TOPICAL VITAMIN E
Over the years, the development of hypertrophic scars has remained an unsolved problem in wound healing. Topical Vitamin E (tocotrienol) is increasingly popular among the public for scar prevention and treatment. A significant number of health professionals believe that topical vitamin E could help in improving the appearance of scars despite the lack of scientific evidence. There is little evidence from well-controlled and randomized clinical trials to justify the beneficial use of Vitamin E in surgical scars. (6)
Studies have suggested the involvement of free radicals in the formation of hypertrophic scars following thermal injuries. This condition may be weakened by the antioxidant properties of Vitamin E that cause scavenging of the free radicals. Vitamin E can inhibit the inflammatory response and collagen synthesis. All these unique properties of Vitamin E may be valuable in modifying undesirable scar formation. (6,13)
Palmieri et al. (1995) conducted a randomized, simple-blind study to evaluate the efficacy of Vitamin E added Silicone gel sheets in the treatment of hypertrophic scars and keloids. Eighty patienst, of both sexes, aged between 18 and 63 years, and have developed hypertrophic scars and keloids after surgery or burns. The time between surgery or burn and the beginning of the treatment ranged between 3 months and 2 years. (10) The preliminary evaluation was related to the patient’s symptoms such as itching, pain, and skin changes (red, swollen, hard to touch, limiting function). Patients were randomized into two groups. Forty patients in Group A had their scar covered with a silicon gel sheet with added vitamin E; forty patients in Group B had their scar covered with a simple silicone gel sheet. All patients wore the plate at night between 10pm and 8am, removed it each morning, and rinsed with tap water.
The study lasted 2 months; subjective and objective findings were kept at weeks 4 and 8. The improvement was scored on a basis of reduced itching and pain. Photographs were also taken at the beginning and at the end of the study. Photographs compared in terms of color, size, and appearance.
Results at the end of 4 weeks showed a significant subjective and objective improvement (more than 50% on score evaluation) in 85% of the cases in Group A, whereas only 55% in Group B showed similar improvement. At the end of 8 weeks, there was improvement in 95% in Group A and 75% in Group B with the same degree of improvement. Thus, the Vitamin E added to silicone gel sheet produced a better scar remodeling effect. The long-term treatment equally improves the results of the two groups. (10)
Khoo et al. (2011) performed a prospective, randomized, double-blinded clinical trial to evaluate the efficacy of 5% topical tocotrienol in the prevention of hypertrophic scar formation. (6) A total of 122 patients were recruited with recently healed (<2 weeks) surgical scars, who were randomized into either a...