Over the Counter Scar Treatments
Just walk down the aisle of your local pharmacy or grocery store and you will see no shortage of scar creams and treatments. Usually when there are multiple ways to treat something, it’s because there’s no one good treatment. But, there are some treatments that are better than others. So I am going to talk about some of the most common ones that patients bring up during consultations:
Vitamin E: Vitamin E is a fat-soluble vitamin that exists in eight different forms. It is also an antioxidant. Antioxidants such as vitamin E act to protect cells against the effects of free radicals, which are potentially damaging by-products of energy metabolism. Free radicals can damage cells and may contribute to the development of cardiovascular disease and cancer. Studies are underway to determine whether vitamin E, through its ability to limit production of free radicals, might help prevent or delay the development of those chronic diseases.
There have been many studies looking at Vitamin E as a scar treatment. One of these studies looked at the benefits of using Vitamin E in burn patients. Scientists studied a group of 159 people who had suffered burns over the course of a year. They randomly selected some to use vitamin E on their scars and others to use a different topical cream. Those in the vitamin E group showed no improvement in the size, thickness or appearance of their scars by the end of the study.
In a 1999 study conducted at the University of Miami, researchers studied a group of patients who recently had minor surgery. Each patient was given two ointments labeled A and B — one with vitamin E, the other without — and told to apply each to a separate half of their scars twice a day for four weeks. After that, the scars were examined by the patients, the researchers and an outside observer. Not only did the vitamin E not have a beneficial effect on the appearance of the scars, it made some of them worse. Almost a third of the patients had an allergic reaction known as contact dermatitis.
Verdict: Vitamin E has no proven benefit in scar treatment.
Mederma: Mederma is a product that contains Allium cepa, or onion extract. Studies using rabbit ears as the model have shown that onion extract has anti-inflammatory effects and can improve collagen organization. However, these same studies that showed improved collagen organization did not show any improvement in the scar appearance. There have been three clinical studies looking at the effects of onion extract on human scars. The studies compared scars that were treated with onion extract with those using petroleum jelly. In all three studies, the scars treated with onion extract did not have a better appearance than those treated with petroleum jelly. In fact, the scars treated with petroleum jelly looked better.
Verdict: Mederma has no proven benefit in scar treatment.
Silicone: Silicone based scar treatments are very popular. Most come as sheets or creams. The mechanism of action is not fully understood but is believed to be a combination of compression, or pressure therapy, and a change in the electro-negativity of the wound. This combination leads to the flattening of raised scars and an overall improved appearance. Multiple studies have been performed looking at the benefit of silicon sheets in scar treatments. Most required patients to keep the sheets on for at least 12 hours a day. Silicone scar treatments come in various forms, either sheets or creams. The overall effect is the same and there is no true advantage of one form versus the other.
Verdict: Silicone products do have a benefit in improving the appearances of scars.