Nutritional supplements that may be helpful
Antioxidants such as vitamin C, vitamin E, and glutathione are depleted in healing skin
tissue.3 One animal study found that vitamin E (alpha-tocopherol) applied to the
skin shortened the healing time of skin ulcers.4 Another animal study reported that
administration of oral vitamin E before skin lesions were introduced into the skin prevented
some of the tissue damage associated with the development of pressure ulcers.5 A
controlled human trial found that 400 IU of vitamin E daily improved the results of skin graft
surgery for chronic venous ulcers.6 No further research has investigated the
potential benefit of vitamin E for skin ulcers.
Animal research has suggested that vitamin C may help prevent skin ulcers,7 and
in a preliminary study,8 elderly patients with pressure ulcers had lower blood
levels of vitamin C than did ulcer-free patients. Supplementation with vitamin C (3 grams per
day) increased the speed of healing of leg ulcers in patients with a blood disorder called thalassemia, according to a double-blind study.9
And while a double-blind trial of surgical patients with pressure ulcers found that
supplementation with 500 mg of vitamin C twice a day accelerated ulcer healing,10 a
similar double-blind trial found no difference in the effectiveness of either 20 mg per day or
1,000 mg per day of vitamin C.11
An older preliminary report suggested that large amounts of folic acid given both orally and by injection could promote
healing of chronic skin ulcers due to poor circulation.12 No controlled research
has further investigated this claim.
Zinc plays an important role in tissue growth processes
important for skin ulcer healing. One study reported that patients with pressure ulcers had
lower blood levels of zinc and iron than did patients without pressure ulcers,13
and preliminary reports suggested zinc supplements could help some types of skin
ulcer.14 Supplementation with 150 mg of zinc per day improved healing in a
preliminary study of elderly patients suffering from chronic leg ulcers.15
Double-blind trials using 135 to 150 mg of zinc daily have shown improvement16 only
in patients with low blood zinc levels,17 and no improvement in leg ulcer
healing.18 19 A double-blind trial of 150 mg zinc per day in people with
skin ulcers due to sickle cell anemia found that the healing rate was almost three times
faster in the zinc group than in the placebo group after six months.20 Lastly, a
preliminary study of patients with skin ulcers due to leprosy found that 50 mg of zinc per day
in addition to anti-leprosy medication resulted in complete healing in most patients within 6
to 12 weeks.21 Long-term zinc supplementation at these levels should be accompanied
by supplements of copper and perhaps calcium, iron, and magnesium. Large amounts of zinc (over
50 mg per day) should only be taken under the supervision of a doctor.
Topically applied zinc using zinc-containing bandages has improved healing of leg ulcers in
double-blind studies of both zinc-deficient22 and elderly individuals.23
Most controlled comparison studies have reported that these bandages are no more effective
than other bandages used in the conventional treatment of skin ulcers,24
25 but one controlled trial found non-elastic zinc bandages superior to alginate
dressings or zinc-containing elastic stockinettes.26 Two controlled trials of
zinc-containing tape for foot ulcers due to leprosy concluded that zinc tape was similarly
effective, but more convenient than conventional dressings.27 28
Pressure ulcers and diabetic ulcers frequently develop in malnourished and/or
institutionalized people. A double-blind study29 of malnourished people compared
topical application of 20 ml of a solution containing essential fatty acids (EFAs) and
linoleic acid extracted from sunflower oil with a control solution containing topical mineral
oil. Each solution was applied to the skin three times per day. Compared with the control
solution, the solution containing EFAs significantly reduced the incidence of pressure ulcers
and improved the hydration and elasticity of the skin.
A preliminary report suggested that evening
primrose oil improves blood flow to the legs and heals or reduces the size of venous leg
ulcers.30 No controlled research has further investigated this claim.
A double-blind trial found that a combination of 900 mg per day of diosmin and 100 mg per
day of hesperidin, two members of the flavonoid family,
resulted in significantly greater healing of venous leg ulcers after two months.31
32 Related flavonoids known as hydroxyethylrutosides have also been investigated
for venous ulcer healing. While one controlled study reported significant additional benefit
when 2,000 mg per day of hydroxyethylrutosides were added to compression stocking
therapy,33 another double-blind trial using 1,000 mg per day found no effect on
ulcer healing;34 a second double-blind trial found no effect of 1,000 mg per day
hydroxyethylrutosides on the prevention of venous ulcer recurrences.35
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
References
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Reliable and relatively consistent scientific data showing a substantial health benefit.
