Moisturising

This has to be one of the questions I’m asked most often.

Which cream should I use on my scar?

And you might expect there to be a fairly straightforward answer. After all, moisturising sounds like one of the simplest things we do in scar care.

But simple doesn’t mean unimportant. Moisturising is actually one of the most important things you can do for newly healed and scarred skin.

First, let’s talk about why we moisturise scars at all.

Newly healed skin isn’t quite behaving like normal skin yet. One of the important jobs of healthy skin is to act as a barrier and stop too much water escaping from the body. After a wound has healed, that barrier can take time to recover properly, and water can be lost more readily through the skin. You may hear this described as transepidermal water loss, or TEWL.

Scarred skin may also have lost some of the normal structures within the skin, including sebaceous glands, which help produce its natural oils.

So newly healed skin can become dry easily.

And dryness isn’t just uncomfortable. The hydration of the outer layer of the skin appears to influence communication between the cells in the epidermis and the deeper cells involved in scar formation. Dry keratinocytes — cells in the outer layer of our skin — can send signals that encourage fibroblasts deeper in the skin to become more active.

Fibroblasts are the cells responsible for producing much of the collagen in a scar.

So keeping newly healed skin appropriately hydrated isn’t simply about making it feel more comfortable. There are good biological reasons why hydration matters during scar development.

It can also make a real difference to itch. Newly healed skin can be dry, tight and incredibly itchy. Keeping it well moisturised can help calm some of that down, improve comfort and help the area become less fragile.

One important proviso: I’m talking here about skin that has healed. If you still have an open wound or areas that haven’t completely healed, what you put on them is a different question and needs appropriate wound-care advice.

Which moisturiser?

This is where things become much less certain.

Research by Tanja Klotz and colleagues in Australia gives a rather wonderful illustration of the problem. In one survey of burn therapists, 53 clinicians reported recommending 29 different moisturisers. Only three were able to provide published evidence supporting the moisturiser they recommended.

An earlier systematic review by the same research group found remarkably little good-quality evidence to tell us which moisturiser was best.

That doesn’t mean moisturising isn’t important. It means we have much better reasons for saying “moisturise your scar” than we do for saying “this is the moisturiser you must use.”

There are an enormous number of creams, oils and products marketed for scars, sometimes at considerable cost. I regularly meet people who arrive at their first appointment with a collection of expensive products they have bought because they were told they would improve their scar.

Expensive does not necessarily mean better.

And being marketed as a “scar cream” certainly doesn’t mean that there is good evidence behind it. As I talk about in Scar Removal, I would be particularly cautious about creams that claim to remove scars completely.

Sometimes, when you actually look for the evidence supporting a heavily marketed product or ingredient, there is surprisingly little there.

Vitamin E is a good example. It is probably one of the ingredients most commonly associated with scar treatment, yet the evidence does not show a convincing benefit for improving scars, and topical vitamin E can cause skin reactions in some people.

So “everyone knows it’s good for scars” and “we have good evidence that it works” are not necessarily the same thing.

If you want to explore some of the different ingredients and products used in scar creams, My Scar Specialist has a useful overview here.

And if you hear great things about a particular scar cream, do a little digging. There are now websites and apps that can help you understand what is actually in a product, but I’d also search for the evidence behind the product itself. Try searching the product name alongside words such as “scar”, “clinical trial” or “research”. You may be surprised by how much - or how little - you find.

Just remember that finding a study and knowing how much weight to give it are two different things. A small study, a company-funded study and several good independent clinical trials don’t all tell us the same thing.

In my practice, I’m interested in both the evidence and what I observe clinically.

I’ve been a fan of Alhydran for many years. I originally became interested in it after reading research looking at its ability to reduce water loss from the skin, and I’ve found it very useful clinically for some patients. I have no commercial relationship with Alhydran or with any other moisturiser company, and receive no benefit from recommending it.

More recent research makes the story even more interesting. A 2025 study by Klotz and colleagues comparing commonly recommended moisturisers found differences between products, with Eucerin performing particularly well in their experimental scar model. Alhydran did not perform as strongly across all the measures studied.

Does that mean I immediately stop using something I’ve found clinically useful for years? No.

But it makes me think. It adds another piece of information. And it may influence what I recommend as the evidence develops.

I’m always exploring. At the moment, there are products from La Roche-Posay and Avène that I also often like clinically, and for scars on the body I often use products from the Lipikar range. But that may change as I learn more, the evidence changes and new products become available.

You can also learn quite a lot about a moisturiser without a laboratory.

Put some on your fingers. Feel it. Smell it. How easily does it spread? How quickly does it absorb? Does it leave a heavy layer on the skin? Is it highly perfumed? Can you imagine comfortably putting it on three or four times a day?

Newly healed skin can be sensitive, so I favour non-perfumed products, particularly early on.

Because the best moisturiser on paper isn’t much use if you really don’t like using it.

Some very ordinary emollients can do the job perfectly well. Products such as E45, Cetraben and Diprobase are examples of commonly used emollients.

Some moisturisers are also available on prescription from your GP. If you use a lot of moisturiser - perhaps because you have extensive scarring or need to apply it several times a day — this is worth asking about, particularly if you don’t pay prescription charges.

What works well for one person’s skin may not suit another. Where the scar is matters too. A heavy emollient that works very well on a leg or arm may not be something you want spread across your face. If your scar is on your face, we may choose something different - and sometimes use one product on the scar and another on the surrounding, uninjured facial skin.

And how often should you moisturise?

There isn’t a magic number.

I often suggest around three or four times a day for newly healed, dry scarred skin, but really the answer is: as often as your skin needs it.

Look at it. Feel it. If it is becoming dry, it probably needs more. If it remains well hydrated, you may need less.

And wash the skin regularly rather than simply applying layer after layer of cream on top of what is already there. We want the moisturiser in contact with the skin, not sitting on layers of old product.

One other thing I want to separate out is massage.

In hospitals you may sometimes hear scar treatment described as “M&M” - massage and moisturisation. No, not the chocolate.

They are often done together, but they are not the same treatment.

Moisturising has its own purpose. Massage has its own purpose and indications. In my own practice I keep the two quite separate and generally don’t use moisturiser to perform scar massage. I’ll talk about massage properly in another Let’s Talk, because that deserves a conversation of its own.

The same goes for sun protection. Very important - different conversation.

So if you ask me, “Which cream should I use?”, I probably won’t give you the name of one miracle product.

I’ll want to know something about your scar, your skin, where it is, how dry it is, whether it itches, what stage of healing you’re at and what you’re trying to achieve. If I’m treating you, I’ll give you advice based on that.

But if you’re standing in a pharmacy wondering whether you need the £50 beautifully packaged scar cream rather than the much less exciting tub of moisturiser beside it, don’t assume that the price tag — or the claims on the tub — tell you which one will help your scar most.

The important thing is to moisturise. Choose something that doesn’t irritate your skin, ideally isn’t heavily perfumed, feels comfortable, is practical to use regularly and keeps your skin well hydrated. It doesn’t have to say “scar” on the label, and it certainly doesn’t have to be expensive.

Find something your skin likes — and use it regularly. And I’ll keep exploring different creams and following the evidence, so watch this space!