Topical management of postsurgical scars

In conclusion, no one topical product has been shown to be a true front runner in the standard of care of postsurgical scars. Because many patients inquire about OTC products for scar treatment, it is important for the dermatologist to be familiar with the latest research on this topic. In 2009, Morganroth et al ¹⁶ published a review of 20 best-selling scar products for postsurgical patients utilizing the Web site www.drugstore.com in addition to reports in the medical literature with data supporting the use of OTC products for postsurgical wounds. Of the products reviewed, the mean cost was $38.99, with the top 3 best-selling products ranked among the most expensive. Silicone was the only active ingredient listed, which also had evidence-based medicine substantiating its use. The authors cautioned that the silicone gel trials reviewed were of poor quality, but of all the OTC products reviewed, it appeared that silicone gel prevented abnormal scarring in high-risk individuals. ¹⁶ Thus far, not enough clinical data have been reported to support the benefits of onion extract, imiquimod, or topical vitamin E as means of treating fresh surgical scars. Future research into the timing of initiation of these products (ie, preprocedure or postprocedure) as well as head-to-head comparative trials will provide the dermatologist with valuable insight into making substantiated recommendations while dispelling unrealistic expectations about the advertised benefits of these products.