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Vitamin E and Onion Extract for Scars

Doctors disagree about the value of vitamin E and onion extract for reducing the appearance of scars, but there is some evidence they work.

Q. When I had knee replacement surgery, the physical therapist recommended cocoa butter with vitamin E for the scar. It worked beautifully.

Since I had some left over, I began using it on my nail beds at night. This winter I had strong fingernails, no cuticle issues, and no split skin on my fingertips.

Now I have begun using it on my lips instead of Vaseline at night. Is this safe?

A. Cocoa butter is an edible fat, so it is definitely safe to use it on the lips. Since you have already used the product with vitamin E on your skin and not developed a rash, it should be safe on your lips. Some people develop contact dermatitis when vitamin E is applied to the skin.

Vitamine E and Onion Extract:

There has long been a controversy about the benefits of vitamin E for scars. Many visitors to this website swear that vitamin E works. Here is a link to just a few of the personal stories.

Dale reports: 

“I was in an auto accident some years ago. My face slammed into a side window embedding small pieces of glass on the left side of my face and chin. Little by little the pieces dropped out and left very ugly scars.

“After the wounds healed I began to apply daily Vitamin E. I did the same to surgery scars a few years after that. Within a year the scars in both places disappeared and there is no sign of them forty years later.”

Emilee had a bad burn:

“I was burned three months ago in a car accident, which resulted in 3rd degree burns to about 40% of my body. I had multiple skin grafts and was admitted into Johns Hopkins (the best hospital in the country) for a month. The burn doctors there (and I’d take their advice over anyone’s) highly recommended vitamin E to prevent redness and scarring. I’ve also learned that compressing the scars, like with compression socks, helps greatly.”

Caution About Topical Vitamin E on Skin:

Fran reminded us about the possibility of contact dermatitis from vitamin E:

“I recently had bilateral mammoplasty [breast] surgery. I started applying vitamin E ointment to my incisions and ended up with contact dermatitis, a very painful condition. I have been dealing with this condition now for over three weeks. First I was put on an antibiotic for a week, then on cortisone cream for two weeks and it’s still there. It’s a miserable condition. Had I known that vitamin E can burn the skin I would never had used it.”

The Science Behind Vitamin E and Onion Extract:

A study at the University of Pittsburgh found that a lotion containing vitamin E, hydrocortisone and silicone (Scarguard) was better than placebo (Journal of Drugs in Dermatology, May, 2010). So was an onion extract gel (Merderma).

In this study investigators randomized patients with scars or keloids (collagen-containing shiny scars) to receive either placebo or topical onion extract (OE) or the HSE (hydrocortisone, silicone, vitamine E) Scarguard lotion. The researchers were also “blinded” in that they did not know which volunteers received which treatments. Their conclusions:

“Significant improvements were obtained with OE in volume, length, width and induration [hardness] and with HSE in volume, length, induration, erythema [redness] and pigmentation alteration…Both OE and HSE were more effective than placebo in the management of hyhpertrophic [raised] scars and keloids.”

Another study of just onion extract (Merderma Advanced Scar Gel) published in the Journal of Clinical and Aesthetic Dermatology (June, 2012) also reported favorable results. The authors note:

“The present findings are consistent with the majority of published data on onion extract and scar appearance. Over the past decade, numerous studies have shown that onion extract applied 2 to 3 times a day for periods of 3 to 6 months significantly improves the appearance of postsurgical scars, adhesions, stretch marks, and hypertrophic scars in vitro and in vivo. The weight of evidence from these studies and the present data support the claim that onion extract is beneficial in reducing the appearance of new dermal scars when used as directed.

“In conclusion, the results of this study demonstrate that once-daily application of the proprietary advanced formulation of onion extract gel is safe for use on new scars and significantly improves their overall appearance, redness, softness, and smoothness compared to control scars. In the majority of subjects, these benefits are apparent within 2 to 4 weeks of daily application and are fully defined after eight weeks of application of advanced onion extract gel.”

A Different Perspective on Vitamin E and Onion Extract:

British plastic surgeons analyzed all the available data on various treatments of scars in an article titled “A Comprehensive Evidence-Based Review of Topicals and Dressings in the Management of Skin Scarring” (Archives of Dermatological Research, online, June 5, 2015). They considered several prescription drugs as well as onion extract, green tea, Aloe vera and vitamin E.

They concluded that after reviewing the collected research:

“In all cases, there was conflicting evidence as to whether the topical intervention was of benefit…

“Despite the volume of research into treatments for skin scarring, there is little evidence to support many over-the-counter treatments and cosmeceuticals available. A recent review concluded many of the advertising claims made by these products cannot be substantiated.”

The authors call for better research and offer a somewhat wishy-washy conclusion:

“Based on the current levels of evidence presented in this review, it is difficult to recommend the topical treatments identified as alternatives to current practice based on the limited clinical trial data currently available, although some success has been shown when these are utilised as supplementary therapy to standard practice in addressing specific symptoms of concern.”

Share Your Story:

What is your experience with vitamin E and Onion Extract? Share your own scar stories below and please vote on this article at the top of the page.

Revised 1/28/16

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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