Tos (húmeda)

Acemannan, a polysaccharide from Aloe vera inner gel, has been studied for wound healing and scar modulation. In vitro and animal studies demonstrate it stimulates fibroblast proliferation, enhances collagen deposition, and reduces inflammatory cytokines. Human clinical trials specifically on scar tissue are limited but early findings are supportive.

Allantoin is a keratolytic and moisturizing compound used extensively in commercial scar formulations, including the well-studied onion extract/allantoin combination (e.g., Contractubex). Clinical studies show it improves scar texture, reduces pruritus, and supports re-epithelialization. Its moisturizing and immune-modulatory properties complement anti-scarring actions.

Aloe vera has been investigated in multiple clinical studies for wound healing and scar modulation. It reduces inflammation, stimulates fibroblast activity, and supports collagen synthesis. Comprehensive reviews cite it alongside onion extract and vitamin E as a recognized topical plant extract for scar management.

Alpha hydroxy acids (AHAs) promote skin cell turnover and exfoliation, aiding in the improvement of scar texture and pigmentation. They are cited in evidence-based reviews of topical scar treatments and widely used clinically for atrophic and pigmented scars.

Asiaticoside is the primary bioactive triterpenoid saponin of Centella asiatica and has been directly studied for scar treatment. It modulates TGF-β/Smad signaling to regulate collagen synthesis, reduces hypertrophic scar formation, and has shown efficacy in RCTs for burn-related and surgical scars.

Bee propolis has documented wound-healing and anti-scar properties supported by clinical studies. Its flavonoids (including caffeic acid phenethyl ester) exhibit anti-inflammatory, antimicrobial, and collagen-modulating effects relevant to scar healing.

Bromelain, a proteolytic enzyme from pineapple, has evidence for reducing post-surgical swelling and fibrin-related scar tissue formation. It is used as an adjunct to scar treatment by breaking down fibrinous proteins and reducing inflammation that drives scarring.

Centella asiatica (Gotu kola) is one of the best-evidenced natural ingredients for scar treatment, with 6 RCTs and multiple systematic reviews supporting it. Its triterpenoids modulate TGF-β/Smad signaling to regulate collagen, reduce hypertrophic scar formation, and improve post-surgical scar outcomes.

Centella triterpenes (the isolated triterpenoid fraction of Centella asiatica including asiaticoside, madecassoside, asiatic acid) have been studied specifically for scar management and are more potent than crude extracts. They regulate fibroblast activity, suppress TGF-β-driven excess collagen, and improve scar texture and height in clinical trials.

Collagen is the primary structural protein of scar tissue and has been studied extensively as a topical and supplemental agent for wound healing and scar modulation. Clinical trials show hydrolyzed collagen peptides accelerate tissue repair, and collagen dressings improve wound quality and scar outcomes.

Curcumin has been identified in systematic reviews and preclinical/clinical studies as an anti-scarring agent. It suppresses TGF-β/Smad and NF-κB signaling, reduces excessive collagen deposition in hypertrophic scars, and showed benefit in one RCT for scar management.

Topical rosehip oil (Rosa canina) has demonstrated clinically significant benefits for post-surgical scar healing in human studies, including reduced scar dyschromia, erythema, and atrophy. A 2024 systematic review in the Journal of Cosmetic Dermatology confirmed accelerated healing, reduced scar pigmentation, and improved texture in post-surgical scar populations.

EGCG, the primary catechin of green tea, has demonstrated anti-scarring effects by inhibiting the Akt/PI3K pathway, suppressing fibroblast proliferation, reducing TGF-β1 expression, and decreasing collagen synthesis in hypertrophic scar and keloid models. One RCT rated 1b supports its clinical use for scar management.

Glycolic acid is an alpha hydroxy acid used clinically for atrophic scar improvement, working by promoting exfoliation and stimulating collagen production. It is cited in evidence-based dermatological reviews as effective for textural improvement of atrophic scars including acne scars.

Glycosaminoglycans (GAGs), including hyaluronic acid and chondroitin sulfate, are key components of the ECM involved in scar formation and remodeling. Evidence from wound healing and scar models supports their role in promoting organized collagen deposition and reducing pathological scarring.

Multiple clinical trials support Gotu Kola's efficacy in scar prevention and treatment. Topical application has been shown to improve pigmentation and scar scores in split-scar RCTs. Asiaticoside inhibits keloid fibroblast proliferation in a dose-dependent manner while stimulating normal skin collagen synthesis. This is one of Gotu Kola's best-documented dermatological applications.

Green tea extracts, primarily through EGCG, have been studied for scar management with one RCT rated 1b supporting efficacy. Green tea inhibits fibroblast proliferation, TGF-β expression, and collagen synthesis in scar tissue. It is cited in multiple authoritative reviews as a plant extract used for wound healing and scar management.

Hyaluronic acid is a key ECM glycosaminoglycan that modulates wound healing and scar formation. It promotes cell activation, migration, and neovascularization during the scar remodeling phase and has been studied in clinical wound healing formulations, showing improved scar organization.

L-Proline is a critical amino acid for collagen biosynthesis and scar tissue formation. As a primary structural component of collagen's triple helix, it is required for the synthesis of organized scar collagen, and supplementation supports wound healing and collagen quality in scar tissue.

Lavender essential oil has been shown in animal studies to accelerate wound contraction, stimulate type I and III collagen synthesis, increase fibroblast number, and upregulate TGF-β—a key mediator of wound healing and tissue remodeling. A 2020 review in the Journal of Alternative and Complementary Medicine synthesized current evidence. Human clinical data for established scar tissue specifically are limited.

NCCIH reports a preliminary clinical study in which a topical lotion containing mugwort and menthol relieved itching associated with hypertrophic scars. The multi-ingredient nature of the product means mugwort's specific contribution is uncertain. Mugwort is also used in cosmetic formulations recognized by the European CosIng database for skin protective effects.

Nattokinase is a fibrinolytic enzyme from fermented soybeans with evidence for breaking down fibrin-based scar tissue. It is included in clinical pilot studies on systemic enzyme therapy for fibrosis and scar tissue reduction, showing improvements in tissue quality and symptom burden.

Onion extract (Allium cepa) is the most-studied natural ingredient for scar management, with 11 RCTs (4 rated 1b) identified in systematic reviews. Its active flavonoids (quercetin, kaempferol) modulate TGF-β/Smad and IGF-1 signaling, suppress ECM overproduction, and are the basis for commercially available anti-scar products worldwide.

Panthenol (provitamin B5) is commonly incorporated into topical scar formulations for its fibroblast-stimulating, moisturizing, and barrier-repair properties. In vitro and animal studies support fibroblast proliferation promotion, and small clinical studies show improvements in scar redness and pruritus.

Papain has been investigated as a topical scar treatment owing to its proteolytic degradation of excess collagen in hypertrophic scars and keloids. A 2023 PubMed study formulated papain-loaded liposomes and transferosomes for delivery across the stratum corneum specifically targeting hypertrophic scars. An earlier ScienceDirect paper on elastic liposome delivery of papain explicitly cited its role in scar management. Evidence is preclinical/formulation-stage; no controlled human RCTs on scars as a primary endpoint were identified.

Quercetin is the primary bioactive flavonoid in onion extract and has been directly studied for anti-scarring effects. It suppresses TGF-β and IGF-1 signaling, inhibits keloid fibroblast proliferation, reduces ECM deposition, and induces MMP-1 to promote ECM remodeling in scar tissue.

Resveratrol has demonstrated anti-scarring effects in vitro and in vivo by arresting fibroblast cell cycle at G1, reducing hypertrophic scar fibroblast proliferation, decreasing collagen types I and III, and downregulating TGF-β1 and alpha-smooth muscle actin. One RCT (rated 2b) supports clinical use for scar management.

Rose hip preparations have documented evidence for reducing scar formation and stretch marks. Rose hip oil repositions collagen, promotes organized extracellular matrix formation, and avoids abnormal scar tissue development. A HerbalGram 2025 review noted rose hip's ability to avoid development of scars and reduce stretch marks through collagen remodeling and anti-inflammatory mechanisms.

Serrapeptase is a proteolytic enzyme with fibrinolytic activity studied for scar tissue reduction by breaking down excess fibrin in scar tissue. Pilot clinical studies on enzyme supplementation for fibrosis-related scar reduction show improvements in symptoms; anti-inflammatory and fibrinolytic mechanisms are well-established.

Serratiopeptidase is the pharmaceutical name for serrapeptase, with clinical trials demonstrating anti-inflammatory, fibrinolytic, and anti-edemic effects relevant to postoperative scar management. It degrades fibrinous proteins in scar tissue without harming surrounding healthy cells.

Silicon (in the form of organosilicon compounds and silicone gel/sheets) is among the most evidence-based treatments for scar management, with clinical guidelines supporting its use for hypertrophic and keloid scars. Silicone gel and sheeting are first-line recommended non-invasive scar treatments in dermatology.

Turmeric (Curcuma longa), primarily through its curcumin content, has demonstrated anti-scarring effects by inhibiting TGF-β/Smad signaling, reducing fibroblast proliferation, and decreasing pathological collagen deposition in hypertrophic scars. It is cited in multiple systematic reviews of natural products for scar management.

Vitamin C is an essential cofactor for collagen synthesis and scar formation, required for hydroxylation of proline and lysine in procollagen. It is cited in multiple authoritative reviews as a recommended topical and systemic ingredient for scar modulation, and evidence supports it for post-inflammatory hyperpigmentation and scar quality improvement.

Vitamin E has been studied in 4 RCTs for scar management, though evidence is inconsistent. Its antioxidant and anti-inflammatory properties theoretically support scar remodeling; however, current evidence does not strongly support topical vitamin E alone, and it may cause contact dermatitis in some patients.

Zinc plays essential roles in wound healing and scar tissue formation through enzymatic cofactor functions in collagen synthesis, DNA repair, and immune regulation. Zinc deficiency impairs wound healing and scar quality; supplementation supports optimal collagen cross-linking and scar outcomes.

Argan oil is traditionally used in Morocco to heal scars, including post-acne and chicken pox scars. It contains triterpenoids proposed to support scar remodelling. No controlled human clinical trials on argan oil and scar tissue have been published.

Calendula has a traditional cicatrizing (scar-healing) reputation across multiple systems, documented in ethnopharmacological literature. Mechanisms involve collagenase inhibition and fibroblast stimulation. Clinical evidence is indirect; no dedicated scar-reduction RCT exists.

Allantoin, the primary active compound in comfrey, stimulates fibroblast proliferation and ECM synthesis, which are mechanisms relevant to scar tissue remodelling. Allantoin is documented in the cosmeceutical literature to reduce scar visibility by promoting balanced collagen deposition. Traditional herbal use of comfrey for scar management is long-standing, though specific clinical trials in scarring are lacking.

Dragon's blood resin (from Croton lechleri and other species) has a long history of traditional use in wound healing and scar reduction across South American, Asian, and Mediterranean traditional medicine. Scientific studies confirm anti-inflammatory, antioxidant, and fibroblast-stimulating properties, with small clinical studies showing improved scar closure.

Emu oil has been traditionally used by Indigenous Australians for wound and scar healing. Animal studies confirm enhanced wound healing and reduced scar formation. Small clinical studies and reports support anti-inflammatory and scar-modulating effects, though large RCTs are lacking.

Geranium EO is used traditionally to reduce scar formation and promote skin regeneration through its cell-renewal and astringent properties. It is documented in herbal medicine for its use in wound recovery and scar management.

H. italicum has a long tradition in Mediterranean folk medicine for reducing scars and hematomas. Its italidione-containing EO is held in aromatherapy to remodel fibrous scar tissue and reduce bruising. Scientific support is indirect, derived from studies on collagen remodeling and anti-inflammatory activity rather than dedicated scar-reduction trials.

Jojoba oil has traditional use as a skin healing and scar-softening agent, and is included in authoritative scar treatment ingredient lists. It provides a liquid wax ester structure similar to skin sebum, supporting skin barrier function and hydration in scar tissue.

Myrrh has a longstanding traditional application for wound healing and scar reduction, documented in Ancient Egyptian prescriptions and Western herbal traditions. Topical myrrh ointments are used for wounds, chronic ulcers, and scar-prone injuries. A clinical RCT found myrrh mouthwash improved post-extraction wound healing.

Shea butter has longstanding traditional use across Sub-Saharan Africa for wound healing and scar reduction. Its triterpene constituents may inhibit fibroblast overproduction and stimulate collagen remodeling. Clinical evidence is limited but the moisturizing and anti-inflammatory properties plausibly support improved healing environments and reduced scar visibility.