Mucosal wound healing is impaired by examination stress

Phillip T. Marucha, Janice K. Kiecolt-Glaser, Mehrdad Favagehi

Research output: Contribution to journalArticlepeer-review

399 Scopus citations


Objective: Impairment of wound healing is a well-recognized sequelae of conditions that alter immune function, including diabetes, jaundice, and advanced age. There is also growing evidence that psychological stress has adverse consequences for immune function. This study addressed the effects of a commonplace stressor on wound healing. Method: Two punch biopsy wounds were placed on the hard palate of 11 dental students. The first wound was timed during summer vacation, whereas the second was placed on the contralateral side 3 days before the first major examination of the term; thus, each student served as her or his own control. Two independent methods assessed healing (daily photographs and a foaming response to hydrogen peroxide). Results: Students took an average of 3 days longer to completely heal the 3.5-mm wound during examinations, ie, 40% longer to heal a small, standardized wound. Production of interleukin 1β (IL-1β) messenger RNA (mRNA) declined by 68% during examinations, providing evidence of one possible immunological mechanism. These differences were quite reliable: No student healed as rapidly or produced as much IL-1β mRNA during examinations as during vacation. Conclusions: These data suggest that even something as transient, predictable, and relatively benign as examination stress can have significant consequences for wound healing.

Original languageEnglish (US)
Pages (from-to)362-365
Number of pages4
JournalPsychosomatic Medicine
Issue number3
StatePublished - 1998
Externally publishedYes


  • Interleukin 1
  • Oral
  • Psychological stress
  • Surgery
  • Wound repair

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health


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