Chronic wounds, defined as wounds that take more than eight weeks to heal or do not heal at all, are an underestimated public health problem affecting over eight million Americans. The most common forms of chronic wounds are leg ulcers caused by vascular insufficiency and foot diabetic ulceration. The healing process of a wound involves proper circulation, immune status, nutrition, and avoidance of negative mechanical forces, and takes 3–14 days to complete and is divided into three overlapping stages – acute inflammation, proliferation and granulation tissue formation, and tissue remodeling with wound contraction. However, when any of these components are compromised, healing is delayed. Previous studies have shown that self-reported impaired wound healing in young adults was associated with poorer mood, attention deficits, reduced quality of life, and poorer immune fitness.
Migraine is a common headache disorder affecting about 15% of the world’s population and three times more women than men. The pathophysiology of migraine involves both vascular and neuronal mechanisms, with most vascular risk factors related to lower levels of endothelial progenitor cells (EPCs) and endothelial dysfunction. EPCs play an essential role in angiogenesis, and a loss in the number and function of EPC has been found in patients with migraine. Calcitonin gene-related peptide (CGRP) plays a causative role in migraine and has also been associated with wound healing processes by enhancing keratinocyte proliferation and promoting revascularization while reducing the expression of inflammatory mediators.
As EPCs and CGRP play a crucial role in migraine as well as in wound healing, a study was undertaken to evaluate the association between migraine and impaired wound healing. The study comprised an anonymous online survey that recruited Dutch university students between the ages of 18 to 30 years. Subjects were asked whether or not they had experienced wound infections or slow-healing wounds during the past year. If they answered yes, they were allocated to the impaired wound healing (IWH) group. The other subjects served as a control group. A single-item rating assessed immune fitness on an 11-point scale that ranged from 0 (very poor) to 10 (excellent). The ID migraine was completed to evaluate migraine complaints. The study found that migraine contributes to a higher incidence of impaired wound healing, which also results in poorer immune fitness.
In conclusion, chronic wounds are an underestimated public health problem, with slow-healing wounds causing disability, decreased productivity, and loss of independence. The healing process involves proper circulation, immune status, nutrition, and avoidance of negative mechanical forces. Migraine is a common headache disorder affecting about 15% of the world’s population and three times more women than men. Unfortunately, the prevalence of migraine contributes to increasing wound healing complications, which is exacerbated by poor immune fitness. Therefore, mechanisms that could help improve wound healing in patients suffering from migraine headaches need to be studied further.
