Popular beliefs on over the counter scar treatment products differ considerably. Frequently used products are scar creams based on vitamin E, topical vitamin E, ointments based on onion extract such as Mederma, Aloe Vera, Bio Oil, cocoa butter, cucumber butter, lime juice, skin remodeling copper peptides and so on. Abundant positive reviews on these remedies seem to support these beliefs. Less commonly accepted is the fact that there is no scientific evidence these products work. In some cases clinical trials showed these products in fact do not work.
Mederma for example, a currently popular scar treatment cream containing onion extract, does not seem to improve scar appearance and has not shown any benefit over petroleum lubricants (Vaseline). Several studies show the onion extract gel did not benefit scar treatment when results were compared with a petrolatum-based ointment. A leading dermatology website advices medical personnel to tell their patients that using products based on onion extract will likely not cause any harm but will not lead to an improvement either.
This applies to the other aforementioned products as well. For example the topical application of vitamin E on scars. Clinical trials illustrate that vitamin E provides no more effect than other moisturizing 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.
A comparison of available studies on popular over the counter scar treatment products leads to the conclusion that, either there is clinical proof or there has not been done any research on the effects of the product. (On cucumber, lime, lemon juice and cocoa butter are no studies done)
A remarkable exception are silicone gel scar treatment products. Although it remains uncertain how these silicone scar patches actually work, various studies demonstrate their efficacy. Silicones are known to be the most effective over the counter scar treatment for burn, surgical, and other deep wound scars. They also prevent the development of hypertrophic and keloid scars. Used and recommended by burn centers, cosmetic surgeons and dermatologists they are considered ‘the golden standard in scar treatment’. Although starting treatment in an early stadium is recommended silicone patches also benefit treatment of older scars. Additional advantages are they are relatively easy to use, relief itch and pain and their use has no side effects.
Furthermore there are clinical trials showing hydration is a crucial scar treatment factor. Silicone gel sheets are thought to aid hydration but there’s no consensus among experts. Others say it’s the occlusion of the scar tissue. It is clear that hydration of the scar tissue and the surrounding skin benefits scar treatment. None of the examined products have shown to perform better than the commonly used petroleum ointment called Vaseline. In fact, in some cases Vaseline showed to have better hydrating properties than the scar creams it was compared with.
Another, potential, effective scar treatment product is honey. It is clear that the use of honey in wound care speeds wound healing and thus, indirectly, results in less scarring. A recent review (evaluated the results of 22 clinical trials involving more than 2,000 patients) concluded that honey also minimizes scarring, removes infected and dead tissue and speeds healing by stimulating new tissue growth.
A 1996 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) So these preliminary studies are promising regarding honey and its scar fading properties. More dermatologists say applying honey to a healing wound or existing scar has not shown to be harmful and may improve scar appearance. Whether or not the topical application of honey on scar tissue works has to be seen. There has not been done any research on this particular subject but a certain type of honey, Manuka honey, is renowned for its many healing properties of which one is its excellent moisturizing action.
Recent trials show an increased temperature will significantly increase the process that decreases scar tissue (collagenolysis). So heat application products such as paraffin wax and heat packs could be useful too.
Summarizing, the best scar treatment products are silicone gel sheets, moisturizing agents such as Vaseline (and maybe Manuka honey) and paraffin wax or heat packs. More information consumer experiences with brands .