Which Scar Cream? Look For These Safe, Effective Ingredients

Whether from surgery, trauma, pregnancy or acne, scars can be problematic or even embarrassing. A safe, effective scar cream can be hard to find though. There are so many over the counter (OTC) products to choose from and they all make the same amazing claims. So where do you start? Do your research before you spend the money. If you can, check the medical literature. 
While virtually all scar products make amazing claims, very few have any scientific evidence to back these up. Most people are left disappointed when the results fall well short of their expectations. 
Vitamin E is the perfect example. Most people think vitamin E is the best treatment for scars. In reality it causes contact dermatitis in 33% of people who use it topically and it doesn't even do anything for scar healing! Scientific and clinical studies have shown this time and time again yet scar products continue to include it as an ingredient because of marketing.... because people expect it. Onion extract is another example. What do the studies show?.... It is no better than plain petroleum jelly (ie Vaseline) when it comes to improving scar appearance. On the other hand, vitamin C improves scar healing and appearance.
Silicone is another ingredient shown by multiple studies to be very effective in fading, flattening and softening scars. In fact, silicone (gel and sheeting) is the gold standard when it comes to scar therapy. 
Most skin creams contain some sort of preservative like a paraben or a formaldehyde. These are needed to stop growth of bacteria which feed off the water in the cream. These bacteria are typically introduced and contaminate the cream once the tube or container is opened. Unfortunately, these chemicals can be extremely irritating, causing contact dermatitis in up to 9% of people. 
To increase you chances of healing well, it is important you take care of your wound properly from the get-go. All fresh wounds must be kept clean and it's also a good idea to keep them covered for the first few days. Washing gently is recommended as long as you use clean water and a gentle soap (like Dial). 
Some wounds will need a fresh dressing up to 3 times a day (ask your doctor). Many people use peroxide. This is fine to use to clean a dirty wound initially but once the wound is clean, stop using it. Peroxide cleans wounds very well but also prevents healing. It takes time for scars to improve, up to 2 years in fact. 
Even the most effective topical therapies usually need to be used for several weeks before improvement is seen. Start using your treatment of choice as soon as the skin heals over (or your sutures are removed), and keep using it as long as the scar continues to fade and improve. 
Sun block is crucial for protecting newer scars. Prolonged sun exposure can cause progressive and permanent redness. Fresh scars repeatedly exposed to the sun can also turn very dark. Protection from the sun should continue at least until the scar is 2 years old. Once scars are over 2 years old, color changes are much less likely with sun exposure. 
Finally, scar massage helps break down scar tissue which helps soften and flatten scars. This is why most plastic surgeons recommend it. Massage your product of choice into your scar firmly for the best results.