Comparison of the Effectiveness of Onion Extract, Topical Steroid, and Petrolatum Emollient in Cosmetic Appearance of Upper Blepharoplasty Scar

Evaluating efficacy and safety of the topical silicone gel containing onion extract in the treatment of post-cesarean surgical scars

BACKGROUND

Cesarean section scars are post-surgical problems in women. Many active ingredients have been found to diminish scar formation. Clinical investigations on the onion extract have gained more attention due to its properties, such as improvement of scar appearance and texture. However, published studies evaluating the usefulness of the onion extract in the treatment of scars are controversial.

METHODS

The three-month study period followed a prospective, randomized, and double-blinded design. Each enrolled subject's post-cesarean completely sealed wounds were divided into two halves along the closure axis. Each half was randomly assigned to the treatment with either silicone gel containing 5% onion extract or the silicone gel containing vitamin C. All subjects were respectively evaluated at the one, two, and three months of the treatment.

RESULTS

After the three-month follow-up, there was a statistically significant difference in scar improvement between before and after treatment. None of statistically significant difference in the Patient and Observer Scar Assessment Scale (POSAS) and Vancouver Scar Scale (VSS) scores and melanin value was found between silicone gel containing 5% onion extract and the control silicone gel. However, the improvement of scar erythema by treatment with the silicone gel containing 5% onion extract was significantly greater than in the control group. No adverse effects were reported in either group.

Topical onion juice mitigates the morphological alterations of the cornea in the aged male rats

Aging is associated with structural and functional changes of the cornea. Fresh onion juice contains phenolic compounds and flavonoids that may provide an anti-aging effect. The aim of this study was to assess the ability of the onion juice to ameliorate these aging changes. Rats were grouped as adult and aged groups. Rats of both groups received eye drops of diluted onion juice in their right eyes every 8 hours for 12 weeks, while the left ones were served as control eyes. The corneas of both eyes underwent histopathological, immunohistochemical and morphometric assessments, in addition to measuring their intraocular pressure (IOP). The aged group exhibited a significantly elevated IOP, decreased tear secretion, degenerated corneal epithelium and endothelium, surface erosions and stromal edema with irregular collagen fibers. Administration of onion juice led to lowering of IOP, significant increase in tearing, restoration of most of epithelial, endothelial and stromal integrity, and increased epithelial, keratocystic and endothelial cell densities. Immunohistochemically, the epithelium and endothelium revealed positive immune reactions for both epidermal growth factor receptor (EGFR) and paired box protein-6 (PAX6) in the control and onion-treated corneas of the adult group, while these immune reactions were negative in the untreated aged ones. Onion drops in aged corneas showed a positive immune reaction for EFGR and PAX6 involving the epithelial and endothelial layers. In conclusion, topical onion juice improves corneal aging changes through its direct effect, and indirectly through lowering IOP and enhancing tear secretion.