A Guide to Scar Management

Post-injury, surgery, or burn scarring is often second only to the actual injury or surgical procedure in terms of anguish caused.  While cosmetic concerns about scarring shouldn’t be an issue at all, the sad fact is that many dread scarring as much as illness, and some even avoid medical procedures for fear of the scars that may result.  While no scar treatment gives 100% scar-free results, there are treatments available that do dramatically reduce the appearance of scars and help prevent the formation of some scars.  Following is a guide to products promising to minimize the appearance of scars.

Allium Cepa (onion) Bulb Extract

Allium Cepa bulb extract-containing products include Mederma, Palmer’s Cocoa Butter Vitamin E Scar Serum, and CVS Scar Gel.  In studies relying upon patient self-reports, a reduction in redness and a noticeable improvement in texture and overall appearance was reported in most cases.  In cases of keloid reduction, use of Mederma in conjunction with keloid shaving was found to be more effective than keloid shaving alone in terms of reformation of scar tissue.  Allium Cepa bulb extract tends to be well tolerated by most, with few reported side effects.  However, it pays to look at the ingredients list on any product, because, while the Allium Cepa may not cause many side effects, other common ingredients may. 


Vitamin E Products 


Vitamin E products, when used alone, are not known to produce reliable scar reducing effects.  In fact, some studies show a worsening of scar appearance (increased redness) when only Vitamin E is utilized.  In addition, Vitamin E is known to cause contact dermatitis in some individuals. Some reports of an effective combination of Vitamin E oil and silicone strips have surfaced, though Vitamin E is, at best, an unreliable “treatment” for scars. 


Shark Oil 


While Shark Oil (which boasts a substance known as squalene, which is also found in various plants) is currently being touted as a treatment for scars, supporting research is lacking.  While probably not harmful (squalene is often used as a moisturizer in cosmetics), it’s likely not doing much scar-minimizing good, either.  In addition, shark squalene has become popular enough that shark hunting in its pursuit has become a concern.  If squalene is the route you wish to go, it’s probably a kinder idea to seek it from plant sources. 


Emu Oil 


Another popular treatment for scars is Emu Oil, which is popping up in dozens of scar treatment gels and ointments.  Like squalene, Emu Oil has a lot of fans, but not a lot of reputable research to back its claims.  Also like squalene, Emu Oil doesn’t appear to be harmful, does serve as an effective moisturizer, and probably won’t hurt, even if it might not help. 


Topical Vitamin C


 Vitamin C, long known as an anti-oxidant and collagen-stimulating substance, has been shown to lighten dark spots on skin, helping to fade the appearance of scars.  Because Vitamin C is unstable and rapidly oxidizes, only stabilized Vitamin C concoctions are of any conceivable benefit.  While there isn’t a lot of research supporting Vitamin C’s use as a scar-reducer, it has been shown to decrease redness after skin resurfacing.  
 

Silicone strips 


Silicone strips really are the stars of the scar treatment stage.  Unlike most other treatments, silicone has a large body of research backing its claims.  While it’s not known exactly why silicone strips/patches work, it’s suspected that a combination of keeping the wound protected and properly hydrated and the pressure on the wound helps to prevent some raised scarring and lessens the appearance of scars through flattening and fading.  What is believed is that it’s not likely a chemical thing, i.e., it’s not the chemical properties of the silicone but rather the mechanical properties.  When it comes to silicone strips, you often do get what you pay for, with the more expensive products adhering better for longer, and tolerating more washings and reuses before losing their adhesive qualities.   


Silicone Gels


Silicon gels such as Rejuvasil and Kelo-cote are meant to simplify the use of silicone in scar treatment.  Rather than cutting and attaching strips to the treatment area, a silicone-based gel is applied to clean, dry skin and allowed to set for a few minutes.  Manufacturers claim that such gel treatments are as effective as silicone strips, but the jury is still out on that one.  Some users claim great success, others no effect, with most falling in the middle.  Some strip manufacturers recommend gels during the day and strips at night, which have shown better results than just gels.  Many silicone gels incorporate such ingredients as Vitamin C, squalene, emu oil, and Allium Cepa along with silicone.  While not particularly harmful, there’s no body of research showing that these combinations are any more helpful than just silicone gel. 


Sunscreen

While sunscreen will not prevent or reduce scarring, it will help prevent discoloration of scars.  Discolored, darkened scars are more obvious scars, so using sunscreen, especially in the first year after the injury or surgery, can make a dramatic difference in the appearance of scars. 


Scarring can be an emotionally devastating occurrence with deep psychological and social effects.   While there is no sure-fire, absolute cure to scarring, there are products that can, at the very least, reduce the appearance of scars and help minimize the formation of new scars.   With conscientious care, even older scars can appear less red, less raised, and less obvious.