Stress and Wound Healing

Abstract

Over the past decade it has become clear that stress can significantly slow wound healing: stressors ranging in magnitude and duration impair healing in humans and animals. For example, in humans, the chronic stress of caregiving as well as the relatively brief stress of academic examinations impedes healing. Similarly, restraint stress slows healing in mice. The interactive effects of glucocorticoids (e.g. cortisol and corticosterone) and proinflammatory cytokines [e.g. interleukin-1β (IL-1β), IL-1α, IL-6, IL-8, and tumor necrosis factor-α] are primary physiological mechanisms underlying the stress and healing connection. The effects of stress on healing have important implications in the context of surgery and naturally occurring wounds, particularly among at-risk and chronically ill populations. In research with clinical populations, greater attention to measurement of health behaviors is needed to better separate behavioral versus direct physiological effects of stress on healing. Recent evidence suggests that interventions designed to reduce stress and its concomitants (e.g., exercise, social support) can prevent stress-induced impairments in healing. Moreover, specific physiological mechanisms are associated with certain types of interventions. In future research, an increased focus on mechanisms will help to more clearly elucidate pathways linking stress and healing processes.

Investigating the Role of Salivary Cortisol on Vocal Symptoms

“…Psychological stress and elevated cortisol levels can have an impact on wound repair (Christian, Grahamf, Padgetta, Glasera & Kiecolt-Glaser, 2006;Gouin & Kiecolt-Glaser, 2011), this has been confirmed also regarding mucosal wounds (Bosch, Engeland, Cacioppo & Marucha, 2007). The mechanism might be linked to proinflammatory cytokines, which play an important role in the wound healing process, protecting the wound site from infection and preparing the wound for repair (Glaser, 2005).…”

The effect of Mindfulness-Based Stress Reduction on wound healing: a preliminary study

“…A meta-analysis revealed a robust association between stress and impaired healing (Walburn et al 2009). The effects of stress on wound healing can be mediated by multiple immune and neuroendocrine pathways and may affect various stages of the healing process (Christian et al 2006;Gouin and Kiecolt-Glaser 2011).…”

Psychological stress and wound healing in humans: A systematic review and meta-analysis

“…This review aimed to investigate whether a common relationship with stress existed across different wound types and experimental models. There are a number of reviews in existence examining the relationship between stress and wound healing [23][24][25][26]; however, none is systematic in their methodology nor has attempted to quantify the relationship. The aims of this review are twofold: (i) to summarize existing research looking at the nature of the relationship between stress and wound healing in a systematic review and (ii) to quantify the size of the relationship in a meta-analysis of a subset of included studies.…”