well hey guys what's up I'm just putting

a little of the Sara B skin renewing gel

oil on my lips I mentioned this in my

review video of this of this line I've

been enjoying kind of putting it on my

lips as just a little way to to shine

them up so yeah it is it's the end of

the day and my goodness it is boiling

hot here today not to rub it in

everyone's face who's freezing right now

because it is February but yeah it was

like 80 degrees he's at one point today

so it's kind of shorts weather or

whatever reason but who knows that'll

probably change in the blink of an eye

and I'll be freezing again anyways

ramblings aside as you can tell from the

title and thumbnail today's video I'm

going to talk about different

ingredients to look for in creams

intended to improve the appearance of

scars I have many videos on acne scars

hypertrophic scars keloid scars

different types of treatments for them

as far as what we do in the clinic to

treat these different types of scars

post acne hyperpigmentation

and post acne redness I've videos on

those as well but in today's video I'm

going to talk about some of the

ingredients namely a lot of the plant

derived ingredients that are that are

found in scar creams what the evidence

to support their use is if any scarring

occurs because the normal processes that

go into play when we have skin injury

for whatever reason the balance between

breaking down and building that has to

occur that balance is skewed and as a

result tips the tips towards more of the

building and less of the breakdown

aspect of skin injury and repair and as

a result you're left with a persistent

thick scar scars are permanent there is

not a cream or anything that is going to

melt them away they are permanent they

can however be removed through a variety

of surgical procedures

there are a variety of cosmetic

procedures that that would do in clinic

that help the appearance of scars and

help them to appear as though they're

not there none of these ingredients are

going to completely remove this scar but

they can't improve the appearance

probably the most evidence-based

intervention for improving the

appearance of scars are preventing the

formation of scars is using a silicone

gel at the time of injury and for a

continued period of time silicone

improves the elasticity of the injured

skin it improves the color it can also

improve the firmness and the overall

stretch can help the skin behave as it's

healing it can help it behave as it's

supposed to and kind of dyed everything

back into place it also will improve use

of a silicone containing scar cream also

will result in a better outcome in terms

of the color of the scar not only the

pigment so it will reduce the chances of

the scar healing with a dark stain but

it also will reduce the chances of the

scar healing with a lot of redness so

this is important for those of you out

there you suffer from post post acne

redness for example that redness that

persists for a long time after an acne

cyst is healed or for those of you who

have have scarring acne that heals with

a dark mark use of a silicone containing

the cream to that injured acne cyst can

improve down the road potentially or

improve the chances of you having a

better outcome of healing but also very

important during this stage is to keep

the injured skin hydrated I think

probably the largest misconception after

skin injury whether it be from cystic

scarring acne that's injured the skin or

a an external wound is that people think

that you need to dry it out and that is

actually the worst thing you can do you

want to keep the injury

skin hydrated because all of those

factors all of those little signaling

molecules all of those inflammatory

cells and your proliferating skin cells

they need a nice hydrated environment to

flow into into the healing into the

healing wound bed if that is dry it it

stands in the way of that and also

drives inflammation into the skin in the

wrong direction so away from healing and

towards towards kind of the response to

increased trans epidermal water loss and

keeping the injured skin hydrated is

really important for the cosmetic

outcome of injury the other advantage of

silicon and silicon scar creams is that

it provides an occlusive barrier on the

healing tissue to prevent any kind of

external forces from from agitating that

healing tissue and skewing the balance

of breakdown versus build up that

subsequently will lead to scars so it

really can just keep the skin on

lubricated hydrated supple but also also

serve as a barrier to external insults

like friction scars are more common and

more noticeable on areas of the body

where there's a lot of frictional forces

and a lot of tension forces so the

middle of the chest and women is a

common area to develop thick scars I'll

say this the jaw area with healing acne

the tension of the facial muscles favors

the formation of scars either with acne

or with with ingrown hairs you can see

scar formation in those areas so keeping

the area hydrated on decreasing some of

those forces with silicone but the skill

silicone scar gel is one way to do it

and even better are silicone scar sheets

because they can go on top of the on top

of the wound and provide an additional

an additional occlusive bearer not only

to external external horses but also to

you a little bacteria and things getting

in there

and contaminating room so silicone gels

are one of the most evidence-based

interventions for reducing a chances of

a disfiguring scar forming or improving

the appearance of existing scars even

existing scars if you use if you keep

the the the area hydrated with a

silicone containing product it can

improve the appearance of that scar

again not gonna take it away but I can

make make for a better better appearing

scar alongside silicone there's also

very evidence based for scar minimizing

the chances of a disfiguring scar

improving existing scars are the use of

hyaluronic acid containing containing

products so hyaluronic acid is a natural

hydrator that is present in the deeper

layers of the skin so it really just

serves as a humectant to plump up and

hydrate the tissue as it's healing and

again facilitate facilitate proper

response to injury it can help to

replenish some of the extracellular it's

called the extracellular matrix are kind

of thick building structure the

groundwork of that healing wound so by

and foe by and large the most

evidence-based and well studied

interventions are silicone and

hyaluronic acids the other ingredient

that will pop up as vitamin C vitamin C

is an antioxidant and it serves to

neutralize free radicals that can

subsequently damage that collagen that's

trying to be formed properly in the

healing healing skin so there's

enthusiasm for using vitamin C vitamin C

also is a key cofactor in building

collagen so you know it makes sense

perhaps not putting college putting

vitamin C on the skin that's injured

would be helpful for wound healing to be

honest though we don't have a lot of

data of showing vitamin C to be helpful

for improving the appearance of existing

scars or formation of scars

it is frequently present a lot of scar

creams though vitamin C suffers the

limitation and that it's pretty unstable


topical forms and degrades very easily

it's oxidized and when it's oxidized

it's not it's no longer infected and

it's very irritating sponges made a pile

erotic acid that are impregnated with

vitamin C when they are applied to woo

post surgical wounds that has been shown

to to improve the Cosmi sense of the

surgical scar however how that compares

to just the hyaluronic acid microspheres

with the use of hyaluronic acid by

itself which we already know is helpful

and then there's also a silicone

containing gel that has vitamin C in it

which has been shown to be helpful for

the improvement of the appearance of

scars but again it's silicone by itself

does that so it's hard to say for sure

so in short you know vitamin C topically

can be very irritating whether it be a

serum cream what-have-you it can

potentially be irritating and its

ability to act as an antioxidant is

often limited due to its stability all

right but along with same vein as a

vitamin C and vitamin C is an

antioxidant people asked all the time

about putting vitamin E on a wound or on

a scar can that help specifically

everybody is very enthusiastic about

breaking open vitamin E capsules and

putting them on a scar there's actually

a randomized control trial that looked

at the application of vitamin E to a

scar versus nothing and showed no

difference then there was another there

was another clinical trial that actually

looked at application of vitamin E out

of out of the capsules like you guys are

always asking me about out of the

capsules versus versus just plain plain


and they showed that actually the the

vitamin E was not helpful the vitamin E

was very irritating to many people

30 33 30 to 33 percent of people in the

study developed a

sensitivity and subsequent allergy to to

copper all or vitamin E and many people

in the study had a worst outcome with

use of vitamin E applied to apply to

this card now this time was using food

grade vitamin E like in the capsules to

confer all that you will find in skin

care products is mana is different and

is thought to be less irritating and

less allergenic so moisturizers and

things that will often have to copper

all added as an antioxidant to protect

the integrity of the product in the

bottle not so much to offer any benefit

to the user and that form of vitamin E

took off for all and in cosmetic

products is is thought to be less

irritating less less allergenic but the

but the food grade vitamin E is

discouraged from from doing that it's

just been actually been shown to to

worst of the appearance of scars so I I

don't recommend doing that but I know it

is popular then the other ingredient

that I think it's a lot of attention is

onion extract onion extract is what is

in the derma e ScarJo and then what is

in Mederma onion extract is actually

nante like vitamin c and vitamin e an

antioxidant so it can scavenge free

radicals that would get in the way of

proper injury healing and its

anti-inflammatory so kind of helps to

keep the keep the inflammatory response

in the wound right where it needs to be

potentially rather than skewing it away

towards a towards a an abnormal side of

things and it's also anti-infective so

theoretically it could help prevent

infection of the healing of the injured

skin and that infection you know would

subsequently compromise the compromise

the healing of the wound but as an

anti-infective maybe that would be

helpful it contains something called

curse eaten which is a compound that can

stabilize some of the cells in the

immune system help them to function

better and can inhibit abnormal

proliferation of the cells that put out

collagen which is

helpful because that's kind of what

leads to thick scars is the cells called

fibroblasts there they're just going

going to town and doing - too much

building too much of the wrong thing and

so curse eaten from onion extract

potentially could help that there was a

rabbit study in a rabbit ear model

looking at onion extract and that

actually showed the rabbit ear model of

skin injury and improvement in the in

wound healing

so then subsequently you know it's found

its way into a lot of scar creams like I

already said Mederma and that kind of

thing so there's one there was actually

a randomized control trial looking at

onion extract containing cream versus

just plain petrolatum like Vaseline and

that study showed no difference between

onion extract and just plain Vaseline in

terms of the appearance of the scar scar

formation at the time when applied at

the time of injury and for a period of

time thereafter then there was another

trial that actually looked at scars with

onion extract and versus versus control

and then the scars treated with onion

extract actually had were more red more

irritated and there was no difference in

terms of the thickness and overall

overall shape of the scar they were just

more red irritated so if anything onion

extract might not be such a good

ingredient particularly if you were

somebody who makes red scars your acne

heals with the red mark might not be it

might not be the best choice I don't

recommend mederma because because of

that the other ingredient that holds a

lot of promise is a plant derived

ingredients until a ad attica the asian

pennywort this contains a variety of

compounds that are anti-inflammatory and

it has been kind of a dietary it's been

looked at as a dietary supplement and

wound healing and individuals consuming

225 milligrams a day of centella

asiatica and a capsule form had better

better wound wound healing than those

who did not so there are some laboratory


some models of wounding that show that

application of centella asiatica can

help to control some of the abnormal

fibroblast proliferation that leads to

scarring stimulate some of the processes

that down regulate excessive scarring

so if centella asiatica is very

promising as an ingredient for scar scar

intervention but again there's not there

aren't any

randomized control large trials to to

substantiate those so you know stay

tuned it isn't a lot of scar creams and

seems to be well tolerated and seems to

be helpful but we don't have we don't

have a lot many studies to to really say

that for sure the other ingredient that

I get questions about all the time in

fact people were alarmed that I had

reservations about it in my t.j.maxx

video is turmeric or specifically the

the compound within turmeric curcumin

curcumin czar very rich in antioxidants

and they can theoretically help to

facilitate reopen theorization or

healing over of the skin and they're

also antibacterial the problem with

curcumin is in our you know turmeric

curcumin in ingesting them and so they

have kind of a low bioavailability so

it's hard to say what the appropriate

dosage would be however the issue with

putting it on the skin as a few things

first of all it's very alkaline because

it is so alkaline meaning it has a high

ph the skin house has an acidic ph it

can be incredibly irritating the other

issue with curcumin is not it has a low

solubility in and so it's really

difficult to get it to go into into

moisturizer into creams and things like

that and then the third issue with it is

that it stains the skin so those things

kind of kind of have limited its making

its way into mainstream mainstream

interventions for scars or scar

treatments and so it's really more about

figuring out how to use it in a way that

is bioavailable and effective so that we

can study it so at this point

inadequate studies and what we know

about the chemistry it suggests that

it's irritating and you know I've seen

people doing doing turmeric masks I

resent what it with a really bad you

turn dermatitis from doing that I don't

recommend it but I know it is I know it

is popular then the last ingredient that

appears a lot in skincare products so I

think it's worth is worth considering

and it seems to be low low risk you know

no harm no foul at any rate a sea

buckthorn and it's what is in the

stretch of liquid gold I'm reviewed a

long time ago sea buckthorn is rich in

antioxidants again like like most of

these ingredients of interest and it has

been shown to help protect cells so that

they're not they're not as susceptible

to injury so that's important during

during the all those stages of healing

healing injured skin when all these

different cell types come in and it's

also rich in kind of immune modulating

compounds that can help the help the

immune system act in accordance with

what it's supposed to do within the

within the healing tissue so there's a

lot of potential there for sea buckthorn

there is an ant there's some animal

studies showing that it can improve and

accelerate wound healing which you know

you can postulate with subsequently

result in better appearing scars so sea

buckthorn is promising as is centella

asiatica but just don't have just don't

have the studies at this point so far

away my number one recommendation for

reducing the chances of a bad scar

forming are to use a silicone silicone

gel or skill silicone scar sheet

basically to keep with the with the with

the idea in mind that what you're what

you're hoping to accomplish here is to

keep the keep the area hydrated and keep

it protected that's why i like the

sheets because they actually provide a

physical barrier they're a little hard

to wear all the time

so the silicon based scar gel scar

creams are a really good way to go i

like scar away

you know that does what I recommend

outside the silicone scar gel and scar

sheets honestly just keeping just

keeping it hydrated with a little plain

Vaseline is probably your best bet a

little plain Vaseline and keeping it

covered not only is keeping it covered a

good idea to reduce those external

forces but also it's going to help

protect it for them from exposure to Sun

when when that healing tissue is exposed

to Sun and exposed to UV even UV that

comes through clouds on a gray day or

comes through the window comes through

your car that will that will disrupt

that balance of choreography that has to

go on to heal the skin properly not only

that but it will it will tilt everything

over in a direction that favors healing

with a dark mark a dark stain so that's

called post inflammatory

hyperpigmentation so putting putting

some plain Vaseline some plain ointment

on and then covering it up with with a

bandage is a great way to go doesn't

have to be a fancy fancy and greet

doesn't have to be a fancy product at

all in fact you know oftentimes the

fancier the more risky because they

don't have a lot of irritating

ingredients that if anything can only

cause problems you know I mentioned

vaseline is an option I love the Sarah V

healing ointment another just nice

pointment for those of you guys in the

UK and Australia is the Q V intensive

pointment have you guys used this I got

this on Amazon UK we don't have it in

the United States you know you can't buy

it here in the States but you know we

have plenty of ointments so you know you

know how to feel like you have to import

this to the States I'm just bringing it

up here for for my viewers in other

countries to let them know that if they

have this in their bathroom this is a

great option as well you know I started

out the video putting the Sara V skin

renewing gel oil on my lips but this is

also a reasonable a reasonable choice to

put on to put on a on injured you know

on on a scar scars can be very itchy and

dry and this will help keep it hydrated

I just make it feel better it will help

the suppleness so this isn't this is a

good one then in terms of this scintilla

AC Attica a really good good way to go

to pursue that is the LA roche-posay

stick up last bone b5

this contains centella asiatica it's

very occlusive it's it's almost like an

ointment because it has it has an

ingredient called panthenol which makes

things really kind of sticky and viscous

so this is really nice on on a scar if

you know it it prevents it prevents loss

of water because it's nice and inclusive

it's a little sticky and tacky so again

I was with any of these it's a good idea

to go come on over just with a bandage

so that's another option and one not

that I enjoy this this can also you know

you can also use these things if you're

somebody who has healing acne these will

not clog pores so they're fine on the

face so my acne spot video I mentioned

the pimple patches from cause or X I'm a

huge fan of those because they they help

to they help to protect that healing

acne bump not only from frictional

forces keep it hydrated so they can heal

properly but also they protect it from

sun so I'm a fan of those they are

difficult to wear 24/7 if you are

motivated to that is a good way to go

but these creams and ointments that I

mentioned Vaseline included they can be

applied to a healing acne balm you know

I said in the beginning of the video the

compulsion or the desire is always to

dry things out that's actually the last

thing you want to do

keeping the healing acne balm hydrated

and you know keeping it protected with a

physical barrier can actually help the

healthy improve the appearance of that

healing acne balm but anyways guys I

hope this video is helpful to you if you

liked it give it a thumbs up share it

with your friends and as always don't

forget sunscreen and subscribe I'll talk

to you guys tomorrow