Why is new skin not growing over my wound?

New skin forms over the tissue that fills the wound, so an unfilled wound bed has nothing for skin to grow across. A wound is non-healing if it has not started to heal in 2 weeks or not completely healed in 6 weeks.

New skin does not come first. Here’s the order a wound heals in. The wound starts to fill in with new tissue, called granulation tissue. New skin begins to form over this tissue. As the wound heals, the edges pull inward and the wound gets smaller. New skin forms over the tissue that fills the wound. If the wound bed has not filled in, there is nothing yet for new skin to grow across.

That filling-in takes time. The rebuilding stage lasts the next 3 weeks or so. The smaller the wound, the quicker it will heal. The larger or deeper the wound, the longer it takes to heal. That’s also why a dressing is used at all. An open wound will heal from the inside to the outside. A dressing helps absorb drainage and keeps the skin from closing before the wound underneath fills in.

There is a point where slow becomes something else. A non-healing wound is one that has not started to heal in 2 weeks, or has not completely healed in 6 weeks. Those two marks are the most useful thing on this page, because they turn a worry into a date you can check against.

Many things can prevent wounds from healing or slow the process: infection, diabetes, poor blood flow, obesity, age, heavy alcohol use, stress, certain medicines — corticosteroids, NSAIDs and some chemotherapy medicines — and smoking. More than one of these can apply at the same time. Wounds that are slow to heal may need extra care from your provider.

There’s no cream, dressing or supplement recommended here to make new skin grow faster. In fact, the advice for an open wound is the opposite: do not put any lotion, cream, or herbal remedies on or around your wound, unless your provider has said it is OK. If a wound is not covering over, the question for your provider is what is holding it back — not what to put on it.

What to watch for

Contact your provider right away if you have redness, increased pain, or yellow or green pus, or excessive clear fluid around the injury; black edges around the injury, which are a sign of dead tissue; bleeding at the injury site that will not stop after 10 minutes of direct pressure; fever of 100°F (37.7°C) or higher for more than 4 hours; pain at the wound that will not go away, even after taking pain medicine; or a wound that has come open or the stitches or staples have come out too soon.

For this question specifically, check the calendar rather than the wound. If it has not started to heal in 2 weeks, or has not completely healed in 6 weeks, that is the point to ask what is holding it back rather than to wait longer. Take the date the wound started with you.

What we look at

  • Whether the wound bed has filled in with granulation tissue
  • Whether the 2-week or 6-week non-healing marks have passed
  • Whether blood flow to the area has been assessed
  • Which listed healing factors apply — diabetes, circulation, nutrition, smoking, alcohol, medicines
  • Whether dead tissue or infection is sitting between the wound bed and the edges

Sources

  1. MedlinePlus — How wounds heal: https://medlineplus.gov/ency/patientinstructions/000741.htm
  2. MedlinePlus — Wound care centers: https://medlineplus.gov/ency/patientinstructions/000739.htm
  3. MedlinePlus — Surgical wound care, open: https://medlineplus.gov/ency/patientinstructions/000040.htm