[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Conditions](https://durgical.com/en/conditions/) › Scurvy (vitamin C deficiency)

[Conditions](https://durgical.com/en/conditions/) · [Vitamins and minerals](https://durgical.com/en/conditions/)

# Scurvy (vitamin C deficiency)

Scurvy is severe lack of vitamin C: bleeding gums, bruising, wounds that will not close and leg pain.

Updated 2026-11-01

## Structures involved

Tap one to see what it is and open it in 3D.

- [Gums (gingiva)](https://durgical.com/en/anatomy/gums/)
- [Skin](https://durgical.com/en/anatomy/skin/)
- [Femur](https://durgical.com/en/anatomy/femur/)
- [Tibia](https://durgical.com/en/anatomy/tibia/)

## In biochemistry

- [Uronic acid pathway](https://durgical.com/en/biochemistry/topics/uronic-acid-pathway/)
- [Collagen synthesis](https://durgical.com/en/biochemistry/topics/collagen-synthesis/)
- [Collagen](https://durgical.com/en/biochemistry/enzymes/collagen/)
- [Hydroxyproline](https://durgical.com/en/biochemistry/molecules/hydroxyproline/)
- [Vitamin C (ascorbic acid)](https://durgical.com/en/biochemistry/molecules/vitamin-c/)

## In histology

- [Connective tissue proper: cells and fibres](https://durgical.com/en/histology/connective-tissue-proper-cells-and-fibres/)
- [Extracellular matrix: collagen types, elastin, ground substance](https://durgical.com/en/histology/extracellular-matrix-collagen-types-elastin-ground-substance/)

## In physiology

- [Vitamins and minerals: a physiological overview](https://durgical.com/en/physiology/vitamins-and-minerals-a-physiological-overview/)

## Why it happens

- [What delays healing: infection, diabetes, nutrition, glucocorticoids, poor blood flow](https://durgical.com/en/general-pathology/what-delays-healing-infection-diabetes-nutrition-glucocorticoids-poor-blood-flow/)
- [Vitamin deficiencies: what each one does to tissue](https://durgical.com/en/general-pathology/vitamin-deficiencies-what-each-one-does-to-tissue/)
- [Granulation tissue and scar formation](https://durgical.com/en/general-pathology/granulation-tissue-and-scar-formation/)

## What it is

A disease of ascorbic acid deficiency in which collagen is made defective, leaving vessels, skin, gums and bone fragile. It appears after one to three months without vitamin C.

## Who gets it

Rare but not gone: older adults living alone, alcoholism, eating disorders, children with autism or very selective diets, homeless people and patients on dialysis.

## Causes

- Diet without fresh fruit or vegetables
- Alcoholism and smoking
- Malabsorption or dialysis
- Very selective diets (autism spectrum disorder, anorexia)

## Risk factors

- Poverty and social isolation
- Older age
- Psychiatric illness
- Boiled cow's milk as the only food in infants

## Pathophysiology

Prolyl and lysyl hydroxylases need ascorbate to keep their iron reduced. Without hydroxyproline, procollagen cannot form a triple helix stable at body temperature and is degraded; without hydroxylysine, cross-links are missing. Capillaries break (perifollicular petechiae, bleeding gums, subperiosteal haemorrhage), wounds do not heal and bone cannot form normal matrix. Carnitine (fatigue) and noradrenaline synthesis also fail.

## Symptoms and signs

- Tiredness, irritability, leg pain
- Swollen, purple, bleeding gums; loose teeth
- Petechiae around hair follicles and corkscrew hairs
- Easy bruising, especially on the legs
- Wounds that do not heal or reopen
- Infants: pain on moving the legs (pseudoparalysis), irritability

## Red flags

- Major bleeding (joint, subperiosteal, cerebral)
- Marked anaemia
- A child who stops walking because of pain

## Diagnosis

**Clinical**
A clinical diagnosis based on the [skin](https://durgical.com/en/anatomy/skin/) and gum signs with a history of poor diet; a quick response to vitamin C confirms it.

**Tests**
Low plasma or leucocyte ascorbic acid; blood count (anaemia is common from bleeding and iron or folate deficit).

**Imaging**
Long-bone X-ray in children: white line of Frankel, Wimberger ring at the epiphyses, calcified subperiosteal haemorrhages.

## Treatment

**Medical**
Replace vitamin C orally (or intravenously if there is malabsorption)

**Lifestyle**
Diet with fresh fruit and vegetables; nutritional support and treatment of the cause (alcoholism, restrictive diet)

**Follow-up**
Look for other associated deficiencies (iron, folate, vitamin D)

## Complications

- Internal bleeding
- Tooth loss
- Anaemia
- Sudden death from bleeding or arrhythmia if untreated

## Prognosis

Excellent with treatment: bleeding and fatigue improve within days and skin and gum lesions within weeks.

## Prevention

- Daily fresh fruit and vegetables
- Spotting restrictive diets in children and older adults

## Test yourself

Think of the answer, then tap the question to see it.

## Which step of collagen synthesis fails in scurvy?

Hydroxylation of proline and lysine by vitamin C-dependent enzymes; without it the triple helix is unstable.

## Which skin sign is typical of scurvy?

Perifollicular petechiae with corkscrew hairs, especially on the legs.

## Why do children with scurvy stop walking?

Subperiosteal haemorrhages and metaphyseal damage cause severe leg pain.

## Who is most at risk of scurvy today?

Older adults living alone, people with alcoholism, children with very selective diets and people with eating disorders.

[Add to my cards (4)](https://durgical.app/estudiar/?add=/en/conditions/scurvy/)

Educational information, not medical advice. For any symptom, see a health professional.

Sources: [Scurvy: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/000355.htm) (MedlinePlus, US National Library of Medicine, 2026); [Vitamin C: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/002404.htm) (MedlinePlus, US National Library of Medicine, 2026); [Vitamin C: MedlinePlus](https://medlineplus.gov/vitaminc.html) (MedlinePlus, US National Library of Medicine, 2026); Textbook of Biochemistry for Medical Students, 6th ed. (Jaypee Brothers Medical Publishers (Vasudevan DM, Sreekumari S, Vaidyanathan K), 2011).

[← All conditions](https://durgical.com/en/conditions/)

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

---
Source: https://durgical.com/en/conditions/scurvy/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/conditions/scurvy/