Wound-healing effects of vitamin C on the skin?

Essential points to remember.

Vitamin C plays a role in all stages of wound healing : inflammation, cell proliferation and collagen maturation.
Vitamin C deficiency slows wound healing and impairs the quality of the collagen formed.
Preclinical studies indicate that an oral vitamin C supplementation may be beneficial for wound healing, but clinical evidence remains insufficient and heterogeneous.
When applied topically, vitamin C may accelerate the repair of certain superficial lesions, but the data remain limited.

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What is the role of vitamin C in wound healing?

The vitamin C, or L-ascorbic acid, is a water-soluble nutrient that the body cannot synthesise. Only topical application and dietary intake can provide it to the body. Vitamin C plays an important role in cellular protection thanks to its antioxidant properties, but it also participates in numerous enzymatic reactions directly involved in skin repair. Its involvement in all stages of wound healing — inflammation, proliferation and remodelling — explains why even a moderate deficiency can slow tissue reconstruction.

As early as the inflammatory phase, vitamin C contributes to the regulation of immune cell activity. It is essential for apoptosis and the subsequent clearance of neutrophils recruited in the first hours following injury. This resolution mechanism prevents the establishment of a prolonged inflammatory response, which is known to disrupt the transition to the proliferation phase. Moreover, plasma and tissue levels of vitamin C fall rapidly after injury: the metabolic environment becomes highly catabolic, demands increase, and the body uses its reserves to control the oxidative stress generated by acute inflammation.

During the proliferative phase, vitamin C plays a central role in the synthesis of collagen, a structural protein essential for the formation of granulation tissue. It acts as a cofactor for two key enzymes: prolyl hydroxylase and lysyl hydroxylase, responsible for stabilising and maturing collagen fibres. A deficiency in vitamin C impairs the correct hydroxylation of collagen chains, which reduces their tensile strength, disrupts the three-dimensional organisation of the tissue and slows the formation of new dermis.

Vitamin C also has immunomodulatory effects. Recent studies show that it limits pro-inflammatory processes via different mechanisms, including in macrophages. The vitamin C can notably modulate inflammatory signalling pathways, notably NF-κB and MAPK, resulting in reduced production of pro-inflammatory cytokines. This molecule also helps to decrease the expression of pro-inflammatory enzymes COX-2 and iNOS.

Maintaining adequate levels of vitamin C is essential for the body to heal properly.

Does vitamin C exhibit wound-healing properties?

Beyond its well-established role in wound-healing mechanisms, one may ask whether vitamin C, whether ingested orally or applied topically, accelerates tissue repair. Several studies have endeavoured to evaluate its efficacy. A 2018 systematic review collated data from ten articles on the use of vitamin C following musculoskeletal injury. This analysis aimed to examine supplementation protocols, the impact on collagen repair and the speed of bone, tendon and ligament healing, as well as its antioxidant effects.

Preclinical results are encouraging: two animal studies report significantly accelerated bone consolidation with vitamin C, two others demonstrate an increase in type I collagen in injured tendons, and one study observes an improvement following anterior cruciate ligament reconstruction. However, human data remain limited: one clinical study showed no significant difference in the rate of bone consolidation or skin healing. The review nevertheless emphasises that supplementation reduces oxidative stress markers in several animal models and that no adverse effects have been reported.

Despite these favourable preliminary results, the authors conclude that robust clinical evidence is still lacking to recommend vitamin C supplementation in the post-injury period.

Following the data on oral vitamin C intake, let us now turn our attention to the topical application of this vitamin. This route of administration allows direct action at the site of injured tissue. Research on skin wound healing is limited, but a clinical study on second-degree burns offers valuable insight. It evaluated the effect of a topical vitamin C solution at 10% on the healing of second-degree burns. Thirty patients were included. Each had two comparable burn areas (symmetrical or situated on similar regions of the same limb), allowing intra-individual comparison. The first was treated with 1% silver sulfadiazine, a compound used in burn care, while the second also received the vitamin C solution.

Dressings were changed daily. Wound healing was assessed on days 1, 3, 7 and 14 using the Bates-Jensen Wound Assessment Tool, a standardised clinical instrument. The results show a significantly greater improvement in healing in areas treated with vitamin C, with a statistically significant difference in the overall healing score between the two sites and a statistically faster rate of healing. Furthermore, the study reported no adverse effects related to the vitamin C.

Évolution du score de cicatrisation (rouge : sulfadiazine d’argent ; bleu : sulfadiazine d’argent + vitamine C). — Evolution of the healing score (red: silver sulphadiazine; blue: silver sulphadiazine + vitamin C).
Source: SARPOOSHI H. R. & al. Wound healing with vitamin C. Translational Biomedicine (2017).

This study thus suggests that the topical application of vitamin C may accelerate skin healing. However, despite encouraging results, the data remain limited and require confirmation through larger clinical trials.

Note : In the event of open wounds, extensive burns or any injury requiring medical supervision, it is essential to follow your doctor’s recommendations and refrain from applying any non-prescribed products. Moreover, vitamin C serums, particularly when they contain pure ascorbic acid at high concentrations, can be irritating and may not be suitable for weakened or healing skin. Their use should therefore be approached with caution and should never replace medical treatment.