Skin heals very slowly

[DownTheRabbitHole]

My skin heals very slowly. If I get significant enough skin damage, I have to put something like Bionect on it or it won't heal and the skin will deteriorate down to the sub-dermal layers in some cases. This has started getting worse and worse over the past couple of years and I can't figure out why

Less than a year ago I found out about the various genetic mutations I have and I have tried to address the biggest (MTHFR, CBS, VDR, COMT) as best I can.

I'm 34 and eat a clean healthy diet and exercise regularly.

Does anyone see anything in my SNPs that could cause this?

+/+ COMT V158M, COMT H62H, MAO-A R297R, MTHFR A1298C, ACE Del16, BHMT R239Q, MTHFS, MTHFD1 C105T, MTHFR (rs1476413, rs3737964, rs4846048, rs4846049, rs6495446), PEMT (rs4646406), NAT2 R197Q

+/- VDR Bsm, VDR Taq, MTRR A66G, MTRR K350A, MTRR A664A, CBS C699T, ADD1 G460W, AGT M235T/C4072T, CBS A13637G, DAO, DHFR, FUT2 (rs492602, rs601338, rs602662), MTHFD1L, MTRR-11 A664A, GAD1 (rs3749034, rs2241165, rs12185692, rs10432420), GAD1 (rs2058725, rs3791850), MTRR (rs1532268, rs9332), NOS2 (rs2297518), NOS3 (rs1800783, rs1800779, rs3918188), SHMT2, TCN2 C766G, CYP1B1 L432V, CYP1B1 N453S, CYP1B1 R48G, CYP2C9*2 C430T, CYP2D6 S486T, CYP2D6 2850C>T, GSTP1 I105V

 

[Sasha]

Don't know about your SNPs but I read some time back that a lack of Vit C can lead to your body not being able to make collagen and hence to slow wound-healing. I was interested because I get burst blood vessels in my eyes when I sneeze hard (apparently a sign that the blood vessels aren't strong enough due to lack of collagen) and managed to get that under control by taking 1g Vit C a day.

I now think I may generally be deficient in it and am trying liposomal Vit C, which gets much more into the bloodstream - we've got a couple of threads going on that (just put 'liposomal' in the search box!).

 

[DownTheRabbitHole]

I actually take Vitamin C every day and my diet is also rich in it. I had my micro-nutrients tested and my C levels are highly optimized.

I don't think it is a collagen issue either. My face looks almost the same as it did nearly 20 years ago. Most people mistake me for a high schooler (which is actually annoying in a way).

I did find out I have very low glutathione, which I have yet to figure out how to optimize it safely despite many improvements to my diet.

 

[Sherlock]

low zinc is known for slow healing. do you have fingernail ridges?

 

[manna]

In chinese medicine, i believe slow wound healing is thought to be a weak spleen. Aparently it governs the quality and consistency of the blood and hence how it heals and stays in the vessels. I imagine it can be helped while you have mecfs but ultimately i think it'd be there, in some degree, whilst you have the illness.

 

[DownTheRabbitHole]

My zinc is optimal (along with my other minerals).

No idea about spleen function. How would I test that?

 

[Butydoc]

Don't know about your SNPs but I read some time back that a lack of Vit C can lead to your body not being able to make collagen and hence to slow wound-healing. I was interested because I get burst blood vessels in my eyes when I sneeze hard (apparently a sign that the blood vessels aren't strong enough due to lack of collagen) and managed to get that under control by taking 1g Vit C a day.

I now think I may generally be deficient in it and am trying liposomal Vit C, which gets much more into the bloodstream - we've got a couple of threads going on that (just put 'liposomal' in the search box!).

Hi Sasha,

Vitamin c deficiency causes scurvy. For scurvy to develope, you need the near complete lack of vitamin c for a prolonged period. People with scurvy will notice old scars start to widen and even open. This was a common problem among sea goers many years ago when on prolonged voyages. Vitamin c is required for cross linking of collagen which makes the collagen strong.
In my experience, slow wound healing is noticed in people with diabetes, peripheral arterial disease, steroid use, chemotherapy, autoimmune diseases like scleroderma and severe malnutrition.

Best,
Gary

 

[Sasha]

Hi Sasha,

Vitamin c deficiency causes scurvy. For scurvy to develope, you need the near complete lack of vitamin c for a prolonged period. People with scurvy will notice old scars start to widen and even open. This was a common problem among sea goers many years ago when on prolonged voyages. Vitamin c is required for cross linking of collagen which makes the collagen strong.
In my experience, slow wound healing is noticed in people with diabetes, peripheral arterial disease, steroid use, chemotherapy, autoimmune diseases like scleroderma and severe malnutrition.

Best,
Gary

Hi Gary - isn't scurvy essentially the final stages of extremely severe Vit C deficiency with milder symptoms reflecting milder deficiency?

 

[DownTheRabbitHole]

Hi Sasha,

Vitamin c deficiency causes scurvy. For scurvy to develope, you need the near complete lack of vitamin c for a prolonged period. People with scurvy will notice old scars start to widen and even open. This was a common problem among sea goers many years ago when on prolonged voyages. Vitamin c is required for cross linking of collagen which makes the collagen strong.
In my experience, slow wound healing is noticed in people with diabetes, peripheral arterial disease, steroid use, chemotherapy, autoimmune diseases like scleroderma and severe malnutrition.

Best,
Gary

Of which I have none of those as culprits....including the long voyages at sea. :-/

 

[Butydoc]

Hi Gary - isn't scurvy essentially the final stages of extremely severe Vit C deficiency with milder symptoms reflecting milder deficiency?

Hi Sasha,
I was the director of a busy wound care unit for more than a decade and have never seen a case of scurvy. I'm not sure if there is a mild form of the deficiency. In my experence there is always a cause of slow wound healing.

Best,
Gary

 

[Sasha]

Hi Sasha,
I was the director of a busy wound care unit for more than a decade and have never seen a case of scurvy. I'm not sure if there is a mild form of the deficiency. In my experence there is always a cause of slow wound healing.

Best,
Gary

Thanks, Gary - I've been mugging up on Vit C but as a layperson it's hard for me to judge whether what I'm reading is likely to be accurate or not. In Dr Thomas E. Levy's book on Vit C (with the schlocky title 'Primal Panacea') I've read that oxidative stress increases demand for Vit C so that conditions such as ME, viral infections and so on mean that you don't have enough Vit C, and that lack of Vit C can cause various conditions before it gets so extreme that it causes scurvy. I really don't have the knowledge to judge it, but certainly the disappearance of endless burst blood vessels in my eyes once I started supplementing even with 1g/day makes me open to the possibility that there's something in it.

During my first bout of ME many years back, during which I was bedbound, I titrated my daily dose up to bowel tolerance (which is 1 or 2 grammes for healthy people) and found it was 50g, which suggests to me that there's something in that. However, even though I was prescribed IV Vit C as well as later taking it orally, it didn't do anything for me that I can remember - I didn't keep a detailed, daily symptom diary then like I do now.

 

[Allyson]

My skin heals very slowly. If I get significant enough skin damage, I have to put something like Bionect on it or it won't heal and the skin will deteriorate down to the sub-dermal layers in some cases. This has started getting worse and worse over the past couple of years and I can't figure out why

Less than a year ago I found out about the various genetic mutations I have and I have tried to address the biggest (MTHFR, CBS, VDR, COMT) as best I can.

I'm 34 and eat a clean healthy diet and exercise regularly.

Does anyone see anything in my SNPs that could cause this?

+/+ COMT V158M, COMT H62H, MAO-A R297R, MTHFR A1298C, ACE Del16, BHMT R239Q, MTHFS, MTHFD1 C105T, MTHFR (rs1476413, rs3737964, rs4846048, rs4846049, rs6495446), PEMT (rs4646406), NAT2 R197Q

+/- VDR Bsm, VDR Taq, MTRR A66G, MTRR K350A, MTRR A664A, CBS C699T, ADD1 G460W, AGT M235T/C4072T, CBS A13637G, DAO, DHFR, FUT2 (rs492602, rs601338, rs602662), MTHFD1L, MTRR-11 A664A, GAD1 (rs3749034, rs2241165, rs12185692, rs10432420), GAD1 (rs2058725, rs3791850), MTRR (rs1532268, rs9332), NOS2 (rs2297518), NOS3 (rs1800783, rs1800779, rs3918188), SHMT2, TCN2 C766G, CYP1B1 L432V, CYP1B1 N453S, CYP1B1 R48G, CYP2C9*2 C430T, CYP2D6 S486T, CYP2D6 2850C>T, GSTP1 I105V

does it vary in different parts of your body ?

is is slower on e legs for example?

DO you have any unusual scarring?

Ally

 

[xks201]

Most likely Low igf1 causing this aka growth hormone

 

[DownTheRabbitHole]

Doesn't matter which part of my body it is on. Same effect. Also, I generally don't scar at all. When I finally heal, I heal very cleanly.

Through process of elimination I figured this out, but it really should have been pretty obvious: alcohol

I was having a glass of wine or two every night. When I reduced my drinking to once per week, minor wounds that wouldn't heal for over a week now heal in 2 days. That's what I get for going with the common wisdom that glass of wine a day is actually good for health...at least, it isn't when applied to my genetic profile. Your mileage may vary.

 

[Donaldchris]

Well People with scurvy will observe old scars, start to expand and even start. This was a prevalent issue among sea goers many years ago when on prolonged voyages. Vitamin C is needed for cross linking of collagen which makes the collagen powerful.

 

[Calathea]

Seafarers kept scurvy at bay by putting a bit of lime juice in their grog. I don't think it was much. We'll all be getting way more Vitamin C than that from our diets.

Now if only I could work out why cat scratches keep on scarring. I've made bigger toys so that I'm less likely to get scratched while playing with her, but it still happens now and again, and my reflexes are hardly sharp.

 

[Butydoc]

Seafarers kept scurvy at bay by putting a bit of lime juice in their grog. I don't think it was much. We'll all be getting way more Vitamin C than that from our diets.

Now if only I could work out why cat scratches keep on scarring. I've made bigger toys so that I'm less likely to get scratched while playing with her, but it still happens now and again, and my reflexes are hardly sharp.

Hi Calathea,

There is a large variance in normal wound healing in terms of the degree of scarring. To improve the likelihood of a better scar outcome, consider covering the wound with an antibiotic ointment and a bandaid until the wound is epithelialized (appears healed), then cover with silicone gel sheeting for the next several weeks. Neosporin had a special bandaid used for that purpose. The mechanism of why this works is not completely clear, but clinically it does help in the majority of people.

Best,
Gary

 

[Hip]

Does anyone see anything in my SNPs that could cause this?

No, but your SNPs do indicate that you will meet a beautiful, mysterious dark-haired woman, who though troublesome, will catalyze a change in your fortunes, and will be the key to the great wealth and happiness soon enter into your life.

Just having some fun! People often assume their SNPs hold the answer to everything.



In terms of slow wound healing, I used to be a fast healer of small cuts, but after I caught the virus that triggered my ME/CFS, I started to experience very slow healing. Sometimes tiny cuts would not seem to heal at all.

I found that putting a tiny, tiny amount of zinc (from a crushed zinc supplement tablet) on the wound helped speed up the healing process. Zinc of course is known to help wound healing, and zinc deficiency retards skin healing.

You may also find this document useful:

Nutritional Support for Wound Healing

 

[Calathea]

Hi Calathea,

There is a large variance in normal wound healing in terms of the degree of scarring. To improve the likelihood of a better scar outcome, consider covering the wound with an antibiotic ointment and a bandaid until the wound is epithelialized (appears healed), then cover with silicone gel sheeting for the next several weeks. Neosporin had a special bandaid used for that purpose. The mechanism of why this works is not completely clear, but clinically it does help in the majority of people.

Best,
Gary

Oh yes! Silicone thingies! Thank you! A friend of mine smashed up his face horribly in a bike crash (don't drunk-cycle, folks), and was covered with tape for ages*, and I thought he'd be horribly scarred, but they used the silicone stuff and now all you can see is that he has a slightly wonky nose. He's got darker skin, which is worse for scarring, too. Any idea how I get hold of this in the UK, or of how long they take to work on older scars? The NHS is hardly going to provide it, it's thoroughly cosmetic. The ones on Amazon are very pricey, although I suppose it's only for tiny scars. How long does the band-aid stage last, and would Germolene work? We have different brands for so much over on this side of the pond. And more to the point, I have a horrible raised scar from when I had my gallbladder out, even though it was keyhole surgery. While no one but myself, my partner and my support workers see it, it'd be nice for it to be gone. I think that one sits under my bra band, though.

One horrible thing about the cat scratch scars is that I am worried people will mistake them for self-harming scars, even though realistically I have never seen SH scars which follow that pattern. I really hate that people who SH get so much stigma. It's massively disproportionate to how damaging SH actually is, and it's sexist as hell, and it makes people who SH more likely to internalise this stigma and feel guilty about what really isn't that bad a coping mechanism (far, far better than, say, getting drunk and punching someone). I also really hate that people with ME spend so much time being told "it's just psychological, dearie, you can snap out of it", which is massively offensive to people with mental illnesses as well as people with ME, so that we are worried that if we show any signs of MI at all, it will cause further problems with our treatment.

...Actually, my friends with SH scars may well be interested in this as well.

Random note on healing for anyone who is on blood thinners, or who finds that they have difficulty stopping bleeding from small cuts: styptic pencils. Amazing things. Why they don't hand them out at the DVT clinics is a mystery, as they're small, cheap and incredibly useful. My partner had only recently come out of a long-term relationship with a beard when he had his DVT, and he has an awkward mole to shave around as well, so he kept on ending up with shaving cuts that would make him half an hour late for coming out! Now we have them sprinkled all over the place.

* We do have an amusing photo of him with a tea cosy on his head, though. A good friend had put me up at short notice due to an appalling smell in my stairwell, some poor sod of a homeless guy on drugs had got in and was camping out in the basement with bags of rotting meat, and I was so grateful that I made a ridiculously complicated patchwork tea cosy. It's very nice and they use it regularly. It also looks fab on my friend's head, tape all over his face and all.

 

[Butydoc]

Oh yes! Silicone thingies! Thank you! A friend of mine smashed up his face horribly in a bike crash (don't drunk-cycle, folks), and was covered with tape for ages*, and I thought he'd be horribly scarred, but they used the silicone stuff and now all you can see is that he has a slightly wonky nose. He's got darker skin, which is worse for scarring, too. Any idea how I get hold of this in the UK, or of how long they take to work on older scars? The NHS is hardly going to provide it, it's thoroughly cosmetic. The ones on Amazon are very pricey, although I suppose it's only for tiny scars. How long does the band-aid stage last, and would Germolene work? We have different brands for so much over on this side of the pond. And more to the point, I have a horrible raised scar from when I had my gallbladder out, even though it was keyhole surgery. While no one but myself, my partner and my support workers see it, it'd be nice for it to be gone. I think that one sits under my bra band, though.

One horrible thing about the cat scratch scars is that I am worried people will mistake them for self-harming scars, even though realistically I have never seen SH scars which follow that pattern. I really hate that people who SH get so much stigma. It's massively disproportionate to how damaging SH actually is, and it's sexist as hell, and it makes people who SH more likely to internalise this stigma and feel guilty about what really isn't that bad a coping mechanism (far, far better than, say, getting drunk and punching someone). I also really hate that people with ME spend so much time being told "it's just psychological, dearie, you can snap out of it", which is massively offensive to people with mental illnesses as well as people with ME, so that we are worried that if we show any signs of MI at all, it will cause further problems with our treatment.

...Actually, my friends with SH scars may well be interested in this as well.

Random note on healing for anyone who is on blood thinners, or who finds that they have difficulty stopping bleeding from small cuts: styptic pencils. Amazing things. Why they don't hand them out at the DVT clinics is a mystery, as they're small, cheap and incredibly useful. My partner had only recently come out of a long-term relationship with a beard when he had his DVT, and he has an awkward mole to shave around as well, so he kept on ending up with shaving cuts that would make him half an hour late for coming out! Now we have them sprinkled all over the place.

* We do have an amusing photo of him with a tea cosy on his head, though. A good friend had put me up at short notice due to an appalling smell in my stairwell, some poor sod of a homeless guy on drugs had got in and was camping out in the basement with bags of rotting meat, and I was so grateful that I made a ridiculously complicated patchwork tea cosy. It's very nice and they use it regularly. It also looks fab on my friend's head, tape all over his face and all.[/QUO
Hi Calathea,

Unfortunately silicone sheeting doesn't work well on old scars. Not familiar with the brands of sheeting across the pond.

I would use the bandaid with ointment until the cut appears healed. Usually about a week. After the wound is healed, need to use the sheeting continuously for a several weeks.

It sounds like you might have hypertrophic scars which are generally raised,red and itchy. The above technique works best before the scar becomes hypertrophic. That is usually less than a month after healing. During the wound healing process, scar maturation is a very dynamic phase where the collagen is deposited and reabsorbed. This is very vascular at this point and in some individuals, the process is exaggerated leaving a raised, red itchy scar. The technique works best before this process becomes becomes well established.


Best,
Gary