Best Scar Treatments

Scar treatments currently available on the market include:

Vitamin E (Tocopherol)
Topical vitamin E may be good for preventing sun-induced skin damage but it has NO effect on, and actually WORSENS the appearance of scars in up to 90% of adults. Up to 33% of users develop a contact dermatitis to vitamin E (redness, itching and flaking). American dermatologists and Canadian pediatricians recommend completely avoiding scar creams containing vitamin E.
VERDICT - VITAMIN E DOESN'T WORK

Vitamin C
One of the skin's main components is collagen. Scars heal through new collagen formation. Untreated skin produces unorganized, haphazard collagen. Vitamin C helps to improve and organize collagen formation. Improved collagen formation leads to faster and more cosmetic scar healing. Vitamin C also decreases inflammation and is used to lighten dark scars. It is vital to use a product that contains a stable form of vitamin C. Most products contain unstable vitamin C which oxidizes and turns brown on exposure to air. Many cosmetic vitamin C products are actually colored brown to disguise this (so choose something that's NOT brown or dark yellow to begin with). While oxidized vitamin C is not unsafe, it certainly does nothing for your skin.
VERDICT - VITAMIN C WORKS

Silicone Gel And Silicone Sheets
Silicone improves the appearance of both old and new scars. Silicone sheets are cumbersome and interfere with clothing and make-up. Silicone gel (Dimethicone) is as effective as silicone sheeting and is much easier to apply. Easy make-up and sun-block application is an added benefit of the gel. Always check the ingredients to make sure the silicone is Dimethicone (certified as safe) and not potentially harmful silicones like D4 or D5 (eg Cyclomethicone, Cyclotetrasiloxane, Cyclohexasiloxane, Cyclopentasiloxane).
VERDICT - SILICONE SHEETS & SILICONE GEL WORK

Topical Steroids
Most people know that steroids decrease inflammation. However, independent studies have shown that topical steroids have no effect in reducing scar thickness or improving the cosmetic appearance of scars.
VERDICT - STEROIDS DON'T WORK

BOTANICALS (Natural Plant Extracts)
Many skin care products include natural plant extracts as ingredients, mainly because of their anti-inflammatory effects. Examples include aloe vera, licorice, curcumin, green tea, ginko, ginseng, soy, tea tree oil, arnica, bromelain, sunflower oil, safflower oil and chamomile to name but a few. Of these, only a small handful improve the way a scar heals and fades.
VERDICT - THE FOLLOWING BOTANICALS WORK:

Aloe Vera:
- accelerates wound healing
- decreases inflammation
- stimulates new skin growth through amino acids
- promotes healthy healing in the deepest skin layers

Linoleic Acid (Safflower Seed Oil) and Oleic Acid (Sunflower Seed Oil):
- regenerate lipid biolayer crucial for skin moisture
- improve wound healing
- improve scar elasticity
- control production of prostaglandins, one of the skin's main "building blocks."
- prevent disturbance in prostaglandin production which causes poor healing
- lighten dark pigment (hyper-pigmentation)

Licorice extract:
- strong anti-inflammatory
- accelerates skin renewal
- lightens dark pigment and brown spots including melasma (especially when combined with a stable form of vitamin C)
- anti-acne effects (both prevention and treatment)

Onion Extract (eg. Mederma skin care)
Several scientific studies in humans and animals have focused on onion extract, one of the main ingredients in Mederma® skin care products. All showed NO benefit from topical use. Mederma performed no better than plain petroleum gel (or Vaseline®) for scar redness, itchiness, pain, burning, thickness and overall scar appearance.
VERDICT - ONION EXTRACT DOESN'T WORK

Interestingly, most scar treatments on the market contain D4 or D5 silicones, vitamin E, steroids, onion extract, or combinations of these ingredients. Always check the ingredient label to make sure you know exactly what you're buying - that alone will significantly increase your chances of improving your scar's appearance. Also choose a product that can be used in conjunction with sunblock - fresh scars should be protected from the sun for up to 2 years to prevent permanent redness.