[HN Gopher] Doctors in Brazil using tilapia fish skin to treat b...
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Doctors in Brazil using tilapia fish skin to treat burn victims
(2017)
Author : kaycebasques
Score : 258 points
Date : 2026-01-22 05:15 UTC (17 hours ago)
(HTM) web link (www.pbs.org)
(TXT) w3m dump (www.pbs.org)
| sMarsIntruder wrote:
| > In the US, animal-based skin substitutes require levels of
| scrutiny from the Food and Drug Administration and animal rights
| groups that can drive up costs, Lee said. Given the substantial
| supply of donated human skin, tilapia skin is unlikely to arrive
| at American hospitals anytime soon.
|
| This reminds me of Milton Friedman's arguments against the FDA.
| lukebitts wrote:
| I wonder what's the difference between countries that drives
| that. It's not like Brazil doesn't have its own FDA, which is
| much more strict than the US one, from what I know. Maybe some
| kind of lobbying? Or are animal rights group that much
| stronger?
| MattGaiser wrote:
| I imagine it is about this:
|
| > But Brazil lacks the human skin, pig skin, and artificial
| alternatives that are widely available in the US.
|
| This is not an improvement on existing methods (it may end up
| being, but that is not the motivation) but rather a case of
| it being all they have to work with.
|
| Tilapia skin is probably better than no skin at all.
| hu3 wrote:
| > This is not an improvement on existing methods... a case
| of it being all they have to work with.
|
| But the article says Tilapia skin is better in multiple
| aspects:
|
| > "We got a great surprise when we saw that the amount of
| collagen proteins, types 1 and 3, which are very important
| for scarring, exist in large quantities in tilapia skin,
| even more than in human skin and other skins," Maciel said.
| "Another factor we discovered is that the amount of
| tension, of resistance in tilapia skin is much greater than
| in human skin. Also the amount of moisture."
| dmurray wrote:
| It says it's _different_ to human skin in multiple
| aspects.
|
| Do I need more collagen or more moisture in my skin? I
| would expect evolution made some pretty good choices
| around default human skin for typical human activities,
| and if more moisture was obviously good, I would already
| have it.
|
| Maybe tilapia skin is better for people who spend 24
| hours a day swimming in lakes.
| hu3 wrote:
| > It says it's different to human skin in multiple
| aspects.
|
| No it says "even more than in human skin and other
| skins". Not different.
|
| > Do I need more collagen or more moisture in my skin?
|
| For this context? Yes? Clearly the article answers that
| already. I even included in my first reply but you'll
| have a third chance to read it:
|
| > ...which are very important for scarring...
|
| And your attempt to move the goal post fails miserably as
| well. Or do you think humans evolved to perfection by
| thinking this:
|
| > I would expect evolution made some pretty good choices
| around default human skin for typical human activities,
| and if more moisture was obviously good, I would already
| have it.
|
| I don't think you are debating in good faith. Good luck.
| skissane wrote:
| I was having a conversation about this with my father-a
| retired pharmaceutical industry executive-a few weeks back,
| about why certain generic prescription medication
| formulations were unavailable in Australia yet sold in New
| Zealand. He explained to me that the Australian
| pharmaceutical regulator (the TGA) and its New Zealand
| equivalent (Medsafe) had very different regulatory
| philosophies. Medsafe, if a major international regulator
| (such as the US FDA or the EU's EMA) had already approved
| something, they'll just approve it too ("if it is good enough
| for them it is good enough for us"); the TGA's attitude was
| very different, just because the FDA or EMA had approved it
| didn't mean they automatically would, they wanted to analyse
| the safety data for themselves and make up their own mind.
| For blockbuster patented drugs, the extra regulatory cost of
| Australia was worth it, but for the long tail of
| miscellaneous generic formulations, the extra cost of dealing
| with the TGA could make some of them financially nonviable.
| tehjoker wrote:
| Medsafe's strategy only works so long as there is at least
| one stringent regulator though.
| AuryGlenz wrote:
| I would think for a country like Australia a more
| moderate approach would be to approve things that were
| approved by other countries and have been in use for some
| amount of time - say, 5 years or so - apart from the
| things they directly approve.
| skissane wrote:
| The actual drug my father and I were discussing was
| clonidine.
|
| In the UK and New Zealand, they sell 25 microgram
| clonidine tablets; in Australia, the smallest dose on
| sale is 100 micrograms.
|
| Clonidine is a very old drug - it was released back in
| the 1960s. The risks involved are very well understood
| (arguably the biggest risk is fatal overdoses, but
| patient/parent education is the accepted mitigation
| strategy.)
|
| The issue is, in Australia, it is only approved for
| treating high blood pressure in adults. Paediatricians
| and child psychiatrists commonly prescribe it for ADHD,
| and for anxiety, aggression and insomnia (particularly
| but not exclusively in the context of ASD); in adults, it
| is prescribed to treat menopausal hot flushes and
| migraines - but all those indications are off-label.
|
| And this is the problem - given the doses involved, 25
| microgram tablets only really make sense for those off-
| label indications, there isn't much demand for them for
| treating adult hypertension. So to get the TGA to approve
| 25 microgram clonidine tablets, you need to prove to them
| that clonidine is safe and effective for one of those
| currently off-label indications. And that will cost a lot
| of money, and given it is a generic medication long out
| of patent protection, it isn't worthwhile. Whereas
| Medsafe quite possibly just decided "the UK approved it
| for X so we will too".
|
| As a parent, both of whose children are prescribed
| clonidine, this annoys me - cutting tablets in half is no
| fun, and cutting them into quarters is even worse. Or I
| can get them compounded into liquid by a compounding
| pharmacist, which makes it easier to measure out smaller
| doses (I always get 25 microgram/ml), but that adds
| expense and time (the nearest compounding pharmacy is 15
| minutes drive one way). I just wish I could get 25
| microgram tablets, but they can't legally be sold in
| Australia-possibly I could ask our child psychiatrist to
| apply for special permission to import them from New
| Zealand, but the amount of bureaucracy involved probably
| isn't worth it, there's no guarantee the request would be
| approved, and it would be expensive (it wouldn't be
| covered by our national prescription drug insurance).
| Qem wrote:
| > It's not like Brazil doesn't have its own FDA, which is
| much more strict than the US one, from what I know.
|
| Unless we are talking about pesticides, where Brazil is
| effectively dumping grounds for substances banned in EU.
| Every time some pesticide is forbidden in Europe, brazilian
| regulators are happy allowing local agribusiness import it by
| the ton in fire sales:
| https://www.brasildefato.com.br/2025/10/14/export-grade-
| pois...
| sammy_rulez wrote:
| It's old news. There is even "And Dream of Sheep" -- Grey's
| Anatomy, Season 15 Episode 17. That's the episode where they
| mention using tilapia fish skin to treat burns. Original U.S. air
| date: March 14, 2019.
| petesergeant wrote:
| And a 2017 Good Doctor episode
| elemdos wrote:
| Old news comes off dismissive. Doesn't have to be a brand new
| discovery to be noteworthy.
| elric wrote:
| Doesn't make it any less interesting. And in spite of it not
| being new, it doesn't look like it's out of the experimental
| stage: the article mentions it's difficult to get the tilapia
| skin processed and sterilized.
| chipgap98 wrote:
| The article is 9 years old so that may no longer be the case
| sublinear wrote:
| 2019? I'm surprised they kept it running for that long.
| ZeWaka wrote:
| It's still running - season 22 right now.
| primaprashant wrote:
| They used this exact treatment in an episode of The Good Doctor,
| S01E06. Original air date: October 30, 2017
|
| https://the-good-doctor.fandom.com/wiki/Not_Fake
| theblackknight_ wrote:
| I was thinking same, Jared saving that girls skin after burn.
| zekrioca wrote:
| Yes, but the treatment has been devised way prior to 2017.
| ZeWaka wrote:
| They also used it in Grey's Anatomy S15E17 (2019).
| kiernanmcgowan wrote:
| I've read Dune - I know exactly where this is going. Please do
| not apply sand trout directly to you skin unless you are ready to
| control the spice.
| DHRicoF wrote:
| The power to destroy a thing is the absolute control over it.
| jyounker wrote:
| The God Emperor of Brazil would be a brilliant satire. I look
| forward to the new fish speakers.
| 01100011 wrote:
| I'm pretty sure they've done this for decades. I seem to remember
| someone using potato skins like 30 years ago.
| guessmyname wrote:
| > _I 'm pretty sure they've done this for decades [...]_
|
| Yes, the article you read is from 2017.
| 01100011 wrote:
| No, I'm saying I think it's even farther back than that. I
| think the article from 2017 is like the article from today.
| It's presenting something old as something novel.
| vasco wrote:
| This has been going for long enough that there's been several
| metastudies debunking it. Was hyped in the news around 2017.
|
| Fish skin or silver sulfadiazine had similar effects and to me
| are both approximating placebo from the studies I read. The fish
| does nothing for pain and no difference in the scarring time vs
| the silver ointments.
| trhway wrote:
| fish skin (rich in collagen) sounds like a version of collagen
| patch. And for collagen patch for example
| https://pmc.ncbi.nlm.nih.gov/articles/PMC3081477/ where despite
| the "Conclusion" the "Results" show that it helps (and one can
| also expect that collagen patching is starting point to
| engineering artificial skin) :
|
| Results:
|
| With two weeks of treatment, 60% of the 'collagen group' wounds
| and only 42% of the 'conventional group' wounds were sterile
| (P=0.03). Healthy granulation tissue appeared earlier over
| collagen-dressed wounds than over conventionally treated wounds
| (P=0.03). After eight weeks, 52 (87%) of 'collagen group'
| wounds and 48 (80%) of 'conventional group' wounds were >75%
| healed (P=0.21). Eight patients in the 'collagen group' and 12
| in the 'conventional group' needed partial split-skin grafting
| (P=0.04). Collagen-treated patients enjoyed early and more
| subjective mobility.
|
| Conclusion:
|
| No significant better results in terms of completeness of
| healing of burn and chronic wounds between collagen dressing
| and conventional dressing were found. Collagen dressing,
| however, may avoid the need of skin grafting, and provides
| additional advantage of patients' compliance and comfort.
| vasco wrote:
| You made me go re-search for those meta studies and I can
| only find a brazilian one which disputes the claims but I do
| find a few showing benefits. I'm back to not knowing what to
| believe in isolation, but with results also for plasters that
| you shared I'm more leaning towards you being right. Thanks
| for sharing.
| tossaway0 wrote:
| Totally anecdotal but I had a bad burn on my foot and I thought
| I could manage it with otc stuff. It kept getting worse so I
| went to have it checked out and was prescribed the silver
| cream.
|
| From one day to the next it started showing positive effects
| and a week and a half later I was fine. I was kicking myself
| for waiting so long.
| fhe wrote:
| I thought this a pretty mature technique? I have seen more than
| once our local vet using this technique to treat cats with large
| wounds -- with great results by the way. Interestingly, they too
| used tilapia fish skin, and not any of the more common local fish
| species. I wonder if there is something special about tilapia
| fish skin, or it was simply the species on which the technique
| was developed, and nobody bothered to try using other fish
| species.
| sublinear wrote:
| What's special is that tilapia is probably cheaper than even
| the local fish since it's farmed in massive quantities and
| shipped all over the world as food.
|
| If other fish skins were tried it must have been similar
| results.
| worthless-trash wrote:
| Tilapia imports are heavily restricted to Australia, The live
| fish will not be allowed, they are considered "restricted
| noxious fish".
|
| The rules are:
|
| Illegal to Keep: You cannot keep tilapia (dead or alive),
| sell them, give them away, or use them as bait.
|
| Immediate Euthanasia: Humanely kill the fish as soon as you
| catch it.
|
| Disposal:
|
| Bury: Bury them deep and well away from the water's edge to
| prevent scavengers from dragging them back in or floodwaters
| from releasing eggs.
|
| Bin: Place them in a rubbish bin.
|
| No Filleting: You cannot take fillets and dispose of the
| rest; the entire fish must be destroyed.
|
| Various state departments have hotlines for reporting
| tilapia.
|
| There are different hotlines per state:
|
| Queensland Department of Agriculture and Fisheries (DAF) (13
| 25 23)
|
| New South Wales Department of Primary Industries (DPI) (1800
| 675 888)
|
| Victoria (VFA) Reporting hotline (13FISH or 13 34 74)
|
| Western Australia Dept. of Primary Industries & Regional
| Development (1800 815 507)
|
| I've had rewards for reporting them (fishing reel, free bait,
| etc).
| pwagland wrote:
| For those that don't know why, and I didn't, the reason for
| this is that Tilapia are "mouth brooders", that is they
| keep the fertilised eggs in their mouth. So throwing away a
| dead female can cause these eggs to hatch, and reinfect the
| waters with new Tilapia.
| som wrote:
| Where I grew up (in northern Australia) a lot of people
| targeted and ate tilapia out of local estuaries .. there
| were a lot of them and they were big.
| worthless-trash wrote:
| Hello cousin (Daintree adjacent here).
| MisterTea wrote:
| I also hear you can dispose of them by placing them in a
| pan with fresh pulverized tomato, garlic, olive oil, basil,
| then a little lemon juice, oregano then finally, salt and
| pepper to taste. Highly effective, efficient and delicious.
| MeteorMarc wrote:
| No need for antibiotics because the fish got ample amounts
| while growing up in the farm.
| guessmyname wrote:
| > _I thought this a pretty mature technique? [...]_
|
| Yes, it is very mature. The article was written in 2017.
| interludead wrote:
| It's probably a mix of "this species happens to be unusually
| well-suited" and "this is the species people bothered to study
| rigorously first."
| jyounker wrote:
| Tilapia are cheap and abundant, and the skin is an industrial-
| scale waste product.
|
| They're incredibly hardy, and unlike most other food fish you
| can easily grow them in simple container setups.
| deadbabe wrote:
| Horrible to talk about a living creature this way.
| mixmastamyk wrote:
| "Fish are friends, not food"--Finding Nemo. ;-)
| csours wrote:
| "It's okay to eat fish
|
| 'cause they don't have any feelings" - Something in the
| way
|
| https://www.youtube.com/watch?v=hg5behq8PlM
| fsckboy wrote:
| (i pick mackerel at random)
|
| A female Atlantic mackerel typically lays between 200,000
| and 450,000 eggs during a spawning season. However, larger,
| healthier individuals can sometimes produce up to a million
| eggs, often in multiple batches over several weeks.
|
| it is the mackerel themselves who consider baby mackerel
| lives to be industrial in scale. they produce that many in
| anticipation of consumption. Each foodfish humans consume
| has already slaughtered untold thousands of other fish to
| grow themselves to size.
| deadbabe wrote:
| The thrive because all the fish who laid less eggs got
| eaten out of extinction. They don't anticipate anything.
| max_ wrote:
| TLDR;
|
| Its a fantastic substitute for bandages in the sense that you
| don't need to take off the fish skin everyday.
|
| Its also better are retaining moisture in the burn wounds than
| cotton badages.
|
| No need for antibiotics, painkillers etc
|
| Its also really cheap. Fish farms regard them as waste.
| account42 wrote:
| > Fish farms regard them as waste.
|
| I have only seen tilapia sold whole - the skin is one of the
| best parts when you fry them.
| subscribed wrote:
| Same here. Not with just tilapia, but pretty much every fish.
| conductr wrote:
| I think any farmed animal is or should have no waste. Even if
| it's turned into cat food the skin is most definitely not just
| waste, there's uses out there. However, if it is as cheap and
| readily available as cat food then that's great for burn
| victims too.
| AdmiralAsshat wrote:
| How expensive is the sterilization process, though? That would
| be my primary concern if tilapia-skin bandages started to get
| widely available/mass-produced: that unscrupulous vendors would
| cut corners during sterilization, and then the burn victims
| would get nasty infections from remnant bacteria on the tilapia
| skin.
| Scoundreller wrote:
| Dunno what method they use, but gamma irradiation is pretty
| cheap at scale
| throwaway290 wrote:
| (2017)
| poopster wrote:
| i saw that episode of one-piece
| sva_ wrote:
| previously:
|
| https://news.ycombinator.com/item?id=14385336
| RobotToaster wrote:
| Will never be approved by the US FDA since it can't be patented.
| ZeWaka wrote:
| Kerecis got FDA clearance in _2013_ , and then approval in
| _2016_.
| RobotToaster wrote:
| That's made from cod, and it appears they chemically modified
| it so that it can be patented
| https://www.kerecis.com/kerecis-receives-u-s-patent-for-
| fish...
| groundzeros2015 wrote:
| You mean because nobody will pay the cost to go through FDA
| process without profit incentive?
| MrDresden wrote:
| There is an Icelandic company called Kerecis that produces these
| kinds of fish skin based grafts. There are some videos of some of
| their patient's before and after over at their webpage[0] but be
| warned, they might be a bit graphic for some.
|
| [0]: https://kerecis.com
| ljf wrote:
| Wow, those before and after videos really are amazing - while
| my own scars are tiny, they aremore noticeable than some of
| these fairly major wounds.
| dgoldstein0 wrote:
| This article is from 2017 - maybe should say so in the submission
| title?
|
| Still, an interesting read
| dang wrote:
| Added above. Thanks!
| ycombinatrix wrote:
| They did this in the Netflix One Piece series (with a yellowtail
| though)
| binsquare wrote:
| In Chinese villages, I've seen them use fish skin, potato skin,
| various leaves, cooked birds nest, fish fin oil, and etc to treat
| open wounds instead of pure bandaging.
|
| While it's not a new technique, it's fascinating for this area to
| be further explored.
| interludead wrote:
| In a way this feels less like inventing something new and more
| like rediscovering and formalizing old techniques with modern
| safety constraints
| screye wrote:
| It's important in these cases to preserve the lineage of
| where they came from.
|
| There's a tendency to start calling them 'western medicine'
| and crediting it to the person who formalized it in the west
| rather than the source culture where it has existed for
| centuries.
|
| The conversation is bit 2010, but the point still stands.
| interludead wrote:
| The fact that tilapia skin was basically waste, yet turns out to
| have higher collagen content, better tensile strength, and better
| moisture retention than human skin is kind of remarkable
| jenders wrote:
| They do this in Iceland too
| motbus3 wrote:
| This is quite old news. I've heard about this more than 10 years
| ago at least. It has been fairly successful since the beginning
| and I've heard it improved quite a lot
| gaptoothclan wrote:
| great news for humans, bad news for fish
| osmano807 wrote:
| In my hospital we have ample experience with another technique
| using polypropylene sheets for defect coverage, popularized in
| Brazil orthopedics as "Figueiredo's technique", which is in
| practice an extension of common techinques for temporary closure
| of abdominal wall ("Bogota's bag").
|
| We put a transparent polypropylene sheet as skin replacement,
| suture it directly to the skin. We can monitor the wound and its
| secretions, can cover exposed tendons and bones without immediate
| doing microsurgical flaps. For example, we can monitor the second
| intention skin closure with reduced infection and analgesics use,
| sometimes without needing a graft at all.
| DerArzt wrote:
| Modern medicine is pretty metal.
| yndoendo wrote:
| I was informed by a pediatric doctor they also use honey
| bandages for burns since it is a naturally antimicrobial and
| assists with cooling the body.
| dillydogg wrote:
| I think one of the most interesting techniques for burn victims
| is using placentas. I haven't seen it too much in my current
| hospital system, but have seen it talked about at medical
| association conferences and think it's pretty exciting.
|
| Here is a gift link for an article about them in the New York
| Times from about a year ago.
|
| https://www.nytimes.com/2024/10/08/well/placenta-donations-b...
| highhedgehog wrote:
| My nephew had multiple heart surgery, and after the last one, he
| kept having the wound release liquids. For months, they just
| medicated the wound regularly hoping it would solve by itself. At
| last, they decided for a cleaning surgery, and a pediatric
| specialist came from Rome and apparently brought something like
| "fish sheets" to "cover the wound while it heals.
| kylehotchkiss wrote:
| Is this a stem cell thing or a growth factor/morphogens thing?
| modeless wrote:
| I hope they verify that the recipients are not allergic to fish
| first. Would be nice to get a synthetic version for that reason.
| culi wrote:
| tangentially related: before penicillin was formally discovered,
| soldiers in WW1 would use moldy slices of bread to treat their
| wounds (Penicillium being the most common bread mold). This or
| similar practices of using mold on wounds seems to date back
| thousands of years
| nextaccountic wrote:
| > Mar 3, 2017
|
| Title needs (2017)
| SilentM68 wrote:
| Hmm, I remember seeing something like this mentioned in the show
| The Good Doctor. I forget the episode, but it deals with a
| patient who suffers severe burns in a bus crash and receives an
| experimental treatment using fish skin to aid in healing and
| minimize scarring. I never really felt comfortable with animal
| tissue being grafted to human skin. I don't believe animal tissue
| can be totally cleansed of contaminants. I'd rather feel more
| confortable with synthetic skin grafting. The movie, Darkman
| (1990) comes to mind.
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