The scar cream ingredients to look out for

A part of healing

No matter if its acne scarring, stretch marks, post-surgical marks, burns, or something else, our unwanted scars can often make us self-conscious. But scars are an essential part of recovery from a skin wound.

"A scar is part of the body's natural healing process,” explains consultant dermatologist Dr Simon Zokaie. "It develops when tissue is damaged, causing collagen - a protein - to be released to help the tissue heal. Then it continues forming and the blood supply increases, thus causing the scar to become raised."

Over time, our scars usually fade after the excess collagen breaks down and the blood supply returns to normal. But we still may use various scar removal methods, to help reduce the visibility of scars.

Examples include laser treatment and micro-needling, although these methods tend to come with a premium price tag. Scar cream is by far the most cost-effective and convenient option.

What is scar removal cream?

"A scar cream often contains ingredients that help to soften the skin and hydrate it, which can help to reduce the appearance of scar texture and redness," says Dr Zokaie.

Some creams also contain ingredients that reduce collagen production, which further helps to flatten and fade their appearance.

When it comes to rubbing lotions onto your scars, the main treatment involves these types of skin products:

1. Emollients and moisturisers - products that soften the skin and add moisture.

2. Silicone scar gel - can help reduce hyperpigmentation (dark spots) and elevation.

When people talk about scar cream, they could be referring to a moisturiser or gel-based product specifically designed for scars. Let's take a look at the most popular scar cream ingredients and how well they work.

Does silicone cream work on scars?

Many experts regard silicone as the most effective when it comes to scar cream ingredients. While really deep scars tend to respond better to alternative therapies like laser, dermabrasion, and chemical peels, silicone gels are the best scar cream option for punctures that penetrate several skin layers - such as ice pick scars.

'Silicone gels can help to reduce scarring by increasing the hydration of the top layer of the dermis - your second layer of skin. Some studies¹ have suggested that they can also help to regulate the fibroblast production of collagen, which results in softer, flatter skin," Dr Zokaie explains.

Do plant-extracts work on scars - Allantoin and onion extract?

Allantoin and onion extract, both naturally found in plants, feature in many scar gels. Their skin hydrating, softening, and anti-inflammatory properties support scar healing, and like silicone they can stimulate collagen production and make scarred skin smoother in texture.

Evidence² suggests that silicone is the more effective scar ingredient, but there's no reason you can't use these ingredients together. In fact, this combination is found in many effective scar creams or gels and also patches and sheets³.

Does salicylic acid work on scars?

Salicylic acid is a skin peeling agent that sheds dead skin cells from your outermost layer of skin. Not only can it treat acne scars⁴ by reducing swelling and redness, but it can also be an effective acne treatment⁵.

Can vitamin A remove scars?

Retinoids are derived from vitamin A and are a popular element in scar creams. Like salicylic acid, retinoids also promote skin cell turnover and therefore work as both an acne treatment and acne scar treatment. Adapalene is a popular third-generation retinoid which has proven effective in reducing the appearance of scars.

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Can vitamin E cream remove scars?

Vitamin E is often used as a moisturiser to treat dry skin and minor irritations, such as itchiness and rashes. This has led to some people using it on their scars.

"Vitamin E is often regarded as a good ingredient to apply topically,” says Dr Zokaie. "However, studies are inconclusive as to whether or not it actually helps to reduce or treat scars."

One study⁶ not only found this ingredient to be ineffective at reducing scar visibility, but also that it can make some scars appear worse or be a trigger for eczema in some people. For this reason, using a vitamin E based scar cream on surgical scar wounds is discouraged.

Is E45 cream good for scars?

The NHS recommends E45 cream as a good non-perfumed moisturiser for scars. While not a scar cream with tailored ingredients for scar healing, as a moisturiser E45 cream can be an important step in your scar treatment routine, to use as either an emollient wash cream and a moisturising cream before you apply your specialist scar cream.

How to use scar cream

You can't use scar creams once in a while and expect to see significant results. To be effective, you must be dedicated to massaging your scar every morning and evening, or as your scar cream instructs. You also need to think long-term to get the best results. For example, silicone gels should be used continuously for at least three months.

How soon after surgery can I use scar cream?

If you have a surgical scar, it can be important to give your wound time to heal by itself before using creams. Sometimes, dermatologists recommend waiting four weeks, but it's a good idea to check with them about the right timeframe for your particular wound⁹.

Further reading

1. Hanasono: The effect of silicone gel on basic fibroblast growth factor levels in fibroblast cell culture.

2. Karagoz: Comparison of efficacy of silicone gel, silicone gel sheeting, and topical onion extract including heparin and allantoin for the treatment of postburn hypertrophic scars.

3. Kim et al: Effects of silicone-based gels containing allantoin, dexpanthenol and heparin on hypertrophic scarring in the rabbit ear model.

4. Danielson and Walter: Case studies: use of salicylic acid (Avosil) and hydrogel (Avogel) in limiting scar formation.

5. Arif: Salicylic acid as a peeling agent: a comprehensive review”

6. Baumann, The effects of topical vitamin E on the cosmetic appearance of scars.

7. Loss et al: Adapalene 0.3% Gel Shows Efficacy for the Treatment of Atrophic Acne Scars.

8. Kikuchi et al: Gene expression analysis in scars treated with silicone cream: a case series.

9. Memorial Sloan Kettering Cancer Center: Caring for your scars after skin surgery.