Objective: Impairment of wound healing is a well-recognized sequelae o
f conditions that alter immune function, including diabetes, jaundice,
and advanced age. There is also growing evidence that psychological s
tress has adverse consequences for immune function. This study address
ed the effects of a commonplace stressor on wound healing. Method: Two
punch biopsy wounds were placed on the hard palate of 11 dental stude
nts. The first wound was timed during summer vacation, whereas the sec
ond was placed on the contralateral side 3 days before the first major
examination of the term; thus, each student served as her or his own
control. Two independent methods assessed healing (daily photographs a
nd a foaming response to hydrogen peroxide). Results: Students took an
average of 3 days longer to completely heal the 3.5-mm wound during e
xaminations, ie, 40% longer to heal a small, standardized wound. Produ
ction of interleukin 1 beta (IL-1 beta) messenger RNA (mRNA) declined
by 68% during examinations, providing evidence of one possible immunol
ogical mechanism. These differences were quite reliable: No student he
aled as rapidly or produced as much IL-1 beta mRNA during examinations
as during vacation. Conclusions: These data suggest that even somethi
ng as transient, predictable, and relatively benign as examination str
ess can have significant consequences for wound healing.