Medications that slow wound healing: questions to ask.

Start here: do not stop a medication on your own

Reading about medications that slow wound healing can be unsettling, especially if you recognize one of your own. Start with this: do not stop, skip or cut back any medication because of what you read here or anywhere else. Many of these medicines prevent strokes, blood clots, organ rejection or flares of serious illness. Some are dangerous to stop suddenly.

What helps is making sure every clinician knows what you take, and asking the prescriber, who can weigh a medication’s benefit against its effect on a wound.

Medication groups that can affect healing

• Steroids taken by mouth or injection (corticosteroids such as prednisone). They calm inflammation, which is also an early step in healing. With longer use they can thin the skin, slow repair, raise blood sugar and hide signs of infection.
• Medications that quiet the immune system. These are used after organ transplants and for conditions such as rheumatoid arthritis, lupus and inflammatory bowel disease. They can slow repair and make infection more likely.
• Chemotherapy and some other cancer treatments. Many act on fast-growing cells, which include the cells that rebuild tissue.
• Blood thinners and antiplatelet medicines (such as warfarin and aspirin). These do not stop tissue from repairing. They do increase bleeding and bruising, which matters at dressing changes and procedures.
• Anti-inflammatory pain relievers (such as ibuprofen and naproxen). Regular use can affect bleeding, swelling and the kidneys.
• Water pills (diuretics). Less swelling usually helps a leg wound, but losing too much fluid can dry the skin and strain the kidneys.
• Nicotine in any form. Nicotine tightens blood vessels. See smoking and wound healing.

Medication is one factor among many. See why some wounds heal slowly for the others.

Products put on the wound count too

What goes on a wound can matter as much as what you swallow. Hydrogen peroxide, rubbing alcohol, some antiseptics and many home remedies can harm new tissue. Use only what the wound care clinician recommended for this wound, and mention anything else you have been applying, including leftover ointments and creams.

Questions to ask the prescriber

Bring these to the clinician who prescribes the medication, or to a medication review:

1. Could this medication affect how my wound heals?
2. Is it still the right choice for me while I have this wound?
3. Does my wound care clinician need to do anything differently because I take it?
4. Could it raise my blood sugar or hide signs of infection?
5. What should happen with it before a procedure, and who decides?

What to tell your wound care clinician

The wound care clinician needs the whole list, not only the prescriptions you think are relevant. Include:

• Prescription medications, with any recent changes
• Over-the-counter pain relievers, sleep aids and allergy medicines
• Vitamins, herbal products and supplements (some, such as fish oil, ginkgo and high-dose vitamin E, may affect bleeding)
• Injections or infusions you get at a clinic every few weeks or months
• Creams, ointments and sprays used on your skin

For a format to copy, see keeping an up-to-date medication list.

Before a procedure

Some wound treatments involve cutting or removing tissue, such as debridement, a biopsy or a skin graft. If you take a blood thinner or a medication that affects your immune system, the clinician doing the procedure and the prescriber decide together whether anything should be paused.

If you are told to hold a medication, ask exactly when to stop and when to restart, and get it in writing. If no one has mentioned your blood thinner, bring it up before the procedure. Do not hold a dose on your own.

How Gateway helps

Gateway does not prescribe or change medications. Treating clinicians do. We arrange wound care and primary care follow-up with partner clinicians across Greater St. Louis and the Metro East, and when a wound care clinician has a question about a medication, we send it to the prescriber, including your own physician if you have one. See primary care and wound care together.

Call 314-325-0126, or use the request care form, which asks only for a name and phone number.

What to report and when to call 911

Call the prescriber or the treating clinician’s office about new bruising, bleeding that soaks through a dressing, fever, or blood sugar readings well outside your usual range.

Call 911 for bleeding that will not stop with firm pressure, trouble breathing, swelling of the face, lips or tongue, fainting, or sudden confusion. Gateway is not an emergency service.

Common questions

Related pages

• Medication review
• Keeping a medication list
• Why some wounds heal slowly
• Primary care and wound care together
• Pain and comfort
• Request care
• The first two weeks after the hospital
• Annual wellness visit: what it covers