The review compiles evidence showing that stress alters normal physiological responses, potentially delaying the wound-healing process and affecting outcomes related to tissue repair and scarring.  

Psychological stress activates the body’s sympathetic nervous system and the hypothalamic–pituitary–adrenal (HPA) axis, leading to elevated levels of hormones such as cortisol and catecholamines. These hormones are known to suppress immune function, impair circulation, and reduce collagen production – all of which are critical to efficient wound repair. According to several studies cited in the review, individuals experiencing psychological stress may exhibit slower inflammatory responses, delayed re-epithelialisation, and impaired tissue regeneration.  

Meta-analyses and experimental studies support these findings. In one well-known study, caregivers of individuals with Alzheimer’s disease experienced significantly delayed healing of small skin wounds compared to control participants, with healing times increased by up to 24 percent. Such findings suggest that psychological factors can have clinically relevant effects on healing timeframes, particularly in patients with chronic wounds or those undergoing surgical recovery.  

The review also notes implications for healthcare professionals, particularly nurses and wound-care specialists. Stress not only affects patients but can also impair the clinical effectiveness of scar management techniques. Persistent stress appears to interfere with the body’s ability to remodel scar tissue, which may reduce the efficacy of both pharmaceutical and physical interventions aimed at improving scar appearance.  

Although most healthcare practitioners acknowledge that psychological well-being influences physical health, the review points out a gap in routine assessment and management of stress in clinical wound care settings. It suggests that incorporating psychological screening and stress-reduction strategies – such as guided relaxation, cognitive-behavioural support, and patient education – could improve healing outcomes.  

The review concludes by calling for more interdisciplinary approaches to wound management, including collaboration between mental health professionals and wound care teams. Further research is recommended to better understand the mechanisms involved and to develop evidence-based interventions that can be integrated into standard care protocols.