Topical Vitamin E Application
November 1, 1999 2 minutes read
Topical Vitamin E Application
Abstract & Commentary
Synopsis: Investigators put to a brief test the hypothesis that vitamin E improves cosmetic appearance of surgical scars. They found that, in 90% of the cases in this study, topical vitamin E either had no effect on or actually worsened the cosmetic appearance of scars.
Source: Baumann LS, Spencer J. Dermatol Surg 1999;25: 311-315.
Vitamin e is a generic term for a group of tocol and tocotrienol derivatives. Since the discovery that vitamin E is the major lipid-soluble antioxidant in skin, this substance has been tried for the treatment of almost every type of skin lesion imaginable. Anecdotal reports claim that vitamin E speeds wound healing and improves the cosmetic outcome of burns and other wounds. Several physicians recommend topical vitamin E after skin surgery or resurfacing.
This study attempted to determine whether topically applied vitamin E has any effect on the cosmetic appearance of scars as suggested by multiple anecdotal reports. Fifteen patients who had undergone skin cancer removal through Mohs surgery were enrolled in the double-blinded study. All wounds were primary closed in two layers. After the surgery, the patients were given two ointments labeled A (Aquaphor®, a regular emollient) or B (Aquaphor mixed with vitamin E, added at a concentration of 320 IU/g of d-alpha-tocopherol). The scars themselves were randomly divided into two parts, A and B. Patients were asked to put the A ointment on part A and the B ointment on part B twice daily for four weeks. Evaluation criteria were subjective, and the opinions of patients and treating physicians were recorded at weeks 1, 4, and 12. A third blinded investigator was shown photographs of the outcomes, and rated each side of the 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; 33% of patients developed a contact dermatitis. We conclude that the use of topical vitamin E on surgical wounds should be discouraged.
Comment By John La Puma, MD, FACP
These University of Miami investigators put to a brief test the hypothesis that vitamin E improves cosmetic appearance of surgical scars. But three of their 15 patients dropped out after 48 hours, and two of the 12 remaining dropped out after a week. A sharply marginated, pruritic, erythematous rash erupted on the vitamin E side of five patients’ scars. After 12 weeks, most of the 10 remaining patients and the treating physicians felt that there was no difference in the sides of the scar. (Dr. La Puma is Professor of Nutrition, Kendall College, Director, C.H.E.F. Clinic, C.H.E.F. Skills Research, Alexian Brothers Medical Center, Elk Grove Village, Ill.)
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