TOPICAL STEROIDS FOR SCARS
Topical steroids are often recommended as part of a scar treatment regimen.
The study below evaluated the use of topical steroids for scars and showed they do not improve scar appearance after surgery.
Jenkins M, Alexander JW, MacMillan BG, et al. Failure of topical steroids and vitamin E to reduce postoperative scar formation following reconstructive surgery. J Burn Care Rehabil. 1986 Jul-Aug;7(4):309-12.
One hundred fifty-nine operative procedures for postburn contractures of interdigital webs (96), the axilla (46), or the neck (17) were prospectively randomized to be treated postoperatively for four months with a topical steroid (Aristocort A), topical vitamin e, or the base cream carrier for these drugs. The nature of the medication was blinded both to the patient and to the evaluator. Patients were followed for one year. Observations were made for range of motion, scar thickness, change in graft size, and ultimate cosmetic appearance. No beneficial effect of either vitamin E or topical steroid could be demonstrated. However, adverse reactions occurred on 16.4% of patients receiving active drug, compared to 5.9% treated with only base cream. Interestingly, the grafts initially contracted and subsequently grew to be a larger size (about 20%) than the original graft by one year. It is concluded that neither topical steroid nor topical vitamin E is effective in reducing scar formation for postburn contractures.
Editorial note: this prospective, double-blind, randomized trial shows topical steroids do NOT improve the appearance of scars after surgery for burns.