L-Lysine is an essential amino acid, meaning the human body cannot synthesise it and it must be obtained through diet or supplementation. It plays several vital physiological roles, one of the most important—especially in the context of wound healing—is its involvement in the synthesis of structural proteins, notably collagen. Collagen is the primary component of the extracellular matrix found in skin, tendons, and other connective tissues, and its proper production is essential for the effective repair of tissues following injury, surgery, or burns.
In collagen synthesis, L-lysine plays a dual role. First, it is a direct component of the procollagen chains—the precursor form of collagen produced in fibroblasts. Second, lysine must undergo specific modifications to allow collagen to adopt the correct three-dimensional structure and perform its biological function. This involves the hydroxylation of lysine residues—a process in which a hydroxyl group (-OH) is added to the lysine molecule. This reaction is catalysed by lysyl and prolyl hydroxylase enzymes, which require vitamin C (ascorbic acid) to function. Without this step, collagen remains unstable and unable to form strong, well-organised fibres.
Following hydroxylation, lysine residues also serve as targets for lysyl oxidase, another enzyme responsible for forming covalent cross-links between collagen fibres. These cross-links are critical for giving collagen its mechanical strength and resistance to tensile forces. The more properly cross-linked collagen is produced, the faster and more efficiently damaged tissue can regenerate and wounds can close. Therefore, adequate availability of L-lysine is essential at every stage of the healing process—from the early inflammatory phase, through cellular proliferation, to the remodelling phase of scar formation.
Beyond its structural role in collagen, L-lysine also contributes to wound healing in several other ways. Numerous studies indicate that it may act as a stimulant of fibroblast proliferation—cells responsible for producing collagen and other extracellular matrix components. Fibroblasts are key players in the proliferative phase of wound healing, rebuilding the tissue framework. L-lysine also positively influences angiogenesis—the formation of new blood vessels in the wound area—as well as tissue perfusion, improving oxygen and nutrient delivery to the regenerating site. These effects support faster tissue repair and reduce the risk of necrosis.
Another important aspect is L-lysine’s influence on the immune system. It plays a role in synthesising immune-related enzymes and proteins, including antibodies that combat pathogens residing in wounds. This function helps cleanse the wound more rapidly and reduces inflammation, facilitating the transition to the next phase of healing. Emerging evidence also suggests that L-lysine may modulate the expression of certain pro-inflammatory cytokines, such as TNF-α and IL-6, making it a potential immunomodulatory agent in the treatment of chronic wounds.
Finally, L-lysine prevents the consequences of its own deficiency, which can impair collagen synthesis and slow down the healing process. A classic example is scurvy—a disease caused by vitamin C deficiency—in which the body fails to hydroxylate lysine and proline residues properly, leading to the breakdown of collagen fibres and severely compromised wound healing. While outright L-lysine deficiency is rare in healthy individuals, it may occur in malnourished people, the elderly, those with chronic illnesses, or those following low-protein diets (e.g. some forms of veganism), thereby justifying consideration of supplementation in such groups.
In summary, L-lysine plays a multi-layered and essential role in wound healing. It serves not only as a substrate for collagen production but also as a co-factor supporting proper collagen structure, a promoter of fibroblast activity, a facilitator of blood supply to the wound site, a stimulator of angiogenesis, and a regulator of immune response. These combined mechanisms make L-lysine a noteworthy component in strategies aimed at supporting the healing of both acute and chronic wounds.
Scientific Evidence and Clinical Studies
Each year, more high-quality scientific evidence emerges supporting the use of L-lysine as an effective adjunct therapy for both chronic and acute wounds. Previously best known for its role in herpes prevention, this amino acid is increasingly appearing in medical literature as an active ingredient in creams, gels, and supplements used both topically and systemically in wound management.
1. Clinical Studies in Patients with Diabetic Foot Ulcers
In a study conducted by Shashikumara et al. (2023), researchers evaluated the effectiveness of a cream containing 15% L-lysine in the treatment of foot ulcers in patients with type 2 diabetes. The randomised, controlled trial involved 40 participants divided into two groups: one received standard care (antiseptics, offloading, dressings), while the other received the same standard care along with a topical L-lysine cream applied twice daily.
After just six weeks of treatment, there was a significant reduction in ulcer depth and area in the L-lysine group, measured using the Bates-Jensen Wound Assessment Tool (BWAT). The average reduction in wound size was substantially greater in the L-lysine group than in the control group (p < 0.01), suggesting strong healing properties of this amino acid for wound healing.
Similar conclusions were drawn by Vani et al. (2019), who studied the effects of the same 15% L-lysine cream in patients with non-diabetic foot ulcers. Applied twice daily for four weeks, the cream led to a significant reduction in wound size and accelerated epithelialisation compared to standard care alone. Notably, neither study reported any adverse effects, supporting the safety of topical L-lysine therapy.
2. Pressure Ulcer Therapy
In a classic study by Felzani et al. (2011), the effectiveness of a gel containing L-lysine and hyaluronic acid (the Lys-HA formula) was evaluated for pressure ulcer treatment. Fifty participants were randomly assigned to receive either the Lys-HA gel or standard sodium hyaluronate. After 15 days of treatment, patients in the Lys-HA group showed a much greater reduction in wound surface area, particularly in stage III and IV ulcers. The average reduction was 71% in the Lys-HA group compared to 29% in the control group (p < 0.01).
3. Preclinical Studies – Burn Model in Rats
In an experiment published in 2025 by Svotin et al., the researchers investigated the effect of a spray containing L-lysine and dihydroquercetin (a flavonoid with antioxidant properties) on the healing of burn wounds in rats. Animals in the intervention group showed faster epidermal regeneration and increased collagen fibre production in the wound tissue compared to the control group (neutral spray). Histopathological assessment confirmed higher collagen density and more intense angiogenesis.
4. Potential Immunomodulatory Effects
In vitro studies have also shown that L-lysine may affect the expression of inflammatory cytokines. Decreased levels of TNF-α and IL-8 were observed in cells exposed to L-lysine, suggesting a role in reducing chronic inflammation in wounds [5]. Although these findings require further validation in clinical settings, they point to an additional mechanism by which lysine may act as a lysine skin healing factor.
Table: Selected Studies on the Use of L-Lysine in Wound Therapy
| Study | Wound Type & Population | Intervention (L-Lysine) | Clinical Outcomes |
|---|---|---|---|
| Shashikumara et al., 2023 [1] | Diabetic foot ulcers (n = 40) | 15% L-lysine cream (2x/day) | Significant wound reduction (BWAT); faster healing than standard care |
| Vani et al., 2019 [2] | Non-diabetic foot ulcers (n = 20) | 15% L-lysine cream (2x/day) | Accelerated healing and reduced wound size |
| Felzani et al., 2011 [3] | Pressure ulcers (n = 50) | Lys-HA gel vs. sodium hyaluronate | Greater reduction (71% vs. 29%), especially in stage III/IV ulcers |
| Svotin et al., 2025 [4] | Burns (rat model) | L-lysine + dihydroquercetin spray | Faster healing, more collagen fibres, improved histological outcomes |
Scientific Evidence and Clinical Research
In recent years, there has been growing interest within the scientific and clinical communities in the use of L-lysine as an active ingredient supporting the treatment of various types of wounds—both chronic and acute wounds. This essential amino acid, necessary for protein synthesis and collagen production, as well as for maintaining skin integrity, is gaining increasing recognition for its effectiveness in both experimental and clinical studies.
Application of Lysine in the Treatment of Diabetic and Non-Diabetic Foot Ulcers
Particularly promising results have been reported in the context of diabetic foot ulcer treatment—one of the most serious complications of diabetes, associated with a high risk of amputation and significantly reduced quality of life. In a randomised clinical trial conducted by Shashikumara et al. in 2023, the effectiveness of a 15% L-lysine cream in the treatment of such wounds was assessed. Forty patients with diabetic foot ulcers were divided into two groups: a control group treated with standard methods (e.g. dressings, antiseptics, limb offloading), and an experimental group that also applied the L-lysine cream twice daily.
After six weeks of treatment, the L-lysine group showed a statistically significant reduction in both the depth and surface area of the wounds, as assessed by the Bates-Jensen Wound Assessment Tool (BWAT). These findings suggest that topical lysine may significantly accelerate wound healing and reduce clinical severity compared to standard therapy.
Comparable outcomes were observed in the study by Vani et al. (2019), which included patients with chronic non-diabetic foot ulcers. In this trial, a 15% L-lysine cream was also applied topically twice daily for a period of four weeks. The authors reported a notable acceleration of the healing process, as well as a reduction in wound size and depth in the lysine-treated group compared to the control group. These clinical observations support the hypothesis that L-lysine may be a beneficial adjunct in wound care, regardless of diabetic status.
Effectiveness of Lysine in the Treatment of Pressure Ulcers
Another significant application of L-lysine is in the treatment of pressure ulcers—wounds that result from prolonged pressure, often affecting bedridden or elderly patients. In a double-blind, randomised clinical trial published by Felzani et al. in 2011, the efficacy of a novel Lys-HA gel formulation—combining L-lysine with sodium hyaluronate—was evaluated. Fifty hospitalised patients with pressure ulcers were randomly assigned to receive either the Lys-HA gel or a standard hyaluronate gel.
After 15 days of treatment, a substantially greater reduction in wound area was observed in the Lys-HA group. For grade III pressure ulcers, the average reduction reached 71%, compared to just 29% in the control group (p < 0.01). These differences were also noted in other ulcer grades, confirming the therapeutic advantage of the lysine-enriched formulation.
Preclinical Studies – Burn Regeneration and Mechanisms of Action
Encouraging results regarding lysine’s effects have also been confirmed in animal model studies. A notable example is the experiment conducted by Svotin et al. (2025), in which a spray containing L-lysine and dihydroquercetin (a potent antioxidant flavonoid) was tested on burn wounds in rats. Animals treated with the lysine-based preparation showed faster epidermal regeneration, improved tissue vascularisation, and a significantly higher density of collagen fibres in the wound area compared to the control group. These results support the hypothesis that L-lysine enhances collagen synthesis, contributing to more efficient and structurally sound skin regeneration.
Potential Immunomodulatory Properties
Furthermore, some in vitro studies suggest that lysine may also exhibit immunomodulatory properties, reducing the expression of pro-inflammatory cytokines such as TNF-α and IL-8 in skin cells. This effect may help explain the shortened inflammatory phase observed in clinical wound healing studies and the faster transition to proliferative and regenerative phases. While these mechanisms require further confirmation, they represent a promising direction for future research.
Diet, Supplementation, and Dosage of L-Lysine
L-lysine is an essential amino acid that must be obtained through the diet, as the human body is unable to synthesise it on its own. Adequate intake is crucial for proper protein synthesis, collagen production, and supporting tissue regeneration—particularly relevant in wound healing, viral infections (e.g. HSV-1), and periods of recovery after injury or surgery.
Natural Dietary Sources
Lysine is found primarily in foods rich in complete proteins. Its main sources are animal-derived products, including:
- Meat (especially beef, pork, poultry),
- Fish (such as salmon, tuna, cod),
- Dairy products (milk, cheese, yoghurt),
- Eggs.
Plant-based foods can also provide lysine, although often in lower quantities and sometimes with limiting amino acids. A plant-based diet may still offer good lysine sources, such as:
- Soya and soy-based products (tofu, tempeh, soy milk),
- Legumes (beans, lentils, chickpeas),
- Nuts (especially peanuts) and seeds (e.g. pumpkin seeds).
Individuals following vegetarian or vegan diets should pay attention to complementary protein sources to meet their lysine needs. In general, a typical balanced diet provides sufficient lysine to meet physiological requirements.
Supplementation and Requirements
Lysine requirements vary depending on age, body weight, physical activity, and health status. For a healthy adult weighing 70 kg, the average daily requirement ranges from 800 mg to 3,000 mg, which is usually covered by food intake. However, in certain physiological or pathological states, such as:
- Wound healing,
- Burns,
- Post-operative recovery,
- Intense athletic training,
- Viral infections (e.g. cold sores),
It may be appropriate to increase L-lysine intake through supplementation, for example by taking L-lysine capsules.
Typical therapeutic oral supplementation doses of L-lysine range from 1 to 3 grams per day, which is considered safe for most adults. In studies on cold sore outbreaks and prevention, higher doses—up to 3–5 grams per day—have been used, especially during acute phases or in cases of frequent recurrence. However, caution is advised, as intakes exceeding 10–15 grams daily may lead to adverse effects, primarily gastrointestinal (nausea, diarrhoea, stomach cramps).
Topical Preparations
Lysine is also used topically, in the form of creams, gels, and sprays. In clinical trials on the treatment of ulcers and pressure sores, creams containing 15% L-lysine demonstrated both good tolerability and marked efficacy in accelerating wound healing (see: Shashikumara et al. 2023, Vani et al. 2019, Felzani et al. 2011).
Contraindications and Interactions
Lysine supplementation is generally well tolerated and safe at moderate doses, but certain groups should exercise caution:
- People with kidney disease (e.g. chronic kidney failure),
- Individuals with liver dysfunction,
- Pregnant and breastfeeding women – due to limited data on safety in these populations.
Additionally, L-lysine may compete with L-arginine for transport and absorption—another amino acid important in nitric oxide production and cardiovascular function. Therefore, individuals taking high doses of lysine or supplementing with arginine should be cautious, particularly those with amino acid metabolism disorders. People with diabetes or inherited metabolic conditions should consult a doctor before starting supplementation.
L-lysine UK Context
In recent years, the United Kingdom has seen a noticeable increase in interest in dietary supplements, including amino acids such as L-lysine. This trend is evident in the retail sector—lysine supplements are widely available in pharmacies (e.g. Boots, Lloyds), health food stores (e.g. Holland & Barrett), and across online platforms. Recommendations are also increasingly appearing in popular science and lifestyle media, where L-lysine is promoted as a nutrient that supports immunity, helps in viral infections (including cold sores), and may be useful in cases of protein or iron deficiency, such as in anaemia management.
Official Guidelines and the Role of Nutrition in Wound Healing
The UK’s National Health Service (NHS) has long emphasised the importance of proper nutrition in wound healing, particularly for patients with chronic conditions such as diabetes, obesity, or venous insufficiency. In official NHS educational materials and guidelines for healthcare professionals, recommendations include:
- Increased energy and protein intake in patients with wounds—especially pressure ulcers and leg ulcers—at a level of 1.2–1.5 g of protein per kg of body weight per day
- Addressing deficiencies in vitamins and minerals that support skin and connective tissue regeneration, including vitamins A, C, E, as well as iron and zinc
- Careful monitoring of nutritional status in older adults, undernourished individuals, hospitalised patients, and those with limited mobility [1]
As an amino acid essential for collagen synthesis—the key structural protein of the skin—lysine aligns directly with these recommendations. It also plays a role in calcium transport, enzyme function, and immune support, making it a potentially valuable component of a multifactorial approach to managing chronic wounds.
The Impact of Climate and Environmental Factors
The specific climate in the UK may further aggravate wound healing issues. The cold, damp environment can contribute to:
- The development of chronic skin conditions such as abrasions, frostbite, and bacterial infections
- Reduced sun exposure, which limits cutaneous vitamin D synthesis—a nutrient known to affect immune and regenerative processes in the skin
- Increased prevalence of skin inflammation, which interferes with tissue remodelling and prolongs epithelialisation
In this context, adequate intake of essential amino acids, including L-lysine, becomes even more important—particularly for patients with existing wounds, immune deficiencies, or comorbidities.
The Scale of Chronic Wound Issues in the UK
According to British epidemiological data, chronic wounds are a serious public health issue. Data from Diabetesonthenet.com and NHS England analyses show that:
- In 2022 alone, around 25,000 new cases of diabetic foot ulcers were reported in England
- More than 2 million people in the UK suffer from chronic wounds, including pressure ulcers and venous leg ulcers
- The annual cost of wound care to the NHS is estimated at over ÂŁ8 billion, with a large proportion attributed to hospital stays and treatment of complications [4]
In light of this, any effective, safe, and cost-efficient methods that support wound healing—including lysine supplementation as an adjunct therapy—are gaining importance. This may be particularly relevant for:
- Older individuals, whose diets may be low in protein
- Those following plant-based or elimination diets, which may have reduced lysine intake
- Patients with diabetes, obesity, vascular disease, or limited mobility, in whom wound healing is often impaired
Therapeutic and Preventive Potential
Although lysine supplementation is not yet part of official guidelines for chronic wound treatment in the UK, a growing body of research and clinical evidence suggests that including it in comprehensive nutritional interventions—alongside vitamins, zinc, arginine, or probiotics—may provide effective support. This is especially relevant for malnourished individuals, residents of care homes, patients with diabetic foot syndrome, and those managing slow-healing wounds at home.
Scientific Publications
- Shashikumara S., Jayaraman V., Chikkegowda P., Lingaiah D.C., Kalal B.S.
Efficacy of 15% lysine cream in treating diabetic foot ulcers: a randomized interventional study.
International Journal of Physiology, Pathophysiology and Pharmacology. 2023;15(3):88–97.
PMID: 37457650, PMCID: PMC10349317
https://pubmed.ncbi.nlm.nih.gov/37457650/
- Vani J., Shashi Kumara, Prathima C.
A randomized, open-label, comparative study of lysine cream 15% with standard therapy in non-diabetic foot ulcer.
National Journal of Physiology, Pharmacy and Pharmacology. 2019;9(9):907–911.
https://www.njppp.com/?mno=54441
- Felzani G., Spoletini I., Convento A., Di Lorenzo B., Rossi P., Miceli M., Rosano G.
Effect of lysine hyaluronate on the healing of decubitus ulcers in rehabilitation patients.
Advances in Therapy. 2011;28(5):439–445.
DOI: 10.1007/s12325-011-0016-2, PMID: 21499725
https://pubmed.ncbi.nlm.nih.gov/21499725/
- Svotin A.A., et al.
Insights in wound healing properties of water-soluble composition of dihydroquercetin and L-lysine.
Journal of Pharmacy & Pharmaceutical Sciences. 2025;28:13831.
DOI: 10.3389/jpps.2025.13831, PMID: 40144465
https://pubmed.ncbi.nlm.nih.gov/40144465/
- Szymanski K.R., et al.
Biochemistry, Collagen Synthesis.
StatPearls [Internet]. 2022 [updated 2023].
https://www.ncbi.nlm.nih.gov/books/NBK507709/
- Medical News Today
What are the health benefits of lysine?
Medical News Today. Updated: 25 March 2025. Accessed: 9 May 2025.
https://www.medicalnewstoday.com/articles/video-what-are-the-health-benefits-of-lysine
- Oxford University Hospitals NHS
Dietary information to promote wound healing.
Published: January 2025. Accessed: 9 May 2025.
https://www.ouh.nhs.uk/patient-guide/leaflets/files/106907healing.pdf
- Buckinghamshire, Oxfordshire and Berkshire NHS
Wound care nutrition – a resource for patients.
Published: January 2024. Accessed: 9 May 2025.
https://www.oxfordhealth.nhs.uk/wp-content/uploads/sites/51/2024/01/BOB-ICB-Wound-Care-Nutrition-for-Patients.pdf
- Game F.
2022 Update on the National Diabetes Foot Care Audit.
Diabetic Foot Journal (Diabetes on the Net). 2022. Accessed: 9 May 2025.
https://www.diabetesonthenet.com/diabetic-foot-journal/2022-update-on-the-national-diabetes-foot-care-audit/
