The effects of topical vitamin E on the cosmetic appearance of scars. (1999)

Abstract
BACKGROUND:
Vitamin E is a generic term for a group of tocol and tocotrienol derivatives. Since the discovery that vitamin E is the major lipid soluble antioxidant in skin, this substance has been tried for the treatment of almost every type of skin lesion imaginable. Anecdotal reports claim that vitamin E speeds wound healing and improves the cosmetic outcome of burns and other wounds. Many lay people use vitamin E on a regular basis to improve the outcome of scars and several physicians recommend topical vitamin E after skin surgery or resurfacing.
OBJECTIVE:
We attempted to determine whether topically applied vitamin E has any effect on the cosmetic appearance of scars as suggested by multiple anecdotal reports.
METHODS:
Fifteen patients who had undergone skin cancer removal surgery were enrolled in the study. All wounds were primarily closed in 2 layers. After the surgery, the patients were given two ointments each labeled A or B. A was Aquaphor, a regular emollient, and the B was Aquaphor mixed with vitamin E. The scars were randomly divided into parts A and B. Patients were asked to put the A ointment on part A and the B ointment on part B twice daily for 4 weeks. The study was double blinded. The physicians and the patients independently evaluated the scars for cosmetic appearance on Weeks 1, 4, and 12. The criteria was simply to recognize which side of the scar looked better if there was any difference. The patients’ and the physicians’ opinions were recorded. A third blinded investigator was shown photographs of the outcomes and their opinion was also noted.
RESULTS:
The results of this study show that topically applied vitamin E does not help in improving the cosmetic appearance of scars and leads to a high incidence of contact dermatitis.
CONCLUSIONS:
This study shows that there is no benefit to the cosmetic outcome of scars by applying vitamin E after skin surgery and that the application of topical vitamin E may actually be detrimental to the cosmetic appearance of a scar. In 90% of the cases in this study, topical vitamin E either had no effect on, or actually worsened, the cosmetic appearance of scars. Of the patients studied, 33% developed a contact dermatitis to the vitamin E. Therefore we conclude that use of topical vitamin E on surgical wounds should be discouraged.

My comments:

I just looked this up because I had a total knee patient doing leg presses and I commented that her incision looked like it was healing well. She said she had been putting vitamin E on it, and I said I have heard a lot about patients doing that to assist healing and final appearance of their scars. I said, “I wonder if it works,” as I had heard it recommended by physicians, other therapists, and patients over the years. I had always meant to look it up to see if it was true or not. This was the reminder I needed.

The above study found that not only did the vitamin E solution not work, it led to increased complications with 5 of the 15 patients developing an erythematous rash resulting from the vitamin E and none did so with the control solution. At 12 weeks there was no difference in scar appearance judged in 60% of the patients, the control was judged superior in 30%, and the vitamin E superior in only 10% of the patients.

So I think the use of topical vitamin E for scar healing has developed into an urban legend, for which one can look at as a glass half empty or a glass half full. The glass half full conclusion is that most patients are pleased with the healing of their incisions and anecdotal reports of good outcomes with the use of topically applied vitamin E would likely have been at least as good without it. In the future patients can save money by not purchasing vitamin E oil or ointment. What’s interesting is that this study is 15 years old and it’s the first I heard of in only after I looked specifically for it. Medical myths die slow.