The Role of Topical Vitamin E in Scar Management: A Systematic Review

The practice of prescribing vitamin E after surgery for scar prevention and treatment is widespread and increasingly popular among both the public and clinicians. However, very little evidence exists for this "ritual." This review was undertaken to critically analyze the current literature about the effect of vitamin E on treating scars. The Cochrane, Medline, and PubMed databases were searched based on the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). The studies and levels of recommendation were graded according to the American Society of Plastic Surgeons (ASPS) criteria. Only prospective studies were included. Only six studies met the inclusion criteria. Of these six included studies, three reported a significant improvement in the cosmetic appearance of scars when using vitamin E: one study used topical vitamin E in white children as monotherapy, and two studies used vitamin E in an adult population as combination therapy. The other three selected studies showed no significant improvement in scar appearance when using topical vitamin E as monotherapy. Two of the six included studies reported adverse events of vitamin E application: contact dermatitis and increased incidence of itching and rash. We conclude that there is not yet sufficient evidence that monotherapy with topical vitamin E has a significant beneficial effect on scar appearance to justify its widespread use. Further prospective studies with vitamin E monotherapy and/or combination therapy are warranted to draw better conclusions regarding the value of vitamin E in the management of scar healing.