The Internet of Things (IoT) has transformed the healthcare industry by enabling new services and capabilities through connected devices and sensors. These devices, such as smartwatches and fitness tracker bands, can monitor various health metrics such as heart rate, blood pressure, and sleep quality. However, the security of these systems is a critical concern, as the unauthorized disclosure or access of healthcare information could have serious consequences for patients. This information can include personal and medical data, diagnostic and treatment information, as well as private locations. Lightweight encryption schemes are commonly used in IoT systems to protect this sensitive data. These schemes are designed to be fast and efficient, allowing them to encrypt and decrypt data in real-time, which is important for systems with limited computing power or storage capacity. In the last decade, there has been a significant increase in research and development in chaos cryptography. Due to chaotic systems’ unpredictable and sensitive nature, they can provide robust cryptographic schemes for data transmission between embedded devices. This makes it difficult for attackers to intercept and manipulate the data. Therefore, this work proposes a chaos-based lightweight encryption scheme for IoT healthcare systems with a primary application in the encryption of wearable devices. The proposed encryption scheme is based on a 2D 4-scroll chaotic attractor system, uniquely characterized for this work. The scheme is tested on an ARM-based microcontroller for encrypting PPG (Photoplethysmogram) biosignal data. The obtained results show that the chaos-based lightweight encryption scheme effectively improves the security of healthcare IoT systems while maintaining the real-time flow of data.