Supplement Detective

By Curtis Alexander, Pharm.D.

Summary: From the reports I’ve seen and the patients I’ve talked to I believe that vitamin E can help scars.  I would use a mixed tocopherol product which rules out many cheaper, store-bought brands.  Some studies I’ve seen (quoted by some dermatologists) had some shortcomings.

Q: I’ve read that vitamin E can be helpful for scarring.  Do you think this is worthwhile?  Also, how long would a person need to use it if so.

A: I think vitamin E can help scars.  So do other people who have actually used it.  But if you were to ask a dermatologist, I think they would say no.

Why the difference in opinions?

Junk Science

As usual the mainstream has fallen back onto a study published in the April 1999 edition of Dermatologic Surgery which ’showed’ that vitamin E cream applied topically did not help scars.  And in some cases actually made them worse and caused contact dermatitis.

Now, believe me, I’m not trying to be difficult or sound like a person who always thinks natural therapies are better.  There are cases where I think western medicine is the first choice.  But…this is not one of them.  Why?  Let’s look at this ’study’ and compare it to actual real-world experiences of patients who have seen vitamin E help scarring.

In this study researchers took 15 patients who had undergone skin cancer removal surgery and gave them each two jars.  One labeled A and the other labeled B.  Jar A had just Aquaphor, an emollient.  Jar B had Aquaphor and vitamin E in it.  The scars were then randomly assigned to parts A or B (i.e., put A ointment on part A and B ointment on part B).  This was applied twice daily for 4 weeks.  The physicians and patients independently evaluated the cosmetic appearance of the scars on weeks 1, 4 and 12.  Basically, they said which side of the scar (A or B) looked better.  Finally, a third, blinded investigator (meaning he/she didn’t know what had been applied where) was shown photographs and said which side looked better.

The Results Speak For Themselves…Or Do They?

What the investigators concluded is that vitamin E does not help scars, and in some cases, may actually make them worse.  In addition, they said 33% of participants in the vitamin E group experienced contact dermatitis.

So now, dermatologists everywhere have their answer to the question of can vitamin E help scars.  And, for an overworked, too short on time dermatologist I can understand why they would come to that conclusion.  But, if you take a closer look you can see where this study, like many others, has some serious shortcoming that don’t even give the chance for vitamin E to help scars.

Why?  First of all the treatment time, in my opinion, was far too short.  For example, you have probably heard me say before that you need at the minimum three months to evaluate whether a multivitamin or supplement is helping.  Six months would be even better.  Applying a the vitamin E topically is no different.  So, the four week treatment, in my opinion, was too short to see any real improvement.

Secondly, if I were conducting the study I would have applied the vitamin E in it’s natural form, from breaking open a capsule, and applied directly to the skin without diluting it in an emollient.  Why?  Because this is how many patients say they have been applying the vitamin E to help scars.  Not by applying some kind of diluted cream.

Speaking of diluted creams.  Did you know that so-called vitamin E creams and topical vitamin E oils may not contain what they say they do?  In fact, one vitamin E cream when analyzed only contained 58% of the expected amount of vitamin E.  And a topical oil only had 64% of the claimed amount.  And the majority of that was synthetic.  Not natural like the product claimed.

What does this mean.  No matter what you do you have to stick with a reputable company and one that YOU are comfortable with.

Vitamin E Limits

Now, I’m not saying vitamin E will help all scars.  What I think you need to take into account is the severity of the scars.

For example, I think it is pretty unrealistic (and no sound evidence exists) to show that vitamin E will just make a scar disappear.  In fact, many reports clearly show that what vitamin E does do is make the scar less noticeable.  Meaning, if you were to run your hand over the scar you couldn’t feel it as much.  But, the scar is still visible to the naked eye.

I personally would take vitamin E to help scars.  Mainly for the reason that vitamin E is exceedingly safe, inexpensive and appears to help many patients who are willing to apply it diligently for at least three to six months.

Secondly, I would apply the vitamin E from a high quality, mixed tocopherol vitamin E capsule.

I would not apply a store-bought synthetic brand (dl-alpha-tocopherol).  The reason, to reap the benefits of vitamin E helping scars I think you need all components of vitamin E.  And, in addition, the cheaper store-bought brands use vegetable oil as their filler which can, over time, become rancid.  Not something you want to be putting on your skin.

It’s the same old song and dance of studies from the mainstream showing no benefit (and even warning of harm).  While many other people see vitamin E helping their scars.  It is a battle that will probably wage on forever.  And there will probably never be one concrete answer to the question can vitamin E help scars.

But…you can use the evidence presented from other peoples personal experience to make an informed decision.

I think vitamin E can help scars.  I would use it.  I know people who have used it with decent results.  It’s also inexpensive.  However, you must be diligent in applying it or I think it will probably be a waste of your time and money.

The key is to doing what your comfortable with.  I’m certainly not sold on the idea of vitamin E helping scars.  I do, however, think that it is a fairly safe and inexpensive option that may be worthwhile for some patients.  This appears to already be the case.  However, nothing is 100% failproof.  Vitamin E applied topically can irritate your skin (as is the case with many substances).  So monitor what your doing and let common sense serve as your guide.