Cicatricure and Mederma are both popular scar gels that use onion extract as the main ingredient. However, Cicatricure is more affordable than Mederma and has a better ingredient list with chamomile, aloe vera, and centella asiatica to soothe scars and redness. Mederma is more popular and has thousands of reviews, but loses points in our books for containing alcohol, fragrance, and parabens. Overall, we recommend Cicatricure over Mederma for its excellent value and better ingredients.
I also like that Cicatricure includes additional agents like centella asiatica (a.k.a. tigergrass) to promote wound healing, glycerin and aloe vera to improve hydration, chamomile extract to soothe sensitive skin, and bergamot fruit oil for fragrance. Cicatricure is also alcohol-free.
In contrast, Mederma only includes allantoin, panthenol, and hyaluronic acid for hydration.
Finally, Cicatricure recommends applying its scar gel 4x a day while Mederma is only 1x a day. However, it's best to apply an onion extract gel at least twice a day for continuous coverage.
My Verdict: In my opinion, Cicatricure is a better and cheaper version of Mederma with a more extensive ingredient list to help minimize scar formation and maximize recovery results.
Low Risk of Scarring: no family history of keloids, no sensitive areas like the breast/chest
Low Patient Concern: you're okay with how your scar turns out, regardless the outcome
In other words, I recommend using Mederma for less serious wounds, such as mild burns, cuts & scrapes, bruises & accidents, and other minor injuries.
That's because the key ingredient in Mederma Advanced Scar Gel is onion bulb extract (a.k.a. Cepalin in Mederma's marketing materials and allium cepa in the ingredient list).
Some studies showed positive evidence, like the original clinical trial by Draelos et al. (2012) that was sponsored by Merz Pharmaceuticals (the parent company of Mederma).
In short, this study found a statistically significant difference in scar appearance between Mederma-treated scars (test group) and non-treated scars (control group) after 4-8 weeks.
However, there's a number of major flaws with this study:
Control Group: in this study, the control scars were left completely untreated. This is an extremely low benchmark and even then, the test group only surpassed the control group after 4 weeks of treatment. I'd be more convinced if the control scars were treated with at least a moisturizer as keeping scars hydrated improves wound healing.
Sample Group: out of 44 participants, the vast majority were Caucasian (39), followed by African American (4), and Hispanic (1). As you might expect, the Fitzpatrick skin type was mostly I and II (both are considered very light skin tones). However, this sample almost entirely excludes ethnic skin types which creates a bias because abnormal scar formation like keloids is more common in those of African, Asian, and Hispanic descent.
Other studies found that onion extract was no better than similar topical treatments but resulted in more frequent side effects (itchiness, redness) that caused patients to stop using it. (source: International Wound Journal, 2021)
In addition, many studies used multiple active ingredients in their formulations which made it more difficult to isolate the effects of onion extract. (source: Dermatologic Surgery, 2014)
Finally, here's my personal opinion of Mederma Advanced Scar Gel based on 6+ months of using it on my chest keloids:
Application: it's very easy to apply (a bit sticky but dries quickly)
Results: I did not see any significant improvements in scar height, thickness, or redness, however, my scars did feel slightly smoother
Side Effects: I experienced the occasional itchiness, but the more serious side effect was that the area where I applied Mederma turned slightly darker in color (discoloration)
My Verdict: Taking into account the key ingredients, clinical studies, and my own experience, I recommend Mederma Advanced Scar Gel for low risk scars as the medical evidence is mixed. Mederma may help minimize scars from minor injuries and accelerate the recovery process.
For high risk scars, however, I recommend using a silicone gel or silicone sheet because it's safe (no side effects), clinically proven for scar treatment, and reasonably affordable.
Tom is the founder and editor of TheDermDetective.com where he applies his decades of personal experience with skincare problems like acne and acne scarring to provide readers with practical advice and product recommendations.