Scar Prevention
Part 5- Snake Oils and The Placebo Effect

Scar treatment and prevention has been subject to countless untested and unproven therapies.  Patients often swear by treatments that are known to have little to no effect.  Indeed, good studies have demonstrated both subjective and objective improvement in various diseases, when treated with placebos ("sugar-pills).  Recent studies have documented improvement in lung function in those with asthma, when treated with placebos.  Other studies have shown that placebos may be 80% as effective at treating depression as standard medical therapy.  The reasons behind this are complex and poorly understood.  Expectancy plays a role- subjective improvement because you expect improvement.  The expectancy effect is real.  It causes changes in brain chemistry, and can stimulate the production of neurotransmitters, similar to that caused by medications.
So, what does this have to do with scars?  There are countless untested and unproven scar therapies being marketed.  Whether scar improvement is due to the "therapy" or to the placebo effect, is anyones guess.  Often, just getting a patient more involved in their treatment, leads to better results.  Unfortunately, the placebo effect can be taken advantage of.  Scar treatments can easily cost thousands of dollars.  These treatments may sound exciting and complicated- scar creams that contain estrogens, steroids, growth factors, and vasodilators.  Unfortunately, there is little to no data that these are any better than lotion from Victoria's Secret.  So, in the end, if I just want to do something,  it is a good excuse to go to Victoria's Secret.  More to come...

Dutile, Stefanie, Ted JKaptchuk, and Michael EWechsler. "The placebo effect in asthma." Current allergy and asthma reports 14.8 (2014):456-456.

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