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
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.
- Cepalin – Onion Extract ( allium cepa)
- Hyaluronic Acid – Hydrating Agent
- Centella Asiatica – Leaf Extract
Here’s what studies say about Mederma for scars
Some 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.
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
Various 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