Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Proteolytic enzymes, also known as proteases (such as bromelain, papain, serrapeptase, and trypsin), have been investigated for their potential to support the treatment of scars and scar tissue. The rationale is that these enzymes may help break down excess fibrin and extracellular matrix components, potentially reducing abnormal scar formation and promoting tissue remodeling. Some clinical studies and small trials suggest that oral or topical proteolytic enzymes might help with wound healing and reduce inflammation, which could theoretically support better scar outcomes. For example, a few studies have shown that bromelain and serrapeptase can reduce postoperative swelling and inflammation, which may indirectly influence scarring. However, the quality of the evidence is generally low, with many studies having methodological limitations, small sample sizes, or lacking proper controls. Systematic reviews and meta-analyses have found insufficient high-quality evidence to support routine use of proteolytic enzymes for scar management. Most guidelines do not recommend them for this purpose due to lack of robust data. While there is a plausible biological mechanism and some preliminary support, more rigorous research is needed to establish efficacy and safety for scar treatment. Overall, the evidence base is weak but not absent, justifying a moderate-low rating.

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