Contractubex showed best results in the prevention of pathological scars .
BACKGROUND The treatment and prevention of  hypertrophic scars and keloids  represents a special challenge particularly in plastic surgery .
Given their simple , non-invasive and painless application , topical preparations are an attractive therapeutic option .
On the part of the patients , the efficacy in prevention of and therapy for hypertrophic scars and keloids of these topical preparations is regularly question ed .
The clarification of this issue is subject of this review .
A comparative study evaluating the tolerability and efficacy of two topical therapies for the treatment of keloids and hypertrophic scars.
BACKGROUND Onion extract gel ( OE ) and 0.5 % hydrocortisone , silicone and vitamin E lotion ( HSE ) are two over-the-counter preparations used to enhance the cosmesis of keloids and hypertrophic scars . OBJECTIVE To determine the tolerability and efficacy of OE versus HSE versus placebo in subjects with keloids and hypertrophic scars . METHODS Thirty subjects ( > or = 18 years ) with keloids or hypertrophic scars were r and omly assigned to one of three study preparations for 16 weeks . Scar volume was measured at baseline and weeks 4 , 8 , 12 and 16 . Subjects and blinded investigators assessed scar parameters ( in duration , erythema , pigmentation alteration , pain , itching , tenderness and cosmetic appearance ) and patient satisfaction at each visit using a visual analog scale ( VAS ) . Data analysis included : mean percentage change ( MPC ) for subjects completing the study ( n = 15 ) ; the mixed model test to determine differences between the groups over time ; and the Kruskal-Wallis test for the analysis of differences in subjects ' satisfaction within the three groups over 16 weeks for subjects who completed at least one follow-up visit ( n = 21 ) . RESULTS All three preparations were well tolerated with the exception of a mild acneiform-like eruption in one OE patient . Significant improvements were obtained with OE in volume , length , width and in duration and with  HSE in volume , length , in duration , erythema and pigmentation alteration . There was a trend showing that a higher percentage of subjects were satisfied with OE than with HSE or placebo . The Mix Model Analysis ( MMA ) showed significant improvements with OE over placebo in investigator cosmetic assessment , lesion in duration , pigmentation and tenderness and with  HSE  over placebo in investigator cosmetic assessment , lesion in duration , pigmentation and erythema . Improvements in erythema and pigmentation were significantly greater in HSE than in OE . CONCLUSION Both OE and HSE were more effective than placebo in the management of hypertrophic scars and keloids
Contractubex showed best results in the prevention of pathological scars .
BACKGROUND The treatment and prevention of  hypertrophic scars and keloids  represents a special challenge particularly in plastic surgery .
Given their simple , non-invasive and painless application , topical preparations are an attractive therapeutic option .
On the part of the patients , the efficacy in prevention of and therapy for hypertrophic scars and keloids of these topical preparations is regularly question ed .
The clarification of this issue is subject of this review .