Our skin has an incredible ability to regenerate itself. But how exactly does wound healing work—and how can we support it?
Read on to learn about the complex healing process, the different phases of wound healing, and the topical and technological methods that can aid skin regeneration. You’ll also discover why a nutrient-rich diet plays a crucial role in wound recovery.
The Miracle of Self-Repair
A small cut, burn, or abrasion—everyone experiences these everyday skin injuries and is often amazed at how the skin can repair itself. Most wounds heal within two to three weeks, and you can almost watch the skin restore itself to a “normal” state. It’s truly a remarkable process.
However, wound healing can be disrupted by various factors, sometimes resulting in chronic wounds that are slow to heal. Understanding this process is especially important before and after aesthetic treatments or surgical procedures.
What Is a Wound?
A wound is defined as an injury to the skin or underlying tissues that disrupts their normal structure. This damage can result from external forces—like cuts, impacts, or abrasions—or internal factors such as disease.Wounds can range in severity, from superficial skin damage to deeper injuries affecting muscles, tendons, or even organs. They are typically categorized as acute or chronic, depending on the time they take to heal.
Different types of wounds trigger specific healing mechanisms. The body initiates a highly coordinated process to repair tissue, which occurs in four distinct phases.
The Four Phases of Wound Healing
Inflammatory Phase (Secretion Phase):Immediately after an injury, blood escapes from damaged vessels and mixes with tissue fluid in the wound. This rinses and cleans the area. Blood clotting stops the bleeding and begins the regeneration process. Fibrin—a protein—acts like a natural glue, sealing the wound temporarily.
Cleaning Phase (Resorption):In this stage, immune cells (like macrophages) remove cellular debris. The body’s defense system also targets and eliminates pathogens, while releasing substances that attract tissue-repairing cells.
Proliferation Phase (Granulation):Fibroblasts—special connective tissue cells—migrate into the wound and begin producing collagen. The fibrin network laid down earlier serves as a scaffold. At the same time, new capillaries form. This creates granulation tissue: a rich, well-vascularized base that pulls wound edges closer together.
Repair Phase (Epithelialization):The granulation tissue matures into firm, tear-resistant connective tissue. Collagen fibers align with mechanical stress, and new epithelial cells close the surface. A scar forms if the dermis was affected; superficial epidermal injuries typically heal without scarring.
Under normal conditions, wound closure takes about 8–10 days. Full skin resilience is usually restored after three weeks. Scar remodeling may continue for months or even years.
How to Support Wound Healing
Wound and scar healing can be effectively supported with proper care:
Topical treatments like panthenol or aloe vera help soothe and hydrate the skin, especially for superficial injuries.
Scar ointments with ingredients like glycerin, heparin, allantoin, or onion extract help soften the scar and reduce itching or tightness.
Massage improves circulation and helps distribute topical agents more evenly.
Silicone plasters are another proven method for scar care. They create a moist healing environment, apply gentle pressure to prevent raised scars, and protect against friction and UV exposure. Always apply silicone patches only after the wound has fully closed, and wear them consistently—removing only for showers.
Pre- and Post-Treatment Care
Proper care is essential before and after aesthetic procedures, especially for surgeries, thread lifts, or laser treatments. Pre- and post-care routines help support the healing process and reduce the risk of complications.
Key steps include:
Careful cleansing and disinfection of treated areas
Using only approved post-treatment skincare
Avoiding sun exposure during recovery
Laser therapy promotes cell regeneration and blood circulation.
What Can Disrupt Healing?
If wound healing is delayed or infection sets in, the wound may become chronic. Factors that interfere with healing include:
Underlying illnesses (e.g. diabetes)
Poor nutritional status
Certain medications
Smoking
Poor circulation or mechanical stress
Bacterial contamination
Chronic Wounds: Diagnosis and Treatment
Chronic wounds require a thorough diagnosis and a personalized care plan based on:
Healing phase
Infection status
Wound exudate (fluid)
For structured assessment, the ABCDE rule is used in wound care—not to be confused with the skin cancer ABCDE criteria.
ABCDE in Wound Healing:
A – Anamnesis: Medical history
B – Bacteria: Identification of bacterial colonization
C – Clinical examination: Wound assessment, photo documentation
D – Blood circulation: Vascular status, especially in the legs
E – Extras: Additional diagnostics (e.g., biopsies)
Moist wound dressings are the gold standard for treating chronic wounds. Depending on the wound stage and exudate level, options include alginates, hydrocolloids, hydrogels, or superabsorbents. For leg wounds or edema, compression therapy is key—both for healing and preventing recurrence.
New Technologies in Wound Care
Emerging methods offer hope for hard-to-heal wounds:
Cold Plasma Therapy uses ionized gas with antibacterial and anti-inflammatory effects.
Ultrasound Therapy stimulates tissue regeneration and helps clear debris from the wound bed.
Laser Therapy enhances cell regeneration and blood flow, while reducing inflammation and microbial load.
While promising, these treatments are still undergoing clinical validation.
Excursus: The Role of Nutrition in Wound Healing
Proper nutrition is essential—especially in older adults, who are more at risk of impaired healing due to malnutrition.
Wound healing increases the body’s demand for:
Energy (glucose, carbohydrates, fats)
Proteins
Vitamins and trace elements
Without adequate intake, the body draws on lean muscle reserves, potentially delaying healing.
Key micronutrients include:
Vitamin C: Collagen synthesis, anti-inflammatory
Vitamin A: Skin cell growth and differentiation
Vitamin D: Anti-inflammatory and immune support
Vitamin E: Antioxidant protection and infection defense
Dr. med. Christine Schrammek-Drusio, Managing Director of Dr. med. Christine Schrammek Kosmetik GmbH & Co. is a dermatologist and allergist. As an anti-aging expert, she develops treatment methods, including the herbal peeling treatment "Green Peel," and dermatological care products.
Christina Drusio, The author is part of the owner family and a member of the management team of Dr. med. Christine Schrammek Kosmetik GmbH & Co. She is a dermatologist and, as an expert on the subject of skin, a valued speaker at international lectures and seminars.
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