FEB 19, 2023
Within the genetic backbone of our cells, the skin possesses an almost magical ability to heal itself. When skin is damaged, our body naturally triggers biological mechanisms and growth factors to promote skin regeneration. All the while immune cells survey the area to fight off infectious bacteria that could lead to diseases.While this intrinsic superpower is something most of us possess naturally, it can be heavily influenced by the state of our health and lifestyle choices. It’s important to understand the internal and external factors that can either hinder or help skin healing in order to keep our body’s first defense, our skin, in optimal shape.
This blog will explore some reasons why wounds heal slowly, and the science behind why slow wound healing increases with age. It will also dive into the most common factors that contribute to slowed wound healing and provide recommendations to help speed up the process. Finally, this blog will describe what improper wound healing looks and feels like and what to do if a wound is healing slowly.
Why is my wound healing so slowly?
Underlying medical conditions
If blood flow to the wound is poor, the body may not be able to bring the necessary nutrients and oxygen to the site. The blood is also an important vehicle for immune cells that traverse the body in search of pathogens. To ensure optimal blood circulation, you should stay diligent at remaining hydrated and avoid diuretics.
Poor blood circulation
It's worth noting that some wounds take longer to heal than others, especially if the wound is deep or significant. Also, people with an underlying medical condition that affects the healing process may need to take extra precautions and steps to ensure proper and normal wound healing. If you are concerned about the slow healing of your wound, it is best to consult with a healthcare professional for an evaluation and proper treatment. They will be able to examine the wound and determine the cause of slow healing, as well as provide appropriate care.
How long does it take for a wound to heal?
It's not uncommon for wounds to take longer to heal than what is typically expected, especially as you age. Some people may develop an underlying medical condition that affects the healing process, such as an autoimmune disorder, which can slow down the healing process unexpectedly. Additionally, older adults are more susceptible to slow wound healing.
How do you treat delayed wound healing?
- Debridement: Dead or infected tissue can slow down the healing process. Debridement is the process of removing this tissue to allow healthy tissue to grow. This can be done through surgical, mechanical, or chemical means, and should always be done at the advice or care of a medical professional.
- Topical treatments: Various topical therapies can be used to promote wound healing. These include creams and ointments that contain growth factors, antibiotics, vitamins (vitamin A, vitamin C), or other wound healing and/or cell renewal agents.
- Wound dressings: Different types of dressings can be used to keep the wound clean and moist, which can promote healing. These can be something as simple as a bandage, or other advanced dressings such as hydrocolloid dressings, hydrogel dressings, and alginate dressings.
- Nutrition: A diet that is high in protein, vitamins, and minerals can support the healing process. Your healthcare provider may recommend that you take supplements or make dietary changes to ensure that you are getting enough of these essential nutrients. Hyperbaric oxygen therapy (HBOT): This therapy is used to increase the amount of oxygen in the wound. It involves breathing pure oxygen in a pressurized chamber, which can promote healing by stimulating the growth of new blood vessels.
- Surgery: In some severe cases, surgery may be needed to remove infected tissue or to close a large wound.
- Physical therapy: In some cases, physical therapy may be recommended to help improve blood flow and reduce the risk of contractures.
- Medications: Antibiotics may be prescribed if there is an infection. Pain medication can be prescribed when necessary.
What are the typical stages of wound healing?
- Hemostasis (begins within a few minutes/hours after injury): the process of stopping the bleeding by clotting factors at the site of injury.
- Inflammation (begins immediately and lasts for a few days):< characterized by the accumulation of white blood cells to remove bacteria and debris and initiation of the repair process
- Proliferation (begins a few days after injury and lasts for about 3-4 weeks): new blood vessels form, and the wound begins to close. The cells in the wound, such as fibroblasts and keratinocytes, begin to divide and migrate to the wound site, where they will produce new tissue.
- Remodeling (begins several weeks after injury and can last for up to 2 years): the wound continues to mature, and the new tissue becomes stronger. This new, pink-tinted tissue is referred to as granulation tissue, which is composed of new fibroblasts, keratinocytes, endothelial cells, and new thin-walled capillaries. The scar tissue that forms during this stage is not as strong as the original tissue, but it will eventually become almost as strong.
What factors contribute to slowed wound healing?
Knowing what foods to avoid during wound healing is essential as poor nutrition can affect the availability of the necessary building blocks to repair the wound5. Certain medications, such as steroids and biologics, can slow down the healing process by inhibiting the inflammatory response, which is essential for the wound healing process4. Age can also play a role in wound healing as the body's ability to repair itself may decline with age, which makes the elderly more susceptible to slow wound healing.
Lastly, the most important factor that can contribute to slow wound healing is insufficient care for the wound. Poor wound care increases the chances of infection and inflammation, leaves dead tissue to inhibit proliferation and remodeling, and can lead to chronic and deeper wounds. If you are concerned about the slow healing of your wound, it is best to consult with a healthcare professional for an evaluation and proper treatment.
Does the location of a wound impact the rate at which it heals?
Wounds on the hands, feet, or joints may also take longer to heal because these areas have less flexibility and are more prone to movement which can make it more difficult for the wound to stay closed and heal. Areas that are exposed to friction, pressure, or shear forces may take longer to heal due to the constant movement.
Wounds that are in areas with poor blood flow may take longer to heal because the body has a harder time getting the necessary nutrients and oxygen to the wound bed. This can be the case with wounds on the legs, as well as in people who have peripheral artery disease or diabetic wounds.
When should I be concerned when a wound isn't healing?
- The wound is becoming larger or deeper.
- The wound is producing pus or other drainage.
- The wound is becoming more painful or tender.
- The wound is becoming red, warm, or swollen.
- The wound is becoming itchy or has a foul odor.
- The wound is not closing, or the edges are not coming together.
- You have a local/systemic fever or other signs of wound infection6.
How does age impact wound healing?
As we age, the skin becomes thinner and less elastic due to the loss of these structural proteins, making it more fragile and more susceptible to injury. Additionally, the blood vessels in the skin become less efficient at delivering oxygen and nutrients to the wound, which can slow down the healing process. Age-related changes in the immune system can also make it harder for the body to fight off infections7. Using the right topical skin care products to support skin health like a peptide moisturizer, peptide body lotion, or gentle daily cleanser can help support and nurture the structural foundation of skin.
Older adults are more likely to have underlying health conditions, such as diabetes or circulatory diseases, which can also slow down the wound-healing process. They also have a higher risk of developing infections and pressure ulcers, which are difficult to heal and can cause serious complications.
It's important for older adults to be extra cautious about avoiding injuries, and to seek medical attention if they do sustain a wound. They should also be vigilant about monitoring wounds for signs of infection or other complications and seek medical attention if they notice any changes.
- Slow healing wounds can be due to many underlying causes, such as poor nutrition, infection, underlying medical conditions, poor blood circulation, and certain medications.
- Healing time for a wound can vary based on wound size, location, and person's health. Minor wounds can heal within a few days to a week, while larger or deeper chronic wounds can take several weeks or months to heal.
- Age significantly impacts the body’s ability to heal wounds in the skin due to the progressive loss of the primary structural and functional proteins.
- Treatment options vary and depend on the underlying cause of delayed healing. Consult a healthcare professional for an evaluation and proper treatment.