One of the most common questions from patients undergoing plastic surgery procedures relates to scar management. Vitamin E is often believed to minimize the appearance of scars by the general population. As the major lipid soluble antioxidant in skin, researchers were quite optimistic that it would become a leading product for scar management. Patients often wish to apply vitamin E for scars. So, does it work?
Research inconclusive on vitamin E for scars
The evidence for vitamin E for improving the aesthetic appearance of scars is mostly anecdotal. A systematic analysis was recently performed, evaluating all studies on vitamin E and scar outcomes. Evidence is inconclusive and the use of vitamin E is not recommended based on objective studies of scar maturation. In most cases, scars gradually improve in appearance as maturation completes over one year post-operatively. If vitamin E is applied, improvement in scar appearance would likely have occurred anyway due to passage of time and wound healing. In one study, vitamin E was randomly applied to only one half of the scar within each patient. One side was treated with a moisturizer, the other with a moisturizer plus vitamin E. The study was performed in double-blinded fashion, meaning that neither the patient nor physician was aware which portion of the scar was treated with vitamin E. In 90% of cases, there was either no improvement or a detrimental effect of vitamin E on scar healing. Up to one third of patients also developed contact dermatitis in response to the vitamin E, resulting in an itchy red rash at the application site.
What is recommended aside from vitamin E for scars?
Evidence for vitamin E is inconclusive for scar management. The majority of scars will improve as maturation completes over one year post-operatively. Sunscreen is recommended to decrease UV exposure of scars when immature. This may lower the risk of developing permanent hyper- or hypopigmentation of the scar. Scar massage may also desensitize early scars and promote faster remodelling. Although evidence for scar massage is similarly inconclusive, there are few downsides if performed as recommended by your plastic surgeon or health care practitioner. Further recommendations for scar management may be made if indicated based on clinical assessment. Steroid injections or silicone therapy (gel or sheets) may be recommended if scars appear elevated during early healing.
Please contact us to schedule a consultation with female plastic surgeon, Dr. Stephanie Power. She will make specific recommendations regarding scar management during your post-operative course to help you achieve the best plastic surgery outcome.