide delivers zinc directly to the wound microenvironment, where it can support keratinocyte migration, fibroblast proliferation, and collagen synthesis. Research published in the Journal of Wound Care and the International Wound Journal has confirmed that zinc-containing dressings contribute to improved healing outcomes in chronic wounds, particularly when combined with adequate compression therapy.
What Should You Know Before Using Zipzoc Medicated Stocking?
Contraindications
There are specific situations in which Zipzoc Medicated Stocking must not be used. Understanding these contraindications is essential for safe treatment.
- Allergy to zinc oxide or excipients: Do not use Zipzoc if you are allergic to zinc oxide, liquid paraffin, white petrolatum, or any other component of the medicated stocking. Although allergic reactions to zinc oxide are rare, they can occur. Signs of an allergic reaction include widespread rash, significant swelling, hives, or worsening skin irritation at the application site.
- Arterial insufficiency of the lower limbs: Zipzoc Medicated Stocking must not be used in patients with impaired arterial blood supply to the legs. Because Zipzoc is designed to be used in combination with compression bandaging, applying compression to a limb with compromised arterial circulation can seriously worsen tissue ischemia, potentially leading to gangrene or limb loss. Before starting any compression therapy, healthcare professionals should perform an ankle-brachial pressure index (ABPI) assessment. An ABPI below 0.8 generally contraindicates full compression therapy, and patients with an ABPI below 0.5 should not receive any compression at all.
Before applying Zipzoc Medicated Stocking with compression, it is essential to confirm that the patient does not have significant peripheral arterial disease. An ankle-brachial pressure index (ABPI) of 0.8 or above is generally required before initiating compression therapy. Applying compression to a limb with arterial insufficiency can cause severe tissue damage. If you experience increasing pain, color changes (pallor or cyanosis), or numbness in the toes after bandage application, remove the bandage immediately and seek medical attention.
Warnings and Precautions
While Zipzoc Medicated Stocking is generally well tolerated, certain precautions should be observed:
- Wound infection: If the wound shows signs of active infection (increased redness, warmth, swelling, pus, foul odor, or systemic symptoms such as fever), the underlying infection should be treated appropriately before applying or continuing with the Zipzoc bandage system. Occlusive dressings can promote bacterial growth in infected wounds.
- Diabetes: Patients with diabetes may have both venous and arterial components to their leg ulcers. A thorough vascular assessment is particularly important in this population. Diabetic neuropathy can mask the pain of ischemia, making clinical assessment alone unreliable.
- Sensitive or eczematous skin: While zinc oxide is generally soothing, some patients with highly sensitized or eczematous skin may experience increased irritation. If a significant skin reaction develops, the stocking should be removed and an alternative dressing considered.
- Correct application: Wrinkles or folds in the stocking can create pressure points that may damage fragile skin. The stocking should be carefully smoothed after application to ensure uniform contact with the skin surface.
Pregnancy and Breastfeeding
No risks associated with the use of Zipzoc Medicated Stocking during pregnancy or breastfeeding have been identified. Zinc oxide is applied topically to the skin of the lower leg and has very limited systemic absorption. It has a long history of safe use as a skin protectant in pregnant and breastfeeding women. The other ingredients (liquid paraffin and white petrolatum) are inert emollients with no known systemic effects.
Venous insufficiency and leg edema are actually more common during pregnancy due to the increased blood volume and pressure from the growing uterus on the pelvic veins. If compression therapy is indicated during pregnancy, Zipzoc Medicated Stocking can be used as directed by the treating healthcare professional. However, as with all treatments during pregnancy, it is advisable to consult your doctor or midwife before use.
Driving and Operating Machinery
Zipzoc Medicated Stocking has no effect on the ability to drive or operate machinery. It is a topical wound dressing and does not produce any systemic pharmacological effects that could impair alertness, reaction time, or cognitive function.
How Does Zipzoc Medicated Stocking Interact with Other Drugs?
Because Zipzoc Medicated Stocking is a topically applied wound dressing with negligible systemic absorption, the risk of pharmacokinetic drug interactions is extremely low. Zinc oxide acts locally on the skin surface and does not enter the bloodstream in clinically meaningful quantities. It does not affect hepatic enzyme systems (such as the cytochrome P450 family) and does not alter the absorption, distribution, metabolism, or excretion of oral or injectable medications.
However, some practical considerations regarding concurrent topical use should be noted:
Topical Considerations
| Product | Consideration | Recommendation |
|---|---|---|
| Topical antibiotics (e.g., mupirocin, fusidic acid) | May be applied to infected areas before the stocking is placed | Apply to wound bed first, allow to absorb briefly, then apply Zipzoc |
| Topical corticosteroids (e.g., betamethasone, clobetasol) | May be used for surrounding eczematous skin (venous eczema) | Apply to periulcer skin before Zipzoc; the occlusive effect of the stocking may enhance steroid penetration |
| Wound cleansers (saline, antiseptic solutions) | Should be used to clean the wound before redressing | Clean and dry the wound surface before applying a new Zipzoc stocking |
| Other zinc-containing products | Redundant application; excessive zinc may cause irritation | Avoid layering multiple zinc oxide products on the same area |
| Adhesive dressings or tapes | The ointment layer may prevent adhesive products from sticking | Use the compression bandage as the securing layer rather than adhesive tape |
Patients receiving systemic treatments for venous disease (such as pentoxifylline, sulodexide, or aspirin for venous ulcers) can safely use Zipzoc Medicated Stocking concurrently. The topical zinc oxide does not interact with these systemic therapies. Similarly, patients on anticoagulants, antihypertensives, or diabetes medications can use Zipzoc without concern for interactions.
Zipzoc Medicated Stocking is specifically designed to be used with an outer compression bandage. It is compatible with all standard compression bandaging systems, including short-stretch bandages, long-stretch bandages, multi-layer bandaging systems, and cohesive compression wraps. Your healthcare professional will select the most appropriate compression system based on your clinical needs and ABPI results.
What Is the Correct Way to Use Zipzoc Medicated Stocking?
Zipzoc Medicated Stocking should always be used according to the instructions provided by your doctor, nurse, or wound care specialist. While it is classified as an over-the-counter product, the application technique and the associated compression therapy require clinical expertise. Most patients will have their Zipzoc stocking applied by a trained healthcare professional, either in a wound care clinic, hospital, or during a community nursing visit.
Application Method
Step-by-Step Application
Step 1: Clean the wound and surrounding skin according to your healthcare provider's instructions. Gently pat the area dry.
Step 2: Remove the Zipzoc Medicated Stocking from its packaging. The stocking is 80 cm long and made of white viscose fabric impregnated with white zinc oxide ointment.
Step 3: Pull the stocking onto the lower leg, starting from the base of the toes and extending up to the knee crease (popliteal fossa). Ensure the entire lower leg is covered.
Step 4: Carefully smooth out any wrinkles or folds in the stocking. Creases can create pressure points on fragile skin and impair the even distribution of zinc oxide ointment.
Step 5: Apply a suitable compression bandage over the Zipzoc stocking as directed by your healthcare professional. The compression bandage provides the therapeutic pressure needed to manage venous hypertension.
Redressing Frequency
Standard Redressing Schedule
Frequency: The dual bandage (Zipzoc Medicated Stocking + compression bandage) is typically changed once per week.
Adjustment: Your healthcare professional may recommend more frequent changes if the wound is heavily exuding, shows signs of infection, or if the bandage becomes loose or soiled.
Duration of treatment: Treatment continues for as long as clinically indicated. Venous leg ulcers may require weeks to months of consistent compression therapy to heal. Your healthcare professional will regularly assess wound progress and adjust the treatment plan accordingly.
Special Considerations by Population
| Population | Considerations | Typical Frequency |
|---|---|---|
| Adults with venous leg ulcers | Standard application; ensure ABPI ≥ 0.8 before compression | Once weekly |
| Elderly patients | Fragile skin requires gentle handling; monitor for pressure damage | Once weekly; more often if skin is fragile |
| Post-surgical patients | Applied after varicose vein surgery or phlebectomy; short-term use | As directed by surgeon; typically 1–2 weeks |
| Patients with mixed ulcers | Requires specialist assessment; reduced compression may be needed | Individualized under specialist care |
| Pregnant women | Safe to use; compression helps manage pregnancy-related edema | As directed by healthcare provider |
Removing and Changing the Bandage
When it is time to change the bandage, carefully remove the outer compression bandage first, then gently peel off the Zipzoc stocking. Because the zinc oxide ointment prevents adhesion, the stocking should come away easily without sticking to the wound bed. If any part of the stocking is adherent, moisten it with warm saline or water before removal to minimize trauma to the healing tissue.
After removal, clean the wound according to your healthcare provider's instructions, assess the wound for signs of healing or deterioration, and apply a fresh Zipzoc stocking followed by a new compression bandage. Used stockings should be disposed of according to local clinical waste guidelines.
While Zipzoc Medicated Stocking is classified as an OTC product, the associated compression bandaging requires clinical training to apply correctly. Incorrectly applied compression can cause tissue damage, particularly in patients with mixed arterial-venous disease. Always have your compression bandage applied by a trained healthcare professional who has assessed your vascular status.
What Are the Side Effects of Zipzoc Medicated Stocking?
Like all medicinal products, Zipzoc Medicated Stocking can cause side effects, although not everyone will experience them. Because the product is applied topically with minimal systemic absorption, the side effects are almost exclusively local, affecting only the area of skin in contact with the stocking. The zinc oxide ointment is generally very well tolerated, and serious adverse reactions are rare.
The safety profile of zinc oxide in wound care is well established. Zinc oxide has been used in topical preparations for over a century, and its low sensitization potential is well documented in dermatological literature. However, as with any product applied to damaged skin, individual reactions can occur.
Side Effects by Frequency
Common
May affect up to 1 in 10 users
- Local skin rash at the application site
- Redness (erythema) of the skin under the stocking
- Itching (pruritus) at the bandaged area
- Softening or maceration of wound edges due to the moist environment
Rare
May affect up to 1 in 1,000 users
- Allergic contact dermatitis to zinc oxide or ointment base
- Worsening of pre-existing eczema at the application site
Not Known
Frequency cannot be estimated from available data
- Secondary skin infection under the occlusive bandage (usually related to wound status rather than the product itself)
- Pressure damage from improperly applied stocking with wrinkles or folds
Understanding Maceration
Maceration (softening and whitening of the skin around the wound edges) is the most commonly observed local effect. This occurs because the zinc oxide ointment and the occlusive nature of the stocking maintain a very moist environment. While some moisture is beneficial for wound healing, excessive maceration can delay healing and increase the risk of wound breakdown. Healthcare professionals monitor for maceration at each dressing change and may adjust the treatment regimen if it becomes problematic, such as by increasing the dressing change frequency or using additional absorbent layers.
When to Seek Medical Attention
You should remove the bandage and contact your healthcare provider promptly if you experience any of the following:
- A widespread rash or hives extending beyond the bandaged area
- Significant swelling, blistering, or severe itching
- Signs of wound infection: increasing redness, warmth, pain, pus or foul-smelling discharge, or fever
- Increasing pain in the leg or foot, or color changes in the toes (pallor, blueness) which may indicate compromised circulation from the compression bandage
- Any symptoms that concern you or that appear to be worsening despite treatment
It is important to report any suspected side effects to your healthcare provider or to your national pharmacovigilance authority. Reporting helps to continuously monitor the benefit-risk balance of the product. In the EU, suspected adverse reactions can be reported through national reporting systems. In the UK, reports can be made via the Yellow Card scheme. In the US, reports can be submitted to the FDA MedWatch program.
How Should You Store Zipzoc Medicated Stocking?
Proper storage of Zipzoc Medicated Stocking ensures that the product remains effective and safe to use throughout its shelf life. The zinc oxide ointment is stable under standard storage conditions, but exposure to extreme heat or direct sunlight can affect the consistency and distribution of the ointment within the stocking fabric.
- Temperature: Store at room temperature (below 25°C / 77°F). Do not refrigerate or freeze, as this can alter the consistency of the ointment and make the stocking stiff and difficult to apply.
- Light and moisture: Keep the product in its original packaging until ready for use, protected from direct sunlight and excessive humidity.
- Children: Keep out of the sight and reach of children. While zinc oxide is not toxic when applied to intact skin, the product is intended for supervised medical use only.
- Expiry date: Do not use after the expiry date stated on the outer carton. The expiry date refers to the last day of the month indicated. Using expired products may result in reduced effectiveness of the zinc oxide ointment or degradation of the viscose fabric.
- Disposal: Do not dispose of used stockings in household waste or down the drain. Used Zipzoc stockings may contain wound exudate and should be treated as clinical waste. Ask your healthcare provider or pharmacist about the correct disposal method for used wound care products in your area.
Each package of Zipzoc Medicated Stocking contains 10 individually wrapped stockings. Once a stocking is removed from its individual wrapper, it should be applied promptly. Do not reuse a stocking that has been previously applied and removed.
What Does Zipzoc Medicated Stocking Contain?
Active Ingredient
The active substance in Zipzoc Medicated Stocking is zinc oxide. Each gram of the impregnating ointment contains 200 mg of zinc oxide, giving a concentration of 20% w/w. Zinc oxide (chemical formula ZnO) is a white, inorganic compound that has been used in medicine, dermatology, and wound care for well over a century. It is classified as a skin protectant and has mild astringent, antiseptic, and anti-inflammatory properties.
Zinc oxide works by forming a physical barrier on the skin surface. It reflects ultraviolet radiation, absorbs moisture, and provides a soothing coating that reduces friction and irritation. In the context of wound care, the zinc ion (Zn2+) released from the oxide plays a role in supporting cellular processes essential for tissue repair, including keratinocyte migration, collagen synthesis, and immune cell function. Zinc is recognized as an essential trace element by the World Health Organization, and its role in wound healing is well supported by clinical evidence.
Other Ingredients (Excipients)
- Liquid paraffin (mineral oil): A highly refined, purified hydrocarbon oil that serves as the emollient base of the ointment. Liquid paraffin helps to maintain skin hydration, prevents transepidermal water loss, and contributes to the smooth, spreadable consistency of the zinc oxide ointment. It is widely used in pharmaceutical and cosmetic preparations and is considered inert and non-sensitizing.
- White petrolatum (white vaseline): A semi-solid hydrocarbon mixture that provides the structural ointment base. White petrolatum is one of the most effective occlusive moisturizers known, forming a protective layer that retains skin moisture and protects the wound from external contaminants. It is pharmacopoeia-grade and meets strict purity standards for pharmaceutical use.
Physical Description
Zipzoc Medicated Stocking appears as an 80 cm long white knitted tubular stocking made of viscose fibers, uniformly impregnated with a white, smooth ointment. The stocking is elastic and conforms to the shape of the lower leg when applied. The ointment is evenly distributed throughout the fabric, ensuring consistent delivery of zinc oxide to the skin surface.
Packaging
Zipzoc Medicated Stocking is supplied in packages containing 10 individually wrapped medicated stockings. Each stocking is sealed in its own protective wrapper to maintain sterility and prevent the ointment from drying out before use. The product is manufactured by Purna Pharmaceuticals NV in Puurs, Belgium, and is marketed by Evolan Pharma AB.
Frequently Asked Questions About Zipzoc Medicated Stocking
Zipzoc Medicated Stocking is primarily used for the management of chronic venous leg ulcers, chronic venous insufficiency of the lower limbs, and as a post-operative dressing after vascular surgery such as varicose vein operations. It forms the inner layer of a dual-bandage system, worn under a compression bandage, providing a soothing zinc oxide barrier that protects the skin and promotes wound healing.
The standard redressing frequency is once per week. However, your healthcare professional may recommend more frequent changes depending on the wound condition, exudate levels, and signs of infection. Less frequent changes are preferred as they minimize disruption to the healing wound bed.
While the stocking itself is straightforward to apply, it must be used with a compression bandage, which requires clinical training to apply correctly. Incorrectly applied compression can cause harm, especially in patients with any degree of arterial disease. It is strongly recommended that the complete dual-bandage system be applied by a trained nurse or healthcare professional who has assessed your vascular status with an ABPI measurement.
Zipzoc and traditional zinc paste bandages (such as Viscopaste or Calaband) serve a similar purpose, but the delivery format differs. Traditional zinc paste bandages are woven cotton bandages impregnated with zinc oxide paste that are wrapped around the leg in overlapping layers. Zipzoc is a pull-on stocking format, which many practitioners and patients find quicker and easier to apply with a more uniform distribution of the ointment. The active ingredient and therapeutic principle are essentially the same.
Yes, Zipzoc Medicated Stocking can be used on diabetic patients, but with important caveats. Patients with diabetes are at higher risk for peripheral arterial disease, which contraindicates compression therapy. A thorough vascular assessment, including ABPI measurement, is essential before starting treatment. Additionally, diabetic neuropathy can reduce sensation in the feet and legs, making it harder to detect signs of excessive pressure or ischemia. Close monitoring by a healthcare professional is recommended.
Mild itching is a relatively common side effect and may settle on its own. If the itching is persistent or severe, or if you develop a rash, significant redness, or blistering, remove the bandage and consult your healthcare provider. They may recommend an alternative dressing or investigate whether you have developed a sensitivity to one of the components. True allergic reactions to zinc oxide are uncommon but can occur.
References
- European Wound Management Association (EWMA). Management of Patients with Venous Leg Ulcers: Challenges and Current Best Practice. Journal of Wound Care. 2023;32(Suppl 2):S1–S68.
- O'Meara S, Cullum N, Nelson EA, Dumville JC. Compression for venous leg ulcers. Cochrane Database of Systematic Reviews. 2024;(1):CD000265. doi:10.1002/14651858.CD000265.pub4
- British National Formulary (BNF). Wound Management Products and Elasticated Garments: Zinc Paste Bandages. NICE, 2025. Available at: bnf.nice.org.uk
- Lansdown AB, Mirastschijski U, Stubbs N, Scanlon E, Agren MS. Zinc in wound healing: theoretical, experimental, and clinical aspects. Wound Repair and Regeneration. 2007;15(1):2–16. doi:10.1111/j.1524-475X.2006.00179.x
- World Health Organization (WHO). WHO Model List of Essential Medicines – 23rd List (2023). Geneva: WHO; 2023.
- International Wound Infection Institute (IWII). Wound Infection in Clinical Practice: Principles of Best Practice. Wounds International. 2022.
- Scottish Intercollegiate Guidelines Network (SIGN). Management of Chronic Venous Leg Ulcers: A National Clinical Guideline. SIGN Publication No. 120. 2010 (updated 2023).
- Wollina U, Haroske G. Zinc in dermatology – an update. Our Dermatology Online. 2022;13(2):224–230.
- European Medicines Agency (EMA). Zinc Oxide – Monograph for Dermatological Use. European Pharmacopoeia. 2024.
- National Institute for Health and Care Excellence (NICE). Varicose veins: diagnosis and management. Clinical guideline CG168. 2013 (updated 2024).
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