Wound healing

This work will exploit alternative ways to wound healing. Excluding the accidental causes of wounds (cuts, scrapes, thermal injuries, burns e.t.c) there are people who are associated with a high risk factor due to age, malnourishment (vitamin and trace element deficiencies), use of steroids, radiation, chemotherapy, diabetes, smoking, weight loss and obesity. Wounds may also appear as a side-effect to certain medications. These are temporary, dose-dependent and normally stated on the S.P.C (summary of product characteristics) of the drug. Some of the following may be taken in order to speed up the healing time prior to surgery. While some minor wounds may appear innocent, if not treated seriously they can worsen into chronic open sores which can be seriously infected.

A wound affects the first line, of our body’s defence system, the skin. When such takes place, a plethora of symptoms may appear like, bleeding, swelling, redness, pain and tenderness, fever with infection, heat, stiffness, discoloration, scabbing, itching and scar formation.

Wounds on skin and other soft tissues, trigger a self-healing process of our body which is summarizes to the scientific term “inflammation”. This process increases collagen production below the skin (dermis). Then, follows the regeneration of the outer skin layer (epithelia).

How are wounds treated?

If surgery does not necessitate, conventionally wounds are treated by over the counter antibiotics (such as neosporin, bacitracin) and/ prescription medicine as metronidazole and mupirocin.

The five discreet steps to promote wound healing with some alternative remedies are illustrated below.
-Analgesics, or pain relievers ( bromelain- cats claw, chamomile, ...)
-Antiseptics, to clean contaminated wounds (tea tree oil, aloe vera , St John’s wort, calendula, echinacea...)
-Antibiotics (propolis, elderberry, goldenseal root)
-Medicated dressings
-Nutrition (food rich in antioxidants, vitamins A,B,C,E, copper and zinc)

Normally the treatment is two-folded, including the oral intake of supplements/herbs and the topical use of herbal ointments. The herbs/supplements mentioned from hence forward may possess multiple properties (e.g ant-inflammatory and antiseptic). The selection of herb/supplement will be based on how serious the wound is and its symptoms. Furthermore, if one is under medical supervision it is imperative to check whether the supplement is contraindicated with the existing medication. Under this ground, an effort was made to provide as many herbs/supplements as possible.

You can use complementary and alternative therapies for minor household injuries or after more serious injuries have already received thorough medical attention. If you have doubt whether or not your wound is serious, do not use alternative therapies before speaking with your doctor. Never apply topical remedies to any open wound without a doctor’s supervision.

Nutritional Supplements

Pineapple Bromelain (oral) is an enzyme derived from the pineapple stem. Traditionally, it is used as an after meal supplement for protein break-down. However, studies have presented significant anti-inflammatory and analgesic properties. It is used prior to and following surgical procedure, as an aid to reduce healing time, swelling and bruising. Moreover, bromelain is a powerful anticoagulant. A recommended dose is 40mg four times daily in enteric-coated tablets. Those tablets are resistant to the stomach acids which reduce the amount of bromelain that is finally absorbed. Do not use bromelain along with anticoagulants (like warfarin).

Beta-Carotene- Vitamin A (oral and topical)– Beta carotene is converted to Vitamin A which is a fat soluble vitamin. Vitamin A is a powerful antioxidant needed for health skin, hair and nails. In high doses it may have toxic effect so one has to be very careful. For health scar tissue 250,000IU of Beta-Carotene and 25,000IU of Vitamin A is recommended (IU – International Units). The doses mentioned are high and should not be taken for longer than 1-2 weeks unsupervised. Dose should be reduced after 2 weeks, to 15,000IU and 25,000IU for beta-carotene and Vitamin A respectively. High doses of Vitamin A are not recommended if trying to conceive, on pregnancy and on liver disease. Vitamin A creams are also available in combination with herbs and vitamin E and may be useful for people who are on corticosteroid medications.

Vitamin C (oral) plays a key role in collagen formation. The particular connective tissue strengthens the skin, muscles and blood vessels. It is a water soluble vitamin and a powerful antioxidant. There is a strong correlation between vitamin C quantity and healing time. Studies on human suggest that it can speed healing in many types of wounds. The recommended dose is 1-3grams daily. If diarrhea occurs lower dose and add pantothenic acid (Vitamin B5).

Vitamin B complex (oral) particularly B1(thiamine) and B5(pantothenic acid) have been shown to improve wound healing in animal studies. The latter is well known for its analgesic properties. Even though research on human is limited, many herbalists recommend high potency 1,000mcg daily of B complex for wound healing. Be careful though, not to apply it on open wounds.

Vitamin E (oral and topical) is another powerful antioxidant fat-soluble vitamin. The recommended dose to promote healing is 400-800IU daily and is also effective on treating burns (on higher doses). Many doctors couple Vitamin E with Vitamin A to avoid adhesion formation (25,000IU vitamin A and 400IU vitamin E daily) two weeks prior to surgery and for four weeks after. Vitamin E comes in oils and lotions. Often recommended for post-injury scars. The existing research is not enough to support this.

Zinc and (oral and topical) is a trace element that promotes wound healing. A trial has presented a reduction in healing time by 43% with oral supplementation of 50mg zinc three times daily. In general doctors recommend a dosage of 10-30mg daily for about four weeks. Zinc and copper are interrelated. Thus, long term use of Zinc may cause Copper deficiency. In this case for 30mg of Zinc, 3 mg of Copper are recommended. In addition, Copper is involved too in the strengthening of connective tissue. Zinc ointments are also available in combination with other herbs/supplements.

Glucosamine and Chondroitin sulphate (oral/topical) participate in a great extent in the manufacture of skin, tendons, ligaments and joints. The use of the latter, in wound healing in humans, is found in one trial, where there was improvement in healing strength by applying powder topically. Oral supplementation for this purpose is under investigation. Nevertheless, the recommended daily dosage is 1500mg divided into two dosages and 400mg respectively.

Protein/amino-acid supplementation is imperative when wounds develop on malnourished people. Amino acids comprise the building blocks of protein, which in turn is important to set off the repair mechanisms in tissues. The amino acid L-Arginine promotes protein formation and shows improved wound healing in animals. Oral supplementation of 17-25grams daily resulted in increased tissue synthesis in human surgical wounds. People with herpes need to consult their doctor prior to taking arginine. Studies of people with severe burns and other types of injuries had benefit after supplementation of 10-30grams of ornithine-alpha-ketoglutarate(OKG).Not only did improvement in healing occur, they also decreased the hospitalization length.

Oral supplementation of several grams of glutamine, improved healing from major trauma and surgery.

An interesting molecule composed of histidine and alanine, is carnosine. Despite the limited knowledge on its role, animal studies present that it may promote wound healing.

Whey protein may also be useful. For vegetarians, an alternative could be Spirulina which is rich in both amino-acids and the necessary vitamins like beta-carotene, vitamin B(B1,B2,B3,B5,B6,B12),vitamin E (as d-alpha tocopherol) for wound healing.

Honey (topical) has been used since antiquity to enhance wound healing and numerous other conditions. It is a strong disinfectant, antibacterial, antibiotic and very rich in amino-acids. There is a study in infants with large open wounds (where conventional drugs failed to work) that showed magnificent results on recovering fully, both wounds and infections. Honey and cinnamon powder was a traditional remedy in India from ancient years to treat skin conditions like eczema and skin infections. They were used in equal parts and applied on the infected area. For optimum results one can use the powerful Manuka honey .The UMF (unique manuka Factor) determines its strength. Look for factors over 10. In general, the potency of honey is proportional to its darkness. The darker, the better.

Omega-3 Fatty Acids(oral)- have strong anti-inflammatory properties and may prevent infections. Extensively used in skin and joint ailments. Foods rich in omega3 are fish oil, starflower oil, evening primrose oil, blackcurrent seed oil, flaxseed oil, neem oil, Spirulina e.t.c

Herbal Supplements

Aloe Vera (topical)- is said to regenerate cells and also used supplementary to arthritis sufferers. Look for standardised products under the certification sign of International Aloe Science Council and K on the package. If lignin is also in the ingredients then you optimise the results, as lignin is a substance that maximizes the absorption of aloe (and other herbs) in the skin.

Arnica (oral and topical) – is considered as one of the first line herbs for treating wounds. The quantity in gels/creams is 1/30 of the dosage obtained from the raw plant. Can be used immediately after injury. Ideal for broken skin, bruises and skin redness. For oral use one should consult a homeopath.

Bee propolis (oral and topical)- its use dates back to more than 5000 years. It contains 22 amino-acids, B complex vitamins, which are all essential for wound healing. It is regarded a natural antibiotic and believed to stimulate phagocytosis, the means by which the white blood cells eliminate bacteria. Comes in various concentrations. Use the available creams/gels topically to reduce redness and inflammation. In combination with other herbs.

Bladderwrack (topical)- contains alginic acid, which in some animal studies showed promising results in wound healing. It belongs to the algae( brown in particular) family. Since it contains Iodine, people with thyroid condition should be very careful.

Burdock (oral and topical)- is an excellent blood purifier. Used for various skin conditions and lesions like eczema, acne and psoriasis. It has antioxidant and anti-inflammatory properties. Use 2-6 in 150ml of boiling water for approximately 15minutes, then strain and drink three times daily. Make poultice and wrap around wound. Do not use if the wound is open. It is contraindicated on diabetes sufferers, those on anticoagulant and diuretic medications.

Calendula (topical) flowers were used historically as anti-inflammatory, disinfectant and antiseptic for wound healing. Steep 15 grams of calendula flowers in hot water for 15 minutes. Make a compress by steep cloth in the liquid to make a compress. Apply it several times daily for 15 minutes each. For oral use one should consult a homeopath.

Chaparral (oral and topical)-was used traditionally to reduce inflammation pain and accelerate wound healing. The active ingredient is nordihydroguaiaretic acid, a potent antioxidant, also said to exert anti-tumor effect. Soak cloths in oil preparations or tea and apply several times over the affected area (preferably with heat).Prepare a tea by steeping 5grams of herb in 250ml of hot water for 15minutes. Drink three cups daily.

Chamomile (topical)-is used for many centuries to soothe skin complaints and wound healing. It is rich in flavonoids and famous for its anti-inflammatory, antispasmodic and muscle relaxing properties. Effective in treating eczema. Creams and ointments can be applied on wounds three to four times daily. Use of chamomile ointments was effective in treating mild stasis ulcers and bed sores.

Comfrey (topical)- when applied topically has proven to reduce inflammation and decrease bruising. It is used traditionally for wound healing. One of its active ingredients is allantoin, a cell proliferant that speeds up the natural replacement of body cells. Prepare 100grams of fresh, peeled/dried root and simmer it in 500ml of water for fifteen minutes. Soak cloth in the liquid and apply to skin for 15minutes. Alternatively, one can apply lightly-grounded fresh leaves, directly on the skin. Apply each preparation several times daily. Available in creams and ointments. Do not use internally.

Dandelion (oral and topical)- is another powerful antioxidant and anti-inflammatory herb. Rich in vitamins A,B complex, C, D and minerals like iron, potassium and Zinc. Use preparations of 2-6grams daily similar to Burdock. Do not take with Lithium and antibiotics of the quinolone family. Also be careful if allergic to its leaves. Not indicated to those with liver or bladder disease, anticoagulants and diuretics.

Echinacea (topical)-this lovely cone-shaped flower is used for its immune boosting properties. Merely is used for wound healing. It activates the white blood cells and therefore can reduce inflammation. Gel and ointments containing 15% of herb juice, are applied to wounds. Works very well along with Goldenseal to ward off infections.

Goldenseal (topical)- is labelled as one of the natures antibiotics. However, its best use (both medicinal and environmental) would be the topical. It awes its reputation to the active ingredient berberine, which in cooperation with its alkaloids, may speed up wound healing. It can be placed directly onto an infected wound or ulcer. Can also be used in the mouth and pharynx. For optimum results combine it with Echinacea.

Gotu Kola (oral and topical)- is rich in asciaticosides, which exhibit increased antioxidant properties and facilitate connective tissue repair. Used for wide skin conditions as well as scleroderma. A study found it useful for healing large scars (keloids).Use cream containing 1% of the herb. Use tablets, 100% in terpenoids, with concentration of 60mg twice daily. Do not use longer than 2 months.

Horse Chestnut (topical)- with its active ingredient aescin possesses anti-inflammatory properties. It can also reduce swelling (oedema).Used widely for sprains, strains and sports injuries. Gel or cream with 2% can be applied topically three to four times daily.

Horsetail (oral and topical) is rich in silic acid. The flavonoids and saponins present in this herb can speed up wound healing, by strengthening the connective tissues. The herb tea can be used either internally or externally. Boil 2-4 table spoons in 250ml of water for 5 minutes. Steep the tea for 15minutes strain and drink 2-3 times daily. You can also apply the tea topically. In tablet form, use 300mg three times daily. As Horsetail is a diuretic, do not take along with conventional diuretic drugs or combinations of diuretic with anti-hypertension drugs. Not recommended for people with kidney or heart conditions.

Marshmallow (topical)- despite some tribes used it as food it is only the Arabs that used it in poultices from leaves, applying it directly to skin for reducing inflammation. It was the gum in the leaves and roots that were used extensively for minor wounds, sore throat and skin lesions. Use topical preparations from the root, containing 5-10% of the drug in ointment or cream base.

Neem (oral and topical) Neem is regarded the holy plant of India. One of its vast uses in medicine is for skin conditions. It is very rich in nutritients that preserve skin elasticity like omega 3-6-9. All parts of the herb exhibit properties as, antiviral, anti-inflammatory, immuno-modulatory, antibacterial, and antifungal. More than 140 compounds were isolated from different parts of the herb. Used as a base constituent for comsmetics (shampoo, balms,tooth paste e.t.c ) Used for variety skin conditions.

Plantain (oral and topical)- herbalists use it often to treat wounds, inflamed skin, insect bites and dermatitis. The major benefit comes by applying directly fresh leaves on the wound/bruise for three or four times daily.
Slippery Elm bark(topical) Used in healing salves for wounds, boils, ulcers, cuts burns and skin inflammation and certain skin conditions including diaper rash. . Poultices were prepared from the gum of the bark and applied to the infected wound. To make one, mix coarse powdered bark (1tablespoon) with boiling water. Cool and apply to a clean soft cloth.

St’Johns Wort (topical)- was used in ancient Greece to treat poisonous reptile bites and in Europe by herbalists for the topical treatment of burns and wounds. Active ingredients include flavonoids, dianthrones, xanthones, hyperforin and hypericin. It is used in combination with chamomile, plantain and calendula to promote quicker healing. Apply creams and ointments several times daily.

Tea tree oil (topical)- an ideal antiseptic but not suitable for burns. Its leaves were used traditionally to small areas at least twice daily to treat cuts, skin infections and crushing. Herbalists recommend tea-tree with potency between 70-100% for topical application on skin affected areas, twice daily minimum.

Turmeric (oral)-its root and rhizome are used for medical purposes. It possesses strong anti-inflammatory properties. Used for pre and post-surgery health. Normally is recommended 400mg three times daily. It can enhance the effectiveness of bromelain if used together.

Witch hazel (topical)-leaves and bark were used by Native Americans in poultices to treat wounds, haemorrhoids, insect bites and skin ulcers. Tannins are its primary ingredients to which, its anti-inflammatory and vein strengthening properties are attributed. Creams for topical use are available.

Pycnogenol (oral)-is powerful antioxidant used for mainly for skin health mostly by women. It is the extract from the bark of a certain pine tree which is known for its ability to ease jet lag. Use 200mg daily.

Prior to applying any herbal preparations it is imperative to fully cleanse and dress the wound in order to avoid infections.

Homeopathy

The most common homeopathetic drugs are, Arnica, Calendula, Staphysagria, Symphytum(Comfrey), Ledum, Urtica, Wala and Hypericum.

If there is medication receiving already, it would be necessary to check its contraindications and interactions with herbs. Many active ingredients used for wound healing, interact with conventional medicine. Always ask the consent of a professional healthcare provider.