Media release

From: The University of Adelaide

Not all moisturisers are equal when it comes to scar management, according to new research by University of Adelaide experts and researchers at the Royal Adelaide Hospital.

PhD candidate Tanja Klotz, who is also an Occupational Therapist with the Royal Adelaide Hospital's burns unit, researches the effects generic moisturisers have on hydration and TransEpidermal Water Loss (TEWL) for people with active, linear, widespread or keloid scaring.

Normally, water passively evaporates from the skin's surface, but when the skin barrier is impaired by factors like harsh skincare, environmental damage, wounds or scars, the water loss increases, leading to dehydration and increased scar activity.

Eight common moisturising products were tested on normal skin in a scar model, with the findings published in the journal Burns.

"The aim of this study was to help clinicians make informed recommendations for scar treatment," says Miss Klotz.

"We tell recovering patients about the importance of massage, moisturising and using pressure garments -- there are evidence-based guidelines around best practice for massage and compression, but moisturiser is something that remains up to each clinician.

"We found that there was significant variability in the effectiveness of common moisturisers clinicians recommend for scar management.

"Silicone gel sheets are widely used to manage scars and are made of a soft, flexible silicone material which is designed to provide a barrier against TEWL.  The evidence base for the use of these is extensive.

"We were surprised that the gel sheets had a high hydration level, but also recorded a high TEWL due to all the hydration evaporating on removal, while a liquid silicone gel performed poorly for improving hydration and reducing TEWL."

Eucerin Advanced Repair Cream, an American product which can be purchased online ranked the best, while Redwin Sorbolene cream was third best.

"Eucerin efficacy in increasing hydration can be attributed not only to its formulation as an oil-in-water emulsion but also to the presence of glycerine and urea as the primary active ingredients after water," says Miss Klotz.

"In contrast, the products with the lowest hydration efficacy were Alhydran, Strataderm (a gel silicone) and BioOil which were the most expensive, and they all -- besides Alhyrdran showed limited ability to normalise TEWL.

"These findings highlight that higher cost does not necessarily correlate with superior outcomes."