Stress and Wound Healing

Individual differences in wound healing have long been recognized. Clinical observation has suggested that negative mood or stress is associated with slow wound healing. Basic mind-body research is now confirming this observation. Matrix metalloproteinases (MMPs) and the tissue inhibitors of metalloproteinases (TIMPs), whose expression can be controlled by cytokines, play a role in wound healing. Using a blister chamber wound model on human forearm skin exposed to ultraviolet light, researchers have demonstrated that stress or a change in mood is sufficient to modulate MMP and TIMP expression and, presumably, wound healing. Activation of the hypothalamic-pituitary-adrenal (HPA) and sympathetic-adrenal medullary (SAM) systems can modulate levels of MMPs, providing a physiological link among mood, stress, hormones, and wound healing. This line of basic research suggests that activation of the HPA and SAM axes, even in individuals within the normal range of depressive symptoms, could alter MMP levels and change the course of wound healing in blister wounds.