The Role of Topical Timolol in Wound Healing: Current Update and Brief Review

Abstract

Timolol, a first-generation nonselective β-adrenergic receptor antagonist, has recently attracted attention as a potential therapeutic agent for promoting cutaneous wound repair. Its effects are mediated through modulation of β 2 -adrenergic receptors expressed on keratinocytes, fibroblasts, and endothelial cells, where they regulate essential processes such as cellular migration, proliferation, angiogenesis, and extracellular matrix synthesis. By modulating these signaling pathways, timolol has been shown to facilitate re-epithelialization and accelerate wound closure, particularly in the context of chronic wounds such as venous leg ulcers, diabetic foot ulcers, and pressure sores. Clinical studies, including randomized controlled trials and observational studies, consistently report reductions in wound size and improvements in tissue regeneration with topical timolol treatment. Importantly, timolol demonstrates a favorable safety profile, with minimal systemic absorption and a low incidence of adverse effects, supporting its role as an accessible adjunct or alternative to conventional wound management strategies. Nevertheless, the precise molecular mechanisms by which timolol exerts its reparative effects remain incompletely defined, and the optimal dosing strategies and treatment duration have yet to be established. Further large-scale, well-controlled studies are warranted to elucidate these mechanisms, confirm long-term efficacy, and refine its clinical applications across diverse dermatological conditions. Collectively, emerging evidence indicates that timolol represents a novel, safe, and cost-effective therapeutic option for the management of chronic and recalcitrant wounds.

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