The effects of topical vitamin E on the cosmetic appearance of scars

BACKGROUND. Vitamin E is a generic term for a group of tocol and tocotrieno l derivatives. Since the discovery that vitamin E is the major lipid solubl e antioxidant in skin, this substance has been tried for the treatment of a lmost every type of skin lesion imaginable. Anecdotal reports claim that vi tamin 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 aft er skin surgery or resurfacing, OBJECTIVE. We attempted to determine whether topically applied vitamin E ha s any effect on the cosmetic appearance of scars as suggested by multiple a nectodal reports. METHODS. Fifteen patients who had undergone skin cancer removal surgery wer e enrolled in the study. All wounds were primarily dosed 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 vitami n E. The scars were randomly divided into parts A and B. Patients were aske d 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, an d 12. The criteria was simply to recognize which side of the scar looked be tter if there was any difference. The patients' and the physicians' opinion s 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 do es not help in improving the cosmetic appearance of scars and Leads to a hi gh incidence of contact dermatitis. CONCLUSIONS. This study shows that there is no benefit to the cosmetic outc ome of scars by applying vitamin E after skin surgery and that the applicat ion of topical vitamin E may actually be detrimental to the cosmetic appear ance 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 s hould be discouraged.