Whether it's acne pock marks, stretch marks after pregnancy, or the legacy of a burn, wound or surgery, few of us like scars on our skin.
And there is no shortage of remedies that claim to make scars smaller, thinner and less noticeable. One of the most popular is vitamin E, which is found in many skin creams. But will vitamin E really help to improve your scar?
According to Sydney dermatologist Dr Phillip Artemi, the answer is no.
He says despite the marketing hype, research has clearly shown vitamin E has absolutely no beneficial effect on scars.
"People put a vitamin E cream on, [and over time] notice the improvement, and quite incorrectly, think, 'Oh it's this stuff I'm putting on' — but it's not," Dr Artemi said.
As your body forms a scar there is a natural process of slow and gradual improvement over a period of about 12 months.
And this will happen regardless of whether vitamin E cream is applied.
It is true that collagen, a fibrous protein in the skin, is involved in scar formation and that vitamin E, when present in the body, influences the formation and arrangement of collagen fibres.
But Dr Artemi says it does not automatically follow that applying vitamin E to skin will improve the way collagen is formed and laid down when wounds heal and scars form.
In fact several studies have tested this exact idea and shown it to be false. One study even found that in almost a third of cases, vitamin E caused a common skin irritation — known as contact dermatitis.
Dermatologists now consider it "a proven scientific fact" that applying vitamin E is of no value to scars, Dr Artemi says.
Don't waste money on unproven remedies
So if vitamin E will not help scars, is there anything that will?
The notion that aloe vera, lemon juice, and other over-the-counter oils and creams will fade or shrink scars is also "nonsense", Dr Artemi says.
For example, while initial tests on rabbits and in the laboratory suggested onion extract might be beneficial for scars, further studies in humans showed it did not live up to the promise.div contentScore="94"">>
"People are making a lot of money selling products that do nothing for scars," Dr Artemi said.
However using a dressing to trap moisture over a wound when it's healing can help minimise scarring and provide the best possible cosmetic outcome.
Scarring treatment explained
Scar treatments explained
Chemical reconstruction of skin scars: A chemical (usually trichloroacetic acid) is used to frost the scar, in order for the body to produce new collagen fibres during the healing process.
Dermal fillers: Chemical fillers are injected into the skin to decrease the depth of scars.
Fractional laser: A non-wounding laser is used to stimulate collagen growth and tighten skin.
Micro-needling: Small needles are delivered into the dermal layers of the skin, to break down scar tissue and stimulate the formation of new collagen.
Subcision: The sharp edge of a hypodermic needle is used to break down fibrous connective strands underneath the scar to improve appearance .
Dr Artemi says avoiding unnecessary tension and strain on a scar, ensuring that it is not exposed to excessive sunlight and giving it a simple massage for a few minutes twice a day can also help.
Special dressings — known as silicon dressings — are good at trapping moisture, as are silicon gel or gel sheets.
"They've certainly been proven to work well to trap moisture and help scars heal as well as possible — but their effect has nothing to do with silicon itself," Dr Artemi said.
"As a result you could probably achieve the same thing by applying a good smear of Vaseline or any dressing that prevents air reaching the wound and drying it out.
"Such silicone or other occlusive dressings should only be used on clean wounds, where there is low risk of infection."
Dr Artemi says they provide most benefit in the first 12 weeks of use, although in some cases their use may be recommended for six to 12 months.
"It's important to remember that even with an occlusive dressing, a scar will take many months, and sometimes more than a year, to naturally fade to its end point," he said.
"If you are unhappy about a scars redness, bumpiness or thickness it's time to consult a dermatologist to discuss possible options such as an appropriate laser source, micro-needling or injectable treatment."
Dealing with acne scars
When it comes to scars caused by acne, treatment options are not always straight forward.
Acne scarring consists of many different types of scarring including ice-pick scars, pock-like scars, deep depression and areas of skin thickening [also known as termed keloid].
Each scar responds differently and as a result combination treatments are required, according to each patients needs and the severity of the scarring.
These treatments are undertaken by a dermatologist and might include micro-needling, fractional laser treatment, subcision, chemical reconstruction of skin scars or injected dermal fillers.
Depending on your skin type and the degree of scarring, combination treatment for acne scarring can result in a 30 to 60 per cent improvement.
And yes, picking and squeezing your pimples, or picking at the scab of a healing wound, will only make scars worse.
Some people scar worse than others
But some people will have worse than usual scars despite doing all the right things.
Scars are more of an issue for people:
- Who are Asian or who have dark skin — it is not just their skin colour, but other biochemical differences including the fact cells that make collagen are over-reactive;
- Aged between 10 and 30 — especially those who do not have a genetic tendency for skin that heals well;
- Who have a wound on certain parts of their body for example the upper trunk, around the ear lobes or jaw line, or where movement puts extra tension on the scar.
But whether your scar is at the good or bad end of the scale, the evidence suggests spending your hard-earned cash on vitamin E won't make a jot of difference.
"You're just wasting your money," Dr Artemi says.
Dr Phillip Artemi is a Sydney Dermatologist in private practice. In the past he has served as Honorary Secretary, Director of Training (NSW) and Chairman of the Teaching and Learning Committee of the Australasian College of Dermatologists.
Source : http://www.abc.net.au/news/health/2016-09-02/does-vitamin-e-improve-scars/75378901206