Mederma or Silicone Scar Sheets? Here’s What Studies Say About Silicone vs Mederma

which is better, Mederma onion extract cream or silicone scar sheets?

You worry about people staring at your scar. You remember exactly how it got there or you don’t but you’re still anxious to know how to remove it.

You’ve looked for ways to make the scar fade so it’s not so noticeable, but how can you sort out the good information from the pure marketing efforts and questionable products?

Should you buy Mederma, get silicone sheets, or order yet another scar removal product?

After all, there are so many products and brands available and the advice given is even more divers.

To make matters even worse,  even people you should expect would know, such as medical personnel and store owners, don’t know what helps and what doesn’t.

If you were to ask various individuals their thoughts on how to remove a scar you would probably get different answers of which most don’t make any sense.

The result? Confusion galore.

I know what you are going through since I have been there myself.

I have tried many of these so called effective remedies. Not only am I amazed there are still so much misconceptions but I also am displeased about the fact that many professional medical practitioners such as my doctor, the nurses, and even the surgeons did not know what to prescribe or advice to someone who wants to treat his or her scars.

In my case, I was first recommended to use Biodermal PCLE cream and Calendulan cream.

Now, maybe these work for fine lines and wrinkles but they are certainly not appropriate to treat my surgical scars and scars from cuts.

After some research you have limited your choice to two of the most popular products and now you are wondering, shall I use Mederma or silicone scar sheets?

 

Scar Treatment Misinformation

scar treatment fairy tales are abundant sadly enough
scar treatment fairy tales are abundant sadly enough

Yep it’s true, scar treatment fairy tales, sadly, are abundant.

For example you better forget about rubbing vitamin E capsules onto your scar. This is a typical scar removal myth.

Vitamin E capsule use is actually discouraged by dermatologists because they did show to cause skin rash and other irritations in study subjects.

In some cases these bad reactions might actually make a scar worse.

Another common myth is that scar creams have to be expensive to work.  Aloe vera gel and Palmer’s Cocoa butter are commonly thought to be proven effective scar remedies but they are not. (there’s limited research on aloe vera showing some benefits.)

One more misconception, it is commonly thought that sunshine helps fade scars which is not true because immature scars (approx. up to 1,5 to 2 years) should be kept out of the sun because the radiation will worsen them.

Back to the Mederma or silicone sheets dilemma.

Should you use Mederma or silicone gel sheets for your scar?

Mederma cream is an onion extract based cream which is claimed to work on old and new skin marks resulting from injury, surgery, burns, and stretch marks.

As the company says itself the cream is the #1 doctor- and pharmacist-recommended brand.

Lets take a closer look at what Mederma cream is.

Mederma ingredients:

  • Cepalin – Onion Extract  ( allium cepa)
  • Hyaluronic Acid – Hydrating Agent
  • Centella Asiatica – Leaf Extract

 

Here’s what studies say about Mederma for scars

Mederma scar creamSome animals and limited human studies have shown it to have some benefits.

Onion extract gel has shown to have little benefit in one study on rabbits.

One 2008 human clinical trial among patients with surgical scars from keratosis removal found that:

..onion extract gel significantly improved scar softness, redness, texture, and global appearance.

And another study demonstrated that

onion extract gel is safe and significantly improves scar appearance after four weeks of once-daily application.

However, a 1999 study among MOHS surgery patients found that:

Topical onion gel extract was ineffective in improving scar erythema and pruritus in our patients.

Note: scar erythema is redness and pruritus means  itch.

Another study, conducted in 2007, examined the effects on onion extract on keloid and hypertrophic scars and specifically focused on elevation, redness, hardness, itching and pain.

The researchers concluded that:

Onion extract improved hypertrophic and keloids scars via multiple mechanisms. However, it was statistically ineffective in improving scar height and itching. For this reason, onion extract therapy should be used in combination with an occlusive silicon dressing to achieve a satisfying decrease in scar height.

What’s more..

A in 1996 conducted study into the therapeutic values of onion and garlic found that they may act as an anti-inflammatory and bacteriostatic agent. Reducing inflammation is what is thought to help reduce scar thickness and elevation.

Another study conducted in 2002 showed Mederma improved collagen organization after injury in rabbits. Additional studies however have shown topical onion extract unable to improve scars.

To make matters more confusing, some sources state that “products containing onion extract or allium cepa should not be considered as an effective scar treatment. But one study showed Mederma improved collagen organization after injury in rabbits.”

This might be an indication it could work on stretch marks since these are most commonly the result of a disruption of collagen. Fact is, that, as far as I know, there are no independent studies proving this claim.

Mederma vs Vaseline

Vaseline is cheaper and shows to be at least just as good at hydration (which appears to be what makes scars improve).

A randomized, double-blinded, split-scar study showed no more improvement after the use of Mederma as the onion extract gel on scars compared to a petroleum based ointment (such as Vaseline).

It concluded that:

“the onion extract gel did not improve scar cosmesis or symptomatology when compared with a petrolatum-based ointment.”

Another study actually showed petroleum jelly to be beneficial in scar improvement.

Petroleum jelly / Vaseline’s ability to lock in moisture is what is theorized to be its method of action. (similar to the way silicone sheets work). In other words, it has potent  hydrating properties which is what scar appearance seems to benefit from.

 

“a significant reduction in scar erythema (redness) was demonstrated in control patients who used a petrolatum-based ointment for 1 month, possibly because of the effects of petrolatum on scar hydration.”

Do you still get it? So many studies. So many conclusions.

 

Wrapping it up, the pros and cons of Mederma

Research on Allium cepa, or onion extract, the active ingredient in Mederma cream has not shown undisputed clinical efficacy in scar treatment but also no side effects have been reported.

  • Mederma® Advanced Scar Gel is a more concentrated, advanced, onion extract gel formulation than some onion extracts used in the clinical trials.
  • Mederma scar cream is one of the most popular scar removal products and appears to have some clinical evidence behind it.
  • There have been only two randomized comparison trials of Mederma, with a combined total of 38 participants.
  • Mederma has Centella Asiatica as active ingredient which has been documented to aid wound healing in a large number of scientific reports. Its most beneficial effect appears to be:

the stimulation of maturation of the scar by the production of type I collagen and the resulting decrease in the inflammatory reaction and myofibroblast production.

  • Mederma scar gel is very well-reviewed, popular and sells for about 17$ making it one of the most affordable scar products.
  • If you let customer ratings and reviews and sales numbers decide, Mederma Cream with SPF 30 is an Amazon bestseller with a rating of 4 stars out of 5 making it one of the most popular scar removal products available.

 

Here’s what research indicates about Silicone scar sheets

silicone scar sheetsVarious studies on this over the counter treatment have been done. Again, some are positive while others do not indicate any benefits of using silicone gel.

Some studies indicate silicone helps increase scar elasticity, reduce elevation, itch and pain and help prevent hypertrophic and keloid scarring.

Other researchers have concluded that silicone gel creams and sheets are not beneficial and speak of weak evidence and poor quality of research.

According to Wikipedia (as well as many other sources) it is in fact the only non-invasive option for which evidence-based recommendations have been made for both scar treatment and prevention.

“Overall, the success rate (somewhat improved to greatly improved) for the treatment of hypertrophic and keloid scars is high (95%).”

And another study found that:

Topical silicone gel is safe and effective treatment for hypertrophic and keloidal scars. It is easy to apply and cosmetically acceptable.

A Cochrane review however concluded:

Trials evaluating silicone gel sheeting as a treatment for hypertrophic and keloid scarring showed improvements in scar thickness and scar colour but are of poor quality and highly susceptible to bias.

In addition to the Cochrane review some more research did not find any scar improvement upon silicone gel therapy.

One study examined silicone gel sheeting combined with vitamin E. The study reported that the combined action of vitamin E and silicone gel sheets was more succesful than silicone gel alone.

Wrapping it up, the pros and cons of silicone sheeting

I have always been positive about silicone scar sheets and promoted them since I know from personal experience what they do.

At the same time I have been critical about creams such as Mederma because there’s less clinical evidence for their efficacy.

In all honesty and although more research needs to be done, several studies on onion extract seem to indicate this may work too. I still keep favoring sheets over any cream but I’m not as biased anymore as I have been.

I do think that when you take a look at many user experiences and customer reviews it seems like people generally use Mederma for less obtrusive (i.e. flatter) scars than those who use silicone gel. This may cause users to be more positive quickly since such scars fade faster on their own. This however is just a hunch of mine.

when a scar improves after months of  OTC treatment, it’s hard to know whether the treatment or just time made the difference

  • Silicone gel is often called the clinical gold standard in OTC scar treatment.
  • Silicones have been used by burn centers and some hospitals since the 1980’s and are often referred to as the only clinically proven effective home treatment.
  • I have used silicone gel sheets and I noticed my scars getting smoother, less itchy, flatter, softer already after a few days. Redness took longer to improve but eventually did fade too as a result of wearing the sheets. (I noticed that initially the redness disappeared but came back when not wearing the sheets. Prolonged use resulted in permanent toning down. In other words, I saw relatively quick improvements upon applying silicone sheets.
  • ScarAway is one of the most popular silicone sheeting brands on Amazon. It scores a 3,5 out of 5 stars review rating.
  • At about 27$ it is slightly more expensive than Mederma.

 

Mederma or silicone scar sheets, my recommendation

Honesty compels me to say that I have not used Mederma myself. I do hear and read a lot of positive reviews about this product which makes me hesitate  in dissmissing it as utterly useless.

Maybe it could work for me too. Maybe it does work for you..

Study findings contradict each other and there’s also the practice that studies may be paid for by commercial companies. This of course, is the case with any product, also silicones.

All considered, I myself would stick with silicone scar sheets. Just because I know for sure these work and seem better at shrinking raised scars.

  • Another aspect that makes me favor silicones over Mederma is that occlusion is what is thought to play a role in making scars softer, flatter, and less discolored.
  • Studies indicate that scar occlusion:

was able to decrease dermal fibrosis by hydrating the epidermis and altering the pro- and antifibrotic signals produced following injury.

  • Silicone gel, by creating a thin film, and more so, silicone sheets offer occlusive therapy whereas Mederma does not.
  • Other reasons I favor silicone scar sheeting is that these are used by  many burn centers and cosmetic surgery clinics and because there’s research proving their efficacy.
  • Key in proper wound and scar healing is moisture. Make sure to keep your wound as well as the scar moist.

 

What do you think? Which one will you try? Mederma or silicone scar sheeting?

If you want to use both as complementary remedies, keep in mind that you can’t use them at the same time. I can imagine you’d wear the sheets during the night and Mederma at daytime.

I would love to know about your experiences so let me know what you think or how the scar healing process goes for you.

 

Image credit: Mizunoryu | Wikimedia Commons

 

 

 

30 thoughts on “Mederma or Silicone Scar Sheets? Here’s What Studies Say About Silicone vs Mederma

  1. I have a raised lump which is scar tissue on the end of my thumb which arose from my thumb bursting open as a result of closing a car door on if. I have been using silicone pads now for 5 days at night when I go to bed and removing them when I get up and I can see a significant improvement on day 5. The scar is almost 4 months old. And in fact does not feel so sensitive as it did before the silicone treatment. I’m goin to continue with it as traditional methods like heat therapy and massage has done nothing.

    1. Good to hear Mandy. I can imagine scar tissue on your thumb is extra bothersome because of the loss of sense and the frequent use of your fingers. Thanks for sharing and don’t forget to keep your scar out of the sun or UV light in general.

    1. Not at the same time.

      Typically, silicone scar sheets and gels are applied on clean, dry skin. This makes them attach well. Mixing with other topicals would interfere with the action of the silicone / make them less adhesive / cause rash.

      What I did is, when I did not wear my silicone sheets was apply vaseline to keep the scar and surrounding skin hydrated.

  2. My 5-year-old recently suffered a large gash on his cheek when he fell on a juice glass. It was glued together at the hospital. It’s been 2 weeks and the surgical tape is just now starting to peel off. Underneath there is a mix of new skin and scab. When should I apply the silicon sheets? When the scab falls off? Are they easy to remove?

    1. Generally as soon as the wound has closed and when scabs have fallen off. You could also use gentle scar massage to help reduce scar tissue.

      Depends on the brand, Cica Care are very sticky, some other brands somewhat less so. All silicone sheets are easy to remove, they don’t stick like band aids can.

      I know what it is to suddenly have a scar in your face but I can also tell you that in my experience as well as that of peers, facial scars faded a lot.

  3. I’ve been using the Scaraway sheets on an incision (about 1.5″) on my chest for about 2 weeks. I’ve been taking it off when I shower, then wash it as directed and reapply it when it’s dry. If I were to use 2 sheets, alternating them from day to day while they dry after being washed, can the sheet be worn almost 24 hours a day, continuously over the treatment period of 6-8 weeks?
    I also have a long scar from shoulder replacement surgery. It stretches from my collorbone diagonally across the front of my shoulder to my upper arm. I’m still doing PT and have months ahead of me yet, but it’s so ugly and I want to start treating it ASAP. After reading some of your posts, I think the Mepitac silicone tape would work best for the size and location of my scar. Would you agree?
    Thank you for sharing your experience, research, and knowledge on this site. It’s all very informative!

    1. I think you could. If, after a while and many times of washing the sheets don’t adhere anymore you can always use (silk) tape to keep them on.
      Regarding your shoulder scar, since you’re doing PT and the location, yes Mepitac could probably be my choice. On the other hand, as the scar is already a bit older (if I understand correctly) I might opt for a thicker silicone gel sheet. Have you considered Cica Care? They are very sticky and relatively thick, I might have chosen those if I were in your shoes.

  4. Could you please advise what soap to use in washing ScarAway silicone sheets? I have found it hard to find soap without moisturizers, oils, or lotions? Is it all right to just use water? Thanks!

  5. Onion extract is not an active ingredient in Mederma as was stated in the article. It is listed as an inactive ingredient. Allantoin is listed as the active ingredient.

  6. I have a scar in the middle of my left eyebrow. Would the ScarAway sheets still work with my eyebrow in the way? And would there be potential to accidentally pull my eyebrow hair out when removing the sheet?

    1. Not sure, I’m assuming if you can manage to keep the sheets touch the scar they must work. I would be surprised if the sheets would pull out eyebrow hair.

    2. Not really I’m using ScarAway on my upper lip after having a mole removed. Of course there is an area where the hair grows, but I have been applied the silicone patch over that area and every time I removed doesn’t interfere with my hair nor pulling it out. Safe to using on baiting areas.

  7. I had a skin graft on my left arm about 3years ago,for a burnt accident,and the donor site didn’t heal well,the area got raised can I still use scaraway silicon sheet on the donor site plus will it work

    1. If I’m correct they state that their product works on older scars (even years old) as well. I think this goes for most brands. Check the package description to be sure. I can’t tell you from personal experience though. Nevertheless, I would give it a try.

  8. I’ve been using mederma and scar away at the same time for 3wks now..should I stop? So far my tummy tuck scar is flat but still dark. Was gonna give it a couple months.

    1. I’d proceed with ScarAway for a while. Just to be sure it doesn’t raise again and because it may help reduce the discolorization.

  9. I have been using mederma intensive overnight scar cream for 6 weeks now after surgery. The scar looks better than before but it did not disappear, the redness and the mark are still there. Can i use silicone sheets now and stop using mederma? Will it be effective or is it too late to use them now?

  10. I used silicone tape and the next morning woke up with a rash around the base of my neck. Which is odd because I used it on tummy tuck scars!! I tried it again and sure enough, got it again. I just bought the Mederma cream and used it last night for the first time. By 5 pm my neck rash started again. What the heck??!!

  11. Hello , I have 4cm surgical scar and scar from cut on my forehead. and i started to use scaraway silicone sheets 3 days ago. i can see some differences . it’s getting smoother but i still don’t know if i use mederma and Scaraway at the same time it will be better or no… and how’s your scar’s appearance now ? how long time it takes to fade away ? and i am worrying about it. i am still confusing that which way is better… and thank u to sharing your experiences.

  12. The next time you make a post like tbis, cut all the psycho babble. Usher out and get to the POINT!! I read all that just for you to ask US which one works better.. I wanted an answer not a novel and no answer.., you remind me of one of those people that talk just to hear themselves talk to you typed up all that bullshit with no useful information you fucking idiot learn how to write

  13. I just started treatment with a dermatologist for a keloid scar I have had for approximately 5 years. We opted to use the silicone gel sheets. Should or can I be optimistic?

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