No, vitamin E does NOT improve scars. There is no scientific evidence confirming this claim. In fact, some studies do demonstrate vitamin E may cause skin irritation which actually worsen scarring. Anecdotal reports also mention widened scars after using vitamin e topically.

In this study (The Effects of Topical Vitamin E on the Cosmetic Appearance of Scars) the researchers concluded:

This study shows that there is no benefit to the cosmetic outcome of scars by applying vitamin E after skin surgery and that the application of topical vitamin E may actually be detrimental to the cosmetic appearance of a scar.

In 90% of the cases in this study, topical vitamin E either had no effect on, or actually worsened, the cosmetic appearance of scars.

So if vitamin E doesn’t work, what should we use?

The only proven effective scar treatment product you can use at home are Silicone Scar Treatment Sheets . (links to Amazon, read the reviews to learn how they can help you improve your scar tissue)

There are various studies demonstrating the benefits of silicone gel scar sheets. Here’s one published by Archives of Surgery.

Important to remark is that this modality does not work on all types of scars. Burn scars, discolored, and raised scars are known to improve. In some cases keloid scars may also be repulsed by silicones. Such scar tissue will become flat, softer, more pliable, and discolorations will tone down. Also itch and pain will be reduced.

Silicones have been used since the 1960′s in burn centers and hospitals. Only the last decades they have become available on the consumer market. Many people are still not aware of the existence (let alone effectiveness) of silicone sheeting for scars. Among those who are unaware of the benefits of silicones are not only consumers but also medical personnel. It’s a sad fact that many doctors, but even dermatologists, and plastic and cosmetic surgeons are not aware of the clinical proof that backs the use of silicones for scars.

For depressed scars silicones will not be the most appropriate treatment. These types of scar tissue will most likely be treated with fillers, dermarolling (needling), and collagen injections.

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Neaclear Scar Advantage is a product I hadn’t heard of before (although it has been around for a while). Just yesterday I stumbled upon it when reading articles written by cosmetic and plastic surgeons. One of these health care practitioners recommended this cream for facial scars.

To me this doesn’t necessarily mean it is a good product because even among medical experts such as plastic surgeons and dermatologists ignorance occurs. I always like to dig for scientific reports and other indications products may actually work. Let’s have a closer look at Neaclear. Is it really as innovative and revolutionary as they say?

It is said to promote optimal scar healing with ingredients such as;

• cortisone,
• vitamin E,
• silicones,
• vitamins A & D,
• liquid oxygen,
• and vitamin C.

Let’s take a look at the respective actions of these components:

• topical cortisones reduce irritation (used in anti-itch creams) This study concludes there’s no benefit to the scar’s appearance. As there is none for vitamin E
• silicones are proven effective to decrease collagen formation and increase the scar’s maturation process.
• vitamins A (retinoids) has shown to have both benefits as side effects. No sufficient research data available for firm conclusions
• vitamin C seems to have scar healing benefits but stability is needed. It’s difficult to control whether or not Scar Advantage contains such a stable form of vitamin C.
• liquid oxygen



About the addition of liquid oxygen (whatever that may be) has been some rumor. New Scientist notes that “We have certainly never heard of a skin cream that contains liquid oxygen, the temperature of which is normally somewhere below -183 °C.” There has been a discussion on museumofhoaxes.com. Neaclear’s reaction:

the oxygenation is a special 4 step process that enables us to place oxygen into a stable liquid form. liquid oxygen normally exists only at the extremely low temperature of -183 degrees Celsius under normal atmospheric pressure. liquid oxygen in it’s purest form is highly combustible and basically “rocket fuel”.

NO, we do not have rocket fuel (pure liquid oxygen) in our products. please realize the oxygen concentration in our skin care products is not a large amount, definitely less than 5%. again, we always recommend not placing these products close to any sources of fire or anything flammable (a good piece of advice with any skin care products).



One more thing. I know this sounds rather cocky but I’m not convinced the action behind the product is pressure like stated on the Neaclear website. Yes, indeed, pressure (compression) has a beneficial effect on scar healing. Therefore it has been used since the 1960 in the treatment of burn and other scars. But how much pressure does a thin film apply? I have read lots of clinical reports and study abstracts and I am convinced to belief it is occlusion what makes that such products work.



Occlusion by silicone gels and sheets is thought to restore the water balance in the scar tissue thus preventing dehydration and excessive scar tissue. More on this in my post titled; how do silicones for scars work.



Neaclear Scar Advantage can be used on scars of all types – new or existing, traumatic or surgical. Whether or not it really works remains unclear. To me it seems comparable with other scar creams with roughly the same ingredients. The only difference is the addition of the mysterious liquid oxygen.



Have you used Neaclear Liquid Oxygen Scar Advantage? I would love to hear about your experiences. You can drop a comment below or contact me via the contact page.

Note: in order to avoid confusion, there are two Neaclear scar products on Amazon. Both with the same name but with other ingredients. The other product has chamomile and some other components in it.














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There’s a plethora of commercially available home remedies for scars. Think about scar creams based on vitamin E or onion extract like Mederma, Bio Oil, cocoa butter, Aloe Vera, cucumber butter, lime juice, skin remodeling copper peptides and so on.


The superabundance of positive online reviews and upbeat testimonials would indicate these remedies to be helpful in the struggle to reduce scars.


However, considered from a scientific perspective, there’s only one type of home remedy that is proven effective. With proven effective I mean backed by science.



Silicone Gel Sheeting
This is the type of home remedy I am talking about: silicones for scars. Several clinical trials and other studies [1],[2] have demonstrated that silicone gel sheeting prevents the development of problematic scars. It has also shown to be an effective home remedy for keloid and hypertrophic scars.




Silicone gel sheets significantly and clinically improved the appearance of scars. More specific; this remedy makes red, raised, stiff scars more skin colored, softer, pliable, and flat. Also the anti-itch and pain reducing abilities have been proven by studies. It will not surprise that silicone sheets, recommended by many plastic surgeons, burn centers and dermatologists, are called ‘the golden standard in scar treatment’. However early treatment is ideal, silicone gel sheets may also be beneficial for older scars



Medical grade honey for wound care
Wound healing, which can be a of major influence on scarring, can get a real boost when wound care products based on medical-grade honey are used.

A review in which 22 clinical trials were evaluated concluded that honey minimizes scarring, removes infected and dead tissue and speeds healing by stimulating new tissue growth. Some researchers even suspect this type of honey to have beneficial effects when applied directly on scars but at present there’s no research done.

A 1996 preliminary study from India showed that burns treated with honey healed sooner than those treated with conventional methods (petrolatum and gauze) and that scarring was reduced. (6.2% of the 450 patients treated ended up with scars compared to 19.7% of the same number of patients who received conventional treatment)



Conclusion
When we rely on medical science we can conclude that the best home remedies for scars are silicone gel sheets (or gels) and, in case of wound care, medical grade honey dressings. Recently, FDA approved medical grade honey dressings have become available on the consumer market.

More on how silicone gel sheeting works. The best brands to buy, and Medihoney wound care products.

[1] Topical treatments for hypertrophic scars Journal of the American Academy of Dermatology – Volume 55, Issue 6 (December 2006)
[2] Evolution of Silicone Therapy and Mechanism of Action in Scar Management by Dr. Thomas A. Mustoe Aesth Plast Surg (2008) 32:82–92 link (.pdf)

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The use of topical vitamin E for scars is probably the most popular home treatment. There’s an overwhelming amount of anecdotal proof. Take a look at any forum, website, or other source where scar treatment questions are answered and there’s a big chance someone states vitamin E to be the best option to treat a scar. However, there’s no scientific proof confirming this statement.

A few studies on this matter have been conducted the past years. This particular study among 159 test persons, of which the report was published in The Journal of Burn Care and Rehabilitation in 1986 demonstrated that;

“Those in the vitamin E group showed no noticeable improvement in the size, thickness or appearance of their scars by the end of the study.

The conclusion of a more recent study (1999) conducted by the University of Miami stated that:

“This study shows that there is no benefit to the cosmetic outcome of scars by applying vitamin E after skin surgery and that the application of topical vitamin E may actually be detrimental to the cosmetic appearance of a scar.

In 90% of the cases in this study, topical vitamin E either had no effect on, or actually worsened, the cosmetic appearance of scars. Of the patients studied, 33% developed a contact dermatitis to the vitamin E. Therefore we conclude that use of topical vitamin E on surgical wounds should be discouraged.”

That’s why, despite the many positive reviews, the topical use of vitamin E on scars is discouraged. Alternatives are moisturizing agents (such as Vaseline) and silicone gel. More on silicone scar treatment.

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ScarGuard MD ScarCare is a silicone* based cream that dries to a thin film after application. Scarguard Labs (the manufacturer) states that:

“many doctors use ScarGuard MD for old, raised scars, keloids, and to help prevent scar tissue from forming after surgery or injury.”

* (Silicone scar creams are used to flatten, soften, tone down the color, and smoothen thick scars. They are also known to reduce scar pain and itch. )

So does ScarGuard really work? Here’s a short review with the pros and cons of ScarGuard MD.

Scarguard MD differs from other silicone scar creams in that it combines several ingredients. Or, as the manufacturer advertises: “a patented formulation that combines multiple technologies.” Also referred to as “SG5 technology which combines five medically-proven treatments into one easy-to-use solution”. These treatments are:

1)Silicone. Topical silicone is clinically proven to help shrink scar tissue and help prevent new scar formation after surgery.
2)Cortisone. A low dose of hydrocortisone helps reduce irritation.
3)Vitamin E. Helps the healing process by softening and moisturizing the scar and surrounding tissue.
4)Pressure. Slight increase in surface tension is provided.
5)Occlusion. The medical term for adhering to, and protecting, the scar.

A critical note on these five proclaimed medically proven treatments:

Occlusion, especially by silicones, does seem to be effective in scar treatment. However the amount of pressure a silicone sheet, let alone a silicone cream administers is negligible. Vitamin E used as a standalone topical treatment is discouraged by dermatologists because it may cause skin irritation and worsen scar appearance. The benefits of vitamin E as a scar cream component are disputed.

Let’s take a look at the other Scarguard Scar Care ingredients.

Active ingredients: Silicone 12.75%, Hydrocortisone 0.55%, Inactive ingredients: Vitamin E, Specially-formulated flexible collodion.

Collodion is a flexible substance which dries to form a flexible cellulose film when applied on the skin.

Hydrocortisone (or cortisol) is a is a steroid hormone naturally occurring in the human body. It’s function here is to reduce itch. Hydrocortisone is also used in anti itch creams. As most over-the-counter anti itch creams ScarGuard MD also contains less than 1% of this component.

I don’t grasp the reason of the addition of collodion (instead of using silicones).

I’m also wondering why hydrocortisone was added to the formula since silicones have proven to reduce itch themselves. This seems redundant to me. It may be that the limited amount of people who experience skin irritation during the use of silicone creams benefit from using a product that contains hydrocortisone.



I haven’t used this product myself so I can’t speak from experience. So let’s take a look at ScarGuard MD reviews. An analysis of various reviews from different sources yielded the following:

ScarGuard MD Pros

• almost invisible
• dries fast
• easy to apply
• possible to apply makeup on top of the film
• cheaper than the popular Kelo-cote Advanced Formula Scar Gel and ScarAway Silicone Gel Serum

ScarGuard MD Cons

• doesn’t last, may flake, peels off
• looks like paper on your skin very thin, white, translucent paper film
• bad scent, smells like acetone or nail polish remover (smell fades quickly)
• doesn’t seem to work on old scars

My Conclusion:
Since there’s far less silicones in ScarGuard than in some other silicone creams I would personally choose a brand that does contain silicones only. (e.g. ScarAway or Kelo-cote )

However, because of the addition of hydrocortisone ScarGuard might be ideal for people with a very sensitive skin who are prone to sweat rash or other skin irritations.

Alternatives
From the various silicone scar cream brands such as Dermatix, ScarZone, Derma E, ScarFade, Rejuvasil, ScarAway, and Kelo-cote I would choose one of the two latter.

I would order one of these because they contain more (only) silicones. For the best results I would certainly recommend to use them in combination with the clinically proven more effective silicone sheeting. Studies demonstrate that the occlusion is a major component in the effectiveness of these silicone products. The fact that the creams are much easier to apply and wear makes them ideal for particular situations and body locations.

More clinical ScarGuard info in this study report: Efficacy of Scarguard in the Prevention of Scars

Conclusion of this study: “Both patients and investigator noted improved aesthetic effects with Scarguard on the appearance of scars following a minor surgical procedure. [..] study observations were determined in a small group of patients in a nonblinded fashion, further investigation is warranted to confirm these results.”

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The c section scar is the result of the vertical incision made during the surgical procedure and is approximately 4-6 inches long. How wide it is depends on how well it is treated, how healthy someone lives, genetics, and how well the wound heals. The scar is located on the lowest part of the tummy, just above the pubic bone. Because of its location it is mostly covered by underwear or clothes. Here are some c-section scar photos.



I stumbled upon this question on Yahoo Answers about c-section scar treatment and the answers given point out how many misconceptions about scar healing (in general) exist.

The question:

“I had a C-section 6 weeks ago and the scar is red and puffed up. Does anyone recommend a scar treatment for it? and when should I start applying the scar treatment?”

In the answers many of the common, so called effective, scar treatments are mentioned but a really truthful and helpful answer isn’t there. Yes, of course scar tissue improves over time as mentioned by one of the answerers. But no, Mederma is not a proven effective remedy actually. Studies show it works just as good, or even slightly less effective, as Vaseline.

Why so many people swear such products work for them possibly has to do with the massaging of the scar, improved blood circulation, and hydration. Regarding vitamin E capsules, better leave those where they are, or use them where they are intended for but do not use them topically. Studies have shown rubbing vitamin e into scars can make their appearance worse and cause skin reactions.



Wound Care vs Scar Treatment
Also the remark that the wound shouldn’t be treated until it’s fully healed should be clarified. In fact, optimal scar healing actually starts with proper wound treatment and if done well this can really make a difference. When speeded healing occurs and problematic aspects such as inflammation and infections are avoided the chances on developing more prominent scar tissue are decreased. The other way round; wounds that are not kept clean and looked after are prone to poor scar healing. Always consult your surgeon about the fastest way to heal open wounds. Tip: ask your medic about Medihoney wound dressings.

But the person giving this advice has a point. A clear distinction should be made between wound care and scar treatment. Scar healing remedies of a c-section scar should never be started before the incision wound has healed and closed.

The Best C-Section Scar Treatment
In this particular case, where this woman’s c-section scar is red and puffed up silicone strips can be a practical solution. It it is true that many scars, especially those resulting from surgery, can be red, bumpy, and look awful but eventually will improve. But silicone strips, which are in many cases FDA Class 1 Medical Devices, do not only improve the scar appearance, they also reduce or take away itchiness and pain. On top of that they reduce the chance on developing hypertrophic (red and raised) and keloid c-section scars. (keloids are scars that grow beyond the normal wound boundaries.)

Here’s a short review:

“The patches are called scaraway and are silicone sheets. I used them for my c-section scar and am VERY pleased. (My friends scar got red and bumpy..mine healed flat and pretty thin and is regular skin color now).. They adherer to your skin without tape (but they are not sticky like bandaids)..hard to explain..I hardly noticed they were on me…hope that helps”

Scar Pain and Massage
Some women experience pain in their c-section scar. This can vary from tingling to real pain as well as a numb feeling. Where some women loose sensitivity on the skin located around the scar tissue others experience extra sensitivity. Sometimes scar contractions can cause pain and discomfort. This can be solved by massaging the scar tissue because massage loosens the tissue, boosts circulation and thus makes the tissue softer.



C-Section Scars and Compression
Next to silicone strips compression is another scar healing therapy for which clinical evidence exists it actually works (although in lesser amount). Some women use compression belts also called C-Section compression bindersfor extra comfort, pain reduction and faster wound and scar healing. (Also scars seem to benefit from compression.)

Always avoid exposing your c-section scar to direct sunlight or use a high SPF sunscreen. Also when wearing thin clothes because many fabrics do not prevent the sun radiation from coming through.

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Many widespread over the counter scar treatment products are incorrectly thought to be effective. Questions of people asking scar treatment advice online are regularly answered with the same false statements. Cordial replies such as; “rub it  in with Vitamin E capsules” or “Mederma works really great”. Fact is that scars improve over time and the common denominator in these approaches is scar massage. Whether someone uses cream X or Y, their scar will probably improve on itself. Probably thanks to time passing and the effects of massaging the scar tissue but not as a result of these products. When determining which product really works it’s best to focus on scientific research like clinical trials and other studies.

Such studies show DIY treatments like the topical use of vitamin E, the use of scar creams based on vitamin E or onion extract like Mederma don’t work. Various studies do show onion extract gel did not improve scar appearance when compared with a petrolatum-based ointment.

Clinical trials illustrate that vitamin E provides no more effect than other emollient-type ointments, and hydration appears to be its only beneficial effect. Furthermore, topical vitamin E may actually cause more harm than good, possibly worsening a scar’s appearance and causing contact dermatitis (red rash), and other skin irritations in a large percentage of patients. That’s why many experts disencourage the topical use of vitamin E capsules.

Studies on the effects of onion extract, active ingredient in Mederma scar cream, on scar appearance have shown no benefits. Onion extract based ointments did not show to be advantageous over petroleum gel (Vaseline). A leading dermatology website advices medical professionals to tell their patients that using this product will likely not cause any harm but will not lead to an improvement either.

Also cocoa butter, cucumber butter, lime juice, Aloe Vera, skin remodeling copper peptides are used regularly. A scientific approach however, shows these over the counter products are not effective at all or no research has been done yet. (On Lime, cucumber and lemon juice and cocoa butter are no studies done). Information on products that do work here.

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