Fish Skin to Treat Second/Third Degree Burns

 In Naturopathic News

A recent article from Scientific American showcased a novel burn treatment gaining significant traction in Brazil; tilapia skin.1 Because Brazil lacks the same skin bank resources available in the United States – human skin, pig skin, and artificial alternatives –  clinical trials have been initiated using tilapia skin. Dr. Edmar Maciel, a plastic surgeon, and burn specialist leading the trials says that current skin banks only meet about 1 percent of the national need.

(Fish) Skin-Banks for Developing Countries

This isn’t merely a deficit in Brazil, most developing countries do not have functional skin banks large enough to meet demand. Current burn protocols for second and third-degree burns is mainly the application of gauze and silver sulfadiazine cream. The cream keeps infection at bay, however, isn’t a solution for debridement or helping healing time. This burn treatment method also necessitates changing gauze bandages daily, which is painful and cumbersome.

Tilapia for the Win

Tilapia, extensively farmed worldwide, may pose a solution. The skin of the tilapia is viewed as garbage by the fish industry, yet, upon histological inquiry by Maciel’s team, large quantities of collagen proteins (types 1 and 3) were found. These are the same proteins which exist in high quantities in human and other skin, and are factors crucial for scarring. The amount of moisture of the skin was higher than human skin, as well as the tension strength of the tilapia skin.

In addition to the favorable makeup of tilapia skin, it also adheres to wounds incredibly well and can be left on much longer than the gauze/cream alternative. In fact, with second-degree burns, the tilapia skin is placed over the wound and left until scarring occurs. For third-degree burns, it is changed once or twice. It also cuts down on total healing time significantly in comparison to the gauze and cream method and reduces the need for pain medication.

The Skinny on the Process

The skin is prepared at special centers which cut the skin to appropriate sizes before sterilizing it with chlorhexidine. It is then sent away for radiation to kill viruses and packaged. Kept refrigerated, the skins can last up to two years. Current histological research is being conducted in Brazil that compares tilapia with human and frog skin. Cost comparative studies are also ongoing.

Tilapia Feels the Burn

It is unlikely that this alternative would ever be used in countries like the United States or Europe in the near future. Animal rights groups, as well as FDA oversight, make a venture of this sort cost prohibitive and logistically cumbersome. However, the use of tilapia as a skin alternative may be of great benefit to the rest of the world, where skin bank resources are lacking.


  1. Sussman, Nadia. Can Tilapia Skin Be Used to Bandage Burns? STAT [online]. March 4, 2017.

Node Smith, associate editor for NDNR, is a fifth year naturopathic medical student at NUNM, where he has been instrumental in maintaining a firm connection to the philosophy and heritage of naturopathic medicine amongst the next generation of docs. He helped found the first multi-generational experiential retreat, which brings elders, alumni, and students together for a weekend campout where naturopathic medicine and medical philosophy are experienced in nature. Three years ago he helped found the non-profit, Association for Naturopathic ReVitalization (ANR), for which he serves as the board chairman. ANR has a mission to inspire health practitioners to embody the naturopathic principles through experiential education. Node also has a firm belief that the next era of naturopathic medicine will see a resurgence of in-patient facilities which use fasting, earthing, hydrotherapy and homeopathy to bring people back from chronic diseases of modern living; he is involved in numerous conversations and projects to bring about this vision. 

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