Topical Products and Recommendations for Postsurgical Facial Scar Healing: A Systematic Review

In recent decades, a wide range of topical agents have been introduced for scar management. However, data on topicals used specifically for postsurgical facial scar healing have not been thoroughly reviewed. The objective of this study was to review topical therapies evaluated in clinical trials and provide a concise, evidence-based framework for incisional care post-facial surgery. Cochrane database was searched for recent clinical trials on topical products indicated for new facial or neck wounds. A total of 16 studies comprising 870 patients were analyzed. Most studies were prospective, randomized, and blinded, with quality of evidence ratings of 1 or 2. Silicone products remain a mainstay of topical wound care, demonstrating the strongest evidence of safety and efficacy, but novel topical formulations and modalities for administration (eg, hemocoagulase, Centella asiatica , microneedle patches), show promising results. Topicals with higher silicone composition were more effective than standard silicone formulations, significantly improving Vancouver Scar Scale measures. Most interventions were initiated within 1 to 4 weeks after surgery, as soon as wounds closed and sutures were removed, if not earlier. Twice daily applications for 3 months were common. Based on the findings of this review, a regimen of topical silicone, initiated within the first postoperative month and applied at least daily for 3 months, can promote scar healing and may improve patient outcomes following facial surgery.