On the haemato‑oncology ward where I once worked, I observed the same contrast repeatedly: two patients with similar cancers, similar treatment protocols, and similar physical risk profiles had two very different journeys. The woman whose partner sat by her bed every evening, bringing home‑cooked food and offering quiet jokes often seemed to bounce back more quickly from infections and have fewer treatment side‑effects than the woman who faced long nights alone, with few visitors, who came alone to doctors’ appointments. This observation nudged me to read and learn about the role of social support in physical health, especially in times of illness.
This concept is backed by a substantial body of psychoneuroimmunology research. Large cohort studies show that loneliness and social isolation carry mortality risks comparable to smoking, and are associated with chronic low‑grade inflammation (Hawkley & Cacioppo, 2010; Holt‑Lunstad et al, 2015). Conversely, perceived social support and prosocial behaviours such as volunteering and everyday acts of kindness are linked to lower pro‑inflammatory cytokines, better tumour outcomes, and reduced mortality (Uchino et al., 2018; Seeman et al., 2020; Trachtenberg, 2024).
Alongside these relational factors, oxytocin has emerged as a key player. Animal studies suggest that oxytocin, particularly in social contexts, can enhance wound healing and modulate immune responses, whereas human studies link oxytocin to stress buffering and touch sensitivity (Carter et al, 2020; Steele et al, 2025). Schneider and colleagues bring these threads together in a randomised clinical trial that asks a very concrete question:
In healthy romantic couples, does repeated intranasal oxytocin, alongside structured positive interaction and everyday physical intimacy, influence dermatological wound healing and cortisol levels?
Social connection can influence inflammation and recovery. This trial explores whether oxytocin and couple interaction help wounds heal faster.
Methods
Schneider et al conducted a preregistered, double‑blind, randomised, placebo‑controlled trial with 80 healthy heterosexual couples (N = 160), aged 21–45 and in relationships of at least one year. At baseline, each partner received four standardised suction‑blister wounds on the forearm. Couples were then randomised to receive intranasal oxytocin or placebo and to either a 10‑minute structured Partner Appreciation Task (PAT) or 10 minutes of unstructured interaction, yielding four conditions in total.
Participants self‑administered oxytocin or placebo twice daily for five days. During this period, they:
- Completed ecological momentary assessment (EMA).
- Answered brief questionnaires six times per day about partner interactions (including affectionate touch and sexual activity) and stress.
- Collected six saliva samples per day for cortisol assays.
- Rated wound severity at 1 hour, 24 hours and 7 days from standardised photographs using a modified Photographic Wound Assessment Tool (revPWAT).
Three‑level mixed models (repeated measurements within individuals within couples) were fitted, adjusting for sex, age and relevant behavioural covariates.
Results
Baseline comparisons showed no differences between oxytocin and placebo groups and adherence to nasal sprays was high (>89% in both arms). Nearly all couples randomised to PAT completed at least one task, with around two thirds repeating it on multiple days.
Wound Healing
As expected, blister wounds healed significantly over time across all conditions, confirming that the revPWAT scores captured meaningful changes in wound severity. In the primary wound healing model:
- Oxytocin and PAT showed no significant main effects.
- Two-way interactions showed no significant main effects.
This indicates that neither oxytocin alone nor the structured interaction task alone reliably accelerated healing.
A three-way interaction (time × oxytocin × PAT) was statistically significant (b = −0.125, t = −1.983, P = 0.048), suggesting that oxytocin was associated with faster reductions in wound severity over seven days in couples who engaged in PAT, but not in those having unstructured conversations. However, this effect became nonsignificant after excluding two particularly influential cases, although the pattern remained.
Women showed slower wound healing than men overall.
Intimacy and Wound Healing
Daily physical intimacy data from EMA provided a more fine-grained picture. Higher daily affectionate touch predicted steeper declines in wound severity between 24 hours and 7 days, but only in the oxytocin group.
There was also some evidence that more frequent sexual activity may relate to better wound healing trajectories under oxytocin, although this finding is less robust and should be interpreted cautiously.
Stress and Wound Healing
Oxytocin did not significantly change people’s overall daily cortisol levels. In contrast, people who reported more sexual activity tended to have lower cortisol. Affectionate touch was not clearly linked with cortisol.
Lagged EMA analyses further indicated that higher perceived relaxation at one prompt predicted greater odds of affectionate touch and sexual activity at the next, implying that lower stress tended to come first, making intimacy more likely when people already felt relaxed.
Oxytocin may boost wound healing, but only when paired with positive partner interactions.
Conclusions
Schneider and colleagues conclude that intranasal oxytocin is not a stand‑alone wound‑healing or anti‑stress treatment in healthy couples. Oxytocin or PAT alone did not reliably accelerate blister wound healing or reduce cortisol.
Instead, oxytocin’s benefits depended on the social context. When combined with structured partner appreciation and, more robustly, with everyday affectionate touch (and less robustly with sexual activity), oxytocin was associated with faster reductions in wound severity. However, these effects were small and sensitive to outliers.
Notably, daily sexual activity, not oxytocin, was associated with lower cortisol levels.
Taken together with wider psychoneuroimmunology evidence on social support, prosocial behaviour and immune function, this trial suggests that oxytocin acts as a “social amplifier”, enhancing the health benefits of warm, intimate relationships rather than functioning as a universal “love hormone” therapy.
Oxytocin seems to act as a “social amplifier”, enhancing the health benefits of warm, intimate relationships.
Strengths and limitations
Strengths
A major strength of this study is its multimodal, ecologically informed design. The authors combined a tightly controlled dermatological wound‑healing paradigm with high‑frequency assessment of real‑life intimacy behaviours and diurnal cortisol, all within a preregistered, double‑blind RCT. This aligns well with the “social psychoneuroimmunology” agenda, which calls for direct tests of how concrete social contexts shape immune‑related outcomes (Trachtenberg, 2024).
The factorial design (oxytocin/placebo × PAT/no‑PAT) allows for an explicit test of context‑dependent hormone effects, rather than focusing only on main effects. Moreover, the three‑level mixed‑model approach appropriately accounts for clustering within individuals and couples.
Limitations
- The critical three‑way interactions are modest and not fully robust. The oxytocin × PAT × time interaction on wound healing, as well as the oxytocin × sexual activity interaction, lost statistical significance when a small number of influential cases were excluded. This suggests that the trial is underpowered for the complexity of the models used.
- The temporal resolution and measurement of wound healing are limited. revPWAT ratings at only 24 hours and seven days may miss non‑linear healing patterns and increase vulnerability to measurement noise. In addition, the adapted revPWAT uses only four domains originally designed for chronic wounds, raising questions about sensitivity and construct coverage for small experimental blisters.
- Intimacy measures rely on self‑reported “affectionate touch” and “sexual activity” at EMA prompts without standardised definitions. These behaviours may range from fleeting contact to more prolonged, co‑regulatory touch or varied sexual behaviours and this heterogeneity and potential recall or social‑desirability bias could attenuate or distort associations.
- Selection bias is likely. Young, healthy, predominantly well‑educated heterosexual couples willing to be wounded and complete intensive EMA are not representative of older adults, clinical populations, same‑sex couples or distressed relationships, where oxytocin and intimacy may operate differently.
- Residual confounding remains a concern. Even within randomised treatment arms, individuals who are more affectionate or sexually active may differ systematically in attachment security, personality, baseline mental health or socio‑economic status, which could influence both intimacy patterns and biological outcomes (Trachtenberg, 2024). The study does adjust for some covariates (e.g. BMI, day, physical activity) in cortisol models, but cannot fully account for all relevant psychosocial factors.
- Although the trial is funded by a national science foundation and no conflicts are declared, several authors are established figures in oxytocin and couple‑based interventions, underlining the value of independent replication by other groups.
The study’s rigorous design combines lab-controlled wounds with real-life intimacy and hormone measures, but sample and measurement limits mean results need careful interpretation.
Implications for practice
For me, the contrast between the well‑supported patient and the isolated one on the cancer ward is no longer just a poignant clinical memory; it feels like a small, human illustration of the mechanisms we now see across psychoneuroimmunology. Schneider et al.’s study will not, on its own, change dermatological practice or lead us to prescribe intranasal oxytocin for wound healing. But it adds an important experimental piece to a larger puzzle:
Warm, affectionate relationships appear to support our immune systems and recovery, and oxytocin may amplify those relational benefits rather than replace them.
Clinical implications
Clinically, the most immediate implication is not “use oxytocin” but “take social connection seriously”. For patients with conditions where healing and inflammation are critical – chronic skin ulcers, postoperative wounds, cancer – it may be valuable to routinely ask about social support, loneliness and relationship quality, just as we ask about smoking or exercise. It is also important to signpost patients to sources of relational support where possible (Holt‑Lunstad et al, 2015; Trachtenberg, 2024). In couples facing illness, brief, structured exercises that foster gratitude and appreciation – similar to the Partner Appreciation Task – could be integrated into psychoeducation or rehabilitation programmes, not as a magic bullet but as a low‑risk way of nudging relationships towards more supportive patterns.
Policy Implications
At a policy level, the convergence of evidence that loneliness and social isolation drive chronic inflammation and mortality, while social support and prosocial behaviour protect against them, suggests that social connection should be viewed as a core public‑health target (Uchino et al, 2018; Trachtenberg, 2024). Investments in community‑building, structured volunteering schemes, and hospital-based volunteer or peer‑support programmes could have downstream benefits for immune-mediated diseases and recovery, much as exercise promotion does. My colleagues and I argue that helping behaviours and social integration deserve the same policy attention as diet and physical activity, and Schneider et al.’s very tangible outcome – faster skin repair under oxytocin in affectionate couples – adds a compelling story to share with clinicians and patients, as long as the modest, context-dependent nature of the effects is kept in view.
Research Implications
For research, combining the Schneider paradigm with detailed inflammatory biomarkers, immune challenges, and granular assessments of social behaviour could clarify the pathways through which intimacy and oxytocin affect health. Larger, more diverse samples are needed, including older adults, same‑sex couples and clinical populations, to assess who benefits and under what relational conditions. Moreover, oxytocin might amplify negative social contexts in hostile or abusive relationships, as some “social salience” models suggest (Mierop et al, 2020).
Personal Reflections
On a personal level, the lesson I take – both from the bedside and from this trial – is that while we may not yet have a prescription for “oxytocin plus cuddles” on the ward, we do have good reason to encourage patients and their loved ones to lean into everyday moments of affection and care. These small acts are unlikely to harm, may bring psychological comfort, and, if Schneider and the broader PNI literature are right, may also give our immune systems a quiet, cumulative nudge in the right direction.
Clinically, the most immediate implication is not “use oxytocin” but “take social connection seriously”.
Statement of interests
Estherina Trachtenberg has no involvement in the Schneider et al. trial and no personal, professional or financial relationships with its authors. She is the author of one of the papers cited in this blog (Trachtenberg, 2024), which is a short review on social support, prosocial behaviour and immunity. She has no financial conflicts of interest related to oxytocin, wound‑healing products, or couple‑based interventions. She used AI‑assisted tools to help with editing and clarifying the wording of this blog post, but all decisions about content, interpretation and emphasis are her own.
Editor
Edited by Éimear Foley. AI tools assisted with language refinement and formatting during the editorial phase.
Links
Primary paper
Ekaterina Schneider, Cristóbal Hernández, Robert Brock, Monika Eckstein, Guy Bodenmann, Markus Heinrichs, Ulrike Ehlert, Severin Läuchli, Beate Ditzen. (2026) Intranasal oxytocin and physical intimacy for dermatological wound healing and neuroendocrine stress: a randomised clinical trial. JAMA Psychiatry 83(2) 118‑127.
Other references
Carter CS, Kenkel WM, MacLean EL. et al (2020) Is oxytocin “nature’s medicine”. Pharmacological Reviews 72(4) 829‑861.
Hawkley LC, Cacioppo JT (2010) Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Annals of Behavioral Medicine 40(2) 218‑227.
Holt‑Lunstad J, Smith TB, Baker M. et al (2015) Loneliness and social isolation as risk factors for mortality: a meta‑analytic review. Perspectives on Psychological Science 10(2) 227‑237.
Mierop A, Mikolajczak M, Stahl C. et al (2020) How can intranasal oxytocin research be trusted? A systematic review of the interactive effects of intranasal oxytocin on psychosocial outcomes. Perspectives on Psychological Science 15(5) 1228‑1242.
Seeman T, Merkin SS, Goldwater D, Cole SW (2020) Intergenerational mentoring, eudaimonic well‑being and gene regulation in older adults: a pilot study. Psychoneuroendocrinology 111 104468.
Steele SR, Ratuski AS, Hui EI. Et al (2025) Oxytocin administration rescues the negative impacts of social isolation on wound healing in mice. Horm Behav. 171:105741.
Trachtenberg E (2024) The beneficial effects of social support and prosocial behaviour on immunity and health: a psychoneuroimmunology perspective. Brain, Behavior, and Immunity – Health 37 100758.
Uchino BN, Trettevik R, Kent de Grey RG. et al (2018) Social support, social integration, and inflammatory cytokines: a meta‑analysis. Health Psychology 37(5) 462‑471.
