Psychological stress can extend the time required to heal wounds by 25 percent or more. Studies in which we and other researchers have created small wounds about the size of a pencil eraser, and then measured the rate of healing, show that stress slows closure. For example, dental students took an average of 40 percent longer to heal a small, standardized wound made prior to exams, compared to an identical wound made during their summer vacation.
In contrast to the relatively mild and predictable stress of academic examinations, surgery is a high-stakes stressor, and people's anxiety levels before surgery are often very high. After surgery, anxiety and depression can make pain worse—and pain is certainly another stressor that can slow your healing.
The immune system plays a central role in wound healing, and stress alters your immune system's ability to heal wounds. Cortisol, one of the hormones that is very responsive to stress, is a factor. Stress-induced elevations in cortisol interfere with activities important for wound healing, including the production of pro-inflammatory cytokines at the wound site that are important for the early parts of the healing process.
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