Research corner: Tilapia skin and recovery from severe burns

This blog post falls in the category of too cool not to mention.  I came across this story about doctors in Brazil who have been experimenting with using the skin of the ubiquitous tilapia fish to help heal burns. And it seems to be working even better than they’d hoped.

Traditionally, bad burns are covered while they heal. Doctors use either a sort of skin transplant- treated, sterilized skins from humans or pigs- or they use gauze dressings and ointments to keep the burn area moist and free from infection. Treatments with ointments and gauze dressings can be less expensive than human or pig skin. However the dressing needs to be changed in a painful process every day, even on shallow second degree burns. Additionally, in Brazil, skin banks only meet 1% of the demand.

In response to this massive shortage, doctors have been working on a new treatment using the sterilized skin of tilapia. Tilapia is a fish that’s farmed all over Brazil, and the skin has traditionally been considered a waste product and thrown away. But when sterilized and dried, it can not only last up to 2 years, but can be used to treat burns incredibly successfully and inexpensively. 

 Doctors wrap a child’s burnt skin with sterilized tilapia fish skin at Dr. Jose Frota Institute in the northeastern coastal city of Fortaleza, Brazil. Paulo Whitaker / Reuters

Doctors wrap a child’s burnt skin with sterilized tilapia fish skin at Dr. Jose Frota Institute in the northeastern coastal city of Fortaleza, Brazil. Paulo Whitaker / Reuters

Tilapia skin has shown to have a number of other promising advantages. Tilapia skin can stay on until the patient’s own skin has scarred over in many cases; and even with deep second or third degree burns, the tilapia skin need only be changed a few times over the course of treatment (which can last a few weeks). In cases where only a single application of the skin is necessary, the tilapia skin simply dries up and falls off as the skin underneath heals. Imagine the difference: from daily, excruciating bandage treatments for weeks, to a mere two to three changes. Patients also don’t typically need to take antibiotics or pain medication when receiving the tilapia treatment.

 Why does it work so well? Researchers say that tilapia contains loads of vital skin-healing collagen proteins (types 1 and 3), which speeds healing by days, according to the study. One patient even remarked that he immediately noted a reduction in pain after the tilapia skin was applied. Clinical research is ongoing to explore the efficacy of burn treatment with tilapia skin and to better understand just how it helps burns to heal.

This innovative treatment isn’t just helping people. Earlier this year, a cougar cub and two bears were rescued from the Thomas fire in California. All had severe burns to their paws. Treating wild animals with injuries such as these using traditional methods carries even more complications and risks (to the animals and their caretakers) than for human patients. Veterinarians had heard of the burn treatment helping people in Brazil and thought it might be useful for their four legged patients. Due to regulatory restrictions, prepared skins from Brazil couldn’t be shipped to the U.S. So, the vets managed to create their own sterilized skins from tilapia they purchased at a local market. On days where the dressings were applied or changed, the animals were anesthetized. While sedated they also received additional treatments such as cold-laser therapy, chiropractic and acupuncture.

 The younger bear rests in her holding enclosure after her treatment is finished. The outer wrapping on her feet (made of corn husks) will delay her efforts to chew off the tilapia skin bandages underneath. (Karin Higgins/UC Davis)

The younger bear rests in her holding enclosure after her treatment is finished. The outer wrapping on her feet (made of corn husks) will delay her efforts to chew off the tilapia skin bandages underneath. (Karin Higgins/UC Davis)

There’s a video (here) that shows the tilapia skin in action- it’s truly fascinating. Another video (here) shows the how this treatment helped the animals in California. The tilapia burn treatment is a clever example of using the resources at hand, and allowing their natural properties to heal wounds better than we humans can replicate.

Additional Resources:

  1. “Study of tensiometric properties, microbiological and collagen content in nile tilapia skin submitted to different sterilization methods”, Alves et al, Cell Tissue Bank, 2018 Sep;19(3):373-382

  2. “Study to evaluate the Use of Tilapia Skin (Oreochromis Niloticus), in the Treatment of Burn Wounds”, Clinical Trials.gov