Scar therapy and management represent a significant part of today’s dermatologic and skin repair industries. In recent years, the realm of online retail opened the flood gates to countless scar reduction creams, oils, and gels. Advertisements for many of these products all claim to achieve similar results: flatter, smoother, and less noticeable scars after injury or surgery. One brand that has garnered much unwarranted attention over the years is Mederma, a popular scar gel that contains cepalin, an onion extract. There is a number of conflicting sources that seems to indicate no topical or cosmetic benefits are obtained by applying onion extract to one’s scar. In this article, we will further investigate the pharmacological effects of Mederma to find out if it really does what its advertisers claim. We will then compare Mederma to medical grade silicone, a clinically-proven solution to post-operative scar management.

Continue reading to dig into the Mederma myth and to discover a clinically-proven scar therapy alternative.

The truth about Mederma

The first observation we can make about Mederma’s Advanced Scar Gel is the ingredients list. Cepalin—an onion derivative and proprietary component that distinguishes it from other scar gels—is labelled as an inactive ingredient. Inactive ingredients are compounds found in pharmaceuticals and other therapeutic products that have no verified pharmacological effects. In other words, there is no observable evidence to support the claim that cepalin is an anti-inflammatory agent that flattens and reduces the appearance of scars. This raises eyebrows, given the fact that Merz Pharmaceuticals, the manufacturers of Mederma, markets cepalin as a proven and effective topical solution that prevents scar tissue overgrowth.

This leaves us to examine Mederma’s active ingredient, allantoin. Active ingredients are those components of a drug approved by the FDA that have direct therapeutic effects intended to mitigate a certain condition. Allantoin, then, would be Mederma’s primary ingredient that supposedly helps reduce scar tissue and restore skin elasticity. But what exactly is allantoin? And in what way does it target scar tissue to prevent its overgrowth? Allantoin is a chemical compound that can be found occurring naturally in animals, plants, and bacteria, or created synthetically in a lab. In most mammals, excluding humans, allantoin is excreted in urine after uric acid (a normal component of urine formed in the liver) is converted by the uricase enzyme. The reason we don’t excrete allantoin is because the uricase enzyme is absent in humans.

Allantoin created synthetically in the lab is what is used in make skin care products on the market today. This type of allantoin comes in the form of a white odorless powder that is used in many cosmetic and self-care products as a moisturizer and “skin protectant.” In the United States, skin protectants are found in many over-the-counter (OTC) products that supposedly guard damaged skin against irritants and other external stimuli.

So is Mederma’s only claim to fame its ability to protect scars from outside agents? Granted, Mederma does help hydrate the skin, which is vital for wound-repair. But wound hydration can easily be achieved through a number of other methods. There is nothing that stands out with Mederma as an effective scar treatment solution. And in numerous studies that can be found online, including statements published by the American Academy of Dermatology (AAD), onion extract has not been found to improve scar appearance. Scars treated with onion extract versus a common store-bought emollient, like petroleum jelly, seem to have the same effects on scar height, itchiness, and erythema (redness).

Silicone gel sheeting and silicone ointments for scar therapy

Medical grade silicone is a safe and effective topical solution to scar management backed by over 30 years of clinical studies. Silicone gel sheeting works by inducing hydration at the stratum corneum and regulating collagen production at the wound site. Because silicone is semi-permeable, it permits an appropriate amount of oxygen to envelop the scar bed while preventing moisture loss, which occurs excessively in damaged skin. The balance of moisture and oxygen facilitated by silicone gel sheeting creates an optimal wound-repair environment, otherwise known as homeostasis. By encapsulating moisture at the scar site, keratinocyte and fibroblast cells in the dermis (middle) layer of the skin are signaled to scale back collagen production. This helps to soften and flatten scars that would otherwise become raised and lumpy from collagen overproduction, often a natural but undesirable part of wound-healing.

Medical grade silicone comes in a variety of unique forms including gel sheets, ointments, and sticks. These options and many more make scar management convenient and specific to each individual’s post-operative needs. Ask your surgeon if silicone gel sheeting is right for you, or explore products at biodermis.com.

Biodermis is an innovative market leader with 30 years of expertise in the medical silicone industry. Visit Biodermis.com today to explore a complete range of scar management and post-operative care solutions.
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