There are many different types of over the counter scar treatment products available. Commonly used products are the topical use of vitamin E, scar creams based on vitamin E or onion extract like Mederma, cocoa butter, cucumber butter, lime juice, Aloe Vera, Bio Oil, skin remodeling copper peptides and so on. The truth however is that, in contradiction to the abundant positive reviews, most of these natural home remedies are not effective at all.
For example Mederma, a nowadays very popular scar removal cream containing onion extract, does not seem to improve scar appearance and has not shown any benefit over petroleum lubricants.
Various studies show the onion extract gel did not improve scar appearance when compared with a petrolatum-based ointment. A leading dermatology website advices doctors to tell their patients that using this product will likely not cause any harm but will not lead to an improvement either.
This applies to the other aforementioned home remedy scar treatment 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 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.
The conclusion of examining all these studies and clinical trials is that, either there are no significant improvements or there has not been done any research to determine the efficacy of the product. (On Lime, cucumber and lemon juice and cocoa butter are no studies done) Flagrant exception is silicone scar treatment. Several randomised clinical trials have shown that treatment of keloid and hypertrophic scars with silicone gel sheets significantly and clinically improved the appearance of scars. 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
Another, possible effective scar treatment is the use of honey on wounds and scars but more research has to be done. With honey being very beneficial for wound care, 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.
When asked what the best advice concerning this matter is, one must not only think in terms of products (except silicone sheets and maybe honey) but more in terms of what you can do to improve the appearance of a scar. For instance, scar massage can help a lot. Then there are recent trials that show an increased temperature will significantly increase collagenolysis (the process that decreases scar tissue) So heat application e.g. by paraffin wax can be a potent improving measure. Furthermore, hydration is essential. Keeping the scar tissue and surrounding skin moisturized adds to effective scar management.