This is a question that a lot of patients have on their minds, considering that almost all people have had a scrape, burn or surgery that has left a scar on their skin. Scars are the result of the normal wound-healing process the body uses to repair trauma to the skin. The more damaged the skin is and the longer it takes to heal, the higher the chance of an obvious scar. At first, scars are more pinkish red and somewhat thick, then turn more skin-colored over time. Normally, it takes about one year from the time of the injury for the scar to “mature” (ie: to become what it will look like for the rest of your life).
In general, the sooner a scar is treated, the better it will look in the end. Mederma is an over-the-counter product containing onion extract, an anti-infective, purified water, PEG-4, xanthan gum, methylparaben, and sorbic acid. In 2008, Mederma was reformulated and a new ingredient, allantoin, was added. It was called Mederma Advanced Scar Gel. The reason allantoin was added is that, in the lab and on cultured cells in a petri dish, it was shown to stimulate healthy tissue formation. In the manufacturer’s original study, Mederma was applied to 2-week-old non-surgical scars and evaluated for improvement in the appearance of the scar. Compared to not putting anything on the scars, the ones treated with Mederma showed decreased redness and an overall improvement in appearance.
However, researchers at the dermatologic unit at Harvard Medical School conducted an independent, higher quality, and unbiased study comparing Mederma to Aquaphor ointment (an over-the-counter moisturizer similar to Vaseline) for the treatment of surgical scars. That study showed no difference in the appearance or symptoms of surgical scars. The conclusion was clear: it wasn’t the ingredients in the product that counted, only that something was used to cover the wound on a daily basis. This makes sense because a moist wound environment keeps growth factors, proteins, and collagen stimulants within the vicinity of the wound, promoting a better-looking scar in the process.
All in all, the less scab that forms on the wound, the better. This goes without saying that picking at a scab will result in a worse scar as well. What’s more, Aquaphor is $1.14 per ounce, while Mederma Advanced Scar gel is $13.34 per ounce! Old scars that have been around for over 1 year will not improve with any topical cream or gel because the healing process is over. Fortunately, other dermatologic procedures, like laser, chemexfoliation, and soft tissue filler can improve the appearance of older scars.
Dana Point Dermatology’s Bottom Line: For new scars, we recommend applying Vaseline or Aquaphor ointment, immediately after the injury, twice daily for 4 weeks. Mederma gel is 11.7 times more expensive and is proven not to work any better.
