Enhancing Skin Growth Part 1
Foreskin restoration is actually an easy, low effort process. The biggest issue though, is the amount of total time it takes to complete. The average amount of skin that a man needs to grow to recover the glans is about 3 inches of length. Typically, this can be achieved in 2 to 5 years.
As outlined in The Complete Guide to Foreskin Restoration, skin growth is stimulated by the skin being under a specific range of tension and time under tension. In other words, the skin needs to have the right amount of tension applied to it for a minimum number of hours per day to induce growth. Once tension and time under tension are dialed in, skin growth becomes a matter of days, months, and years of total time under tension. The obvious question is, can we reduce the total amount of time under tension it takes to restore a foreskin? Or worded differently, can we increase the amount of skin growth that occurs while the skin is under tension?
Restorers are actually not the first to ask this question. Doctors who use skin expansion to preform reconstructive surgery have been trying to solve this same problem, and for good reason. In medical settings, skin expansion usually involves temporarily implanting a silicone balloon under the skin, and inflating it with saline to create tension. Patients need to have these expanders under their skin for weeks or even months to grow the necessary amount of skin. Not only is their daily quality of life effected by this, but there is also the risk of complications due to having a surgically implanted expander, even if it is only temporary.
There are a few different studies and clinical trials that have been done to evaluate different methods of increasing skin growth during the expansion process. While none of these are specific to foreskin restoration, the skin expansion process is still the same. Not all of these studies are directly applicable to foreskin restoration, but the underlying mechanisms can give us some clues as to how we can possibly speed up foreskin restoration.
Topical Metformin: https://pubmed.ncbi.nlm.nih.gov/35685420/
In this study, the drug metformin was applied topically to rats undergoing mechanical skin expansion. The results showed that rats treated with metformin has increased skin thickness, increased amount of collagen, increased amount of blood vessels, and an increased amount of epidermal stem cells. The authors theorized that the results were due to increased stem cell activity, which seems plausible.
Metformin is actually a drug used to control blood sugar levels. However, it is also commonly used in anti-aging medicine, as there is evidence for it increasing longevity. The anti-aging properties of the drug are probably why it was chosen to be tested on skin expansion. Would it be worth trying for foreskin restoration? Personally, I would not use it. However, metformin is a relatively safe drug, and I am sure someone out there will convince their doctor to compound it into a skin cream. The real take away from this study is that increased stem cell activity seems to play a central role in skin expansion, and particularly by increasing collagen and vascularization.
In this study, the drug papaverine was used topically in conjunction with skin expanders in pigs. The results showed that papaverine did increase the rate of skin expansion. Papaverine is an antispasmodic drug, and it is also a vasodilator. It is used topically as a treatment for erectile dysfunction, and could easily be applied to foreskin restoration. Again, I would still not recommend trying this since it is only one study done on pigs, and a prescription would be required anyway. The key point here though is that increased blood flow is the proposed underlying mechanism as to how papaverine increases skin expansion.
Dimethyl sulfoxide (DMSO): https://pubmed.ncbi.nlm.nih.gov/10474470/
This study was done on women who were undergoing skin expansion for breast reconstruction surgery. For breast reconstruction, expanders are placed under the skin and gradually filled with saline over time, until enough skin is grown to put in a permanent breast implant. In this study, women were split into a control group, and a group that had DMSO applied topically over the skin after the volume of the expander was increased each week. The results showed that the DMSO group grew slightly more skin. What was more significant is that amount of time needed to grow enough skin for reconstruction was reduced by 50% in the DMSO group. This meant that the group that used DMSO grew skin twice as fast!
DMSO has a long and complicated history of use in medicine, but the proposed mechanisms of action for this particular study are that it increases circulation and improves collagen formation in the skin. You can readily buy DMSO online, but you should really know what you are doing before using it. DMSO can severely irritate and burn the skin, and thus is probably not a great candidate for use on the penis.
The takeaway from this study is that circulation and collagen formation are very important for skin expansion, and may be limiting factors in how fast skin can grow. Although DMSO can improve circulation and collagen, there may be better, or more appropriate methods for foreskin restoration.
Conclusion
I would not recommend using metformin, papaverine, or DMSO topically for foreskin restoration. These are all single studies that have not been repeated in order to show efficacy. Only the DMSO study was actually done on humans, and none of the three were done on penile skin, which has some important anatomical differences from skin on other areas of the body. However, these studies do give us some important clues as to how we can increase the growth rate of skin. Circulation and vascularization are key mechanisms. Collagen strength and formation also seems to be a limiting factor in how fast skin can grow. Lastly, stem cell activity is known as a mechanism for skin expansion, and it appears that increasing stem cell activity can increase the rate of skin expansion. All of these mechanisms will be explored in more detail in subsequent parts of this series.