Efficacy of a Silicone-Based Gel Containing Pracaxi Oil (Pentaclethra macroloba) for Treating Post-Surgical Scars

Main Article Content

Mark Nestor
Brian Berman



Scars are an unavoidable consequence of cutaneous surgery. Healing with an excellent cosmetic outcome is a crucial component to any surgical wound to avoid any negative impact on quality of life. Various products exist which claim to improve post-surgical scar appearance and texture. In this blinded, randomized pilot study, we compared the efficacy of a silicone-based topical gel containing Pracaxi oil (PO Gel; Serica™ Moisturizing Scar Formula; Cynova Laboratories, Houston, TX) against a second silicone-based gel containing Cepalin onion extract (OE Gel; Mederma® Advanced Scar Gel, Merz, North America). The Vancouver Scar Scale (VSS), Physician and Subject Global Assessment of Scar Treatment, and digital photography were used to determine efficacy and superior post-surgical care treatment outcomes. Forty healthy subjects (18-75 years old) with recent surgical scar (1 to 4 months old) were randomized to PO gel or OE gel and asked to apply a topical solution three times daily for 8 weeks. There were six study visits (Baseline and Weeks 2, 4, 8, 12 and 16). The results of this study showed that subjects with post-surgical scars achieved significant improvements at 8 and 12 weeks following application of a product with either Pracaxi oil or onion extract gel, based on mean Vancouver Scar Scale scores. Both products generally improved the individual scar signs and symptoms. Subjects using the onion extract product did not achieve improvement in Pain or Itch at the 8-week evaluation or Pain at the 12-week evaluation.



1. Clayton AS, Stasko T. Surgical Complications and Optimizing Outcomes. In: Bolognia JL, Jorizzo JL, Schaffer JV, eds. Dermatology. Vol 3. Atlanta: Elsevier Inc; 2016.
2. Sidgwick GP, McGeorge D, Bayat A. A comprehensive evidence-based review on the role of topicals and dressings in the management of skin scarring. Arch Dermatol Res. 2015;307:461-477.
3. Meaume S, Le Pillouer-Prost A, Richert B, Roseeuw D, Vadoud J. Management of scars: updated practical guidelines and use of silicones. Eur J Dermatol. 2014;24:435-443.
4. Bock O, Schmid-Ott G, Malewski P, Mrowietz U. Quality of life of patients with keloid and hypertrophic scarring. Arch Dermatol Res. 2006;297:433-438.
5. Choi Y, Lee JH, Kim YH, Lee YS, Chang HS, Park CS, Roh MR. Impact of postthyroidectomy scar on the quality of life of thyroid cancer patients. Ann Dermatol. 2014;26:693-699.
6. Kim JS, Hong JP, Choi JW, Seo DK, Lee ES, Lee HS. The efficacy of a silicone sheet in postoperative scar management. Adv Skin Wound Care. 2016;29:414-420.
7. Medhi B, Sewal RK, Kaman L, Kadhe G, Mane A. Efficacy and safety of an advanced formula silicone gel for prevention of post-operative scars. Dermatol Ther (Heidelb). 2013;3:157-167.
8. Spencer JM. Case series: evaluation of a liquid silicone gel on scar appearance following excisional surgery--a pilot study. J Drugs Dermatol. 2010;9:856-858.
9. Kim SM, Choi JS, Lee JH, Kim YJ, Jun YJ. Prevention of postsurgical scars: comparsion of efficacy and convenience between silicone gel sheet and topical silicone gel. J Korean Med Sci. 2014;29(Suppl 3):S249-253.
10. Monstrey S, Middelkoop E, Vranckx JJ, Bassetto F, Ziegler UE, Meaume S, Téot L. Updated scar management practical guidelines: non-invasive and invasive measures. J Plast Reconstr Aesthet Surg. 2014;67:1017-1025.
11. O'Brien L, Pandit A. Silicon gel sheeting for preventing and treating hypertrophic and keloid scars. Cochrane Database Syst Rev. 2006;1:CD003826.
12. Banov D, Banov F, Bassani AS. Case series: the effectiveness of fatty acids from pracaxi oil in a topical silicone base for scar and wound therapy. Dermatol Ther (Heidelb). 2014;4:259-269.
13. Ruthig DJ, Meckling-Gill KA. Both (n-3) and (n-6) fatty acids stimulate wound healing in the rat intestinal epithelial cell line, IEC-6. J Nutr. 1999;129:1791-1798.
14. Cardoso CR, Souza MA, Ferro EA, Favoreto S Jr, Pena JD. Influence of topical administration of n-3 and n-6 essential and n-9 nonessential fatty acids on the healing of cutaneous wounds. Wound Repair Regen. 2004;12:235-243.
15. Simmons CV, Banov F, Banov D. Use of a topical anhydrous silicone base containing fatty acids from pracaxi oil in a patient with a diabetic ulcer. SAGE Open Med Case Rep. 2015;3:2050313X15589676.
16. Guimarães AL, Cunha EA, Matias FO, Garcia PG, Danopoulos P, Swikidisa R, Pinheiro VA, Nogueira RJ. Antimicrobial activity of copaiba (Copaifera officinalis) and pracaxi (Pentaclethra macroloba) oils against Staphylococcus aureus: importance in compounding for wound care. Int J Pharm Compd. 2016;20:58-62.
17. Nedelec B, Shankowsky HA, Tredget EE. Rating the resolving hypertrophic scar: comparison of the Vancouver Scar Scale and scar volume. J Burn Care Rehabil. 2000;21:205-212.
18. dos Santos Costa MNF, Muniz MAP, Negrao CAB, et al. Characterization of Pentaclethra macroloba oil. J Therm Anal Calorim. 2014;115:2269-2275.
19. Oliveira AA, Segovia JF, Sousa VY, Mata EC, Gonçalves MC, Bezerra RM, Junior PO, Kanzaki LI. Antimicrobial activity of Amazonian medicinal plants. Springerplus. 2013;2 371.
20. Leal ICR, Junior II, Pereira EM, Laport MS, Kuster KM, dos Santos KRN. Pentaclethra macroloba tannins fractions active against methicillin-resistant staphylococcal and gram negative strains showing selective toxicity. Rev Bras Farmacogn. 2011;21:991–999.
21. da Silva JO, Coppede JS, Fernandes VC, Santana CD, Ticli FK, Mazzi MV, Giglio JR, Pereira PS, Soares AM, Sampaio SV. Antihemorrhagic, antinucleolytic and other antiophidian properties of the aqueous extract from Pentaclethra macroloba. J Ethnopharmacol. 2005;100:145-152.
22. da Silva JO, Fernandes RS, Ticli FK, Oliveira CZ, Mazzi MV, Franco JJ, Giuliatti S, Pereira PS, Soares AM, Sampaio SV. Triterpenoid saponins, new metalloprotease snake venom inhibitors isolated from Pentaclethra macroloba. Toxicon. 2007;50:283-291.
23. Jenwitheesuk K, Surakunprapha P, Jenwitheesuk K, Kuptarnond C, Prathanee S, Intanoo W. Role of silicone derivative plus onion extract gel in presternal hypertrophic scar protection: a prospective randomized, double blinded, controlled trial. Int Wound J. 2012;9:397-402.
24. Wananukul S, Chatpreodprai S, Peongsujarit D, Lertsapcharoen P. A prospective placebo-controlled study on the efficacy of onion extract in silicone derivative gel for the prevention of hypertrophic scar and keloid in median sternotomy wound in pediatric patients. J Med Assoc Thai. 2013;96:1428-1433.
25. Draelos ZD. The ability of onion extract gel to improve the cosmetic appearance of postsurgical scars. J Cosmet Dermatol. 2008;7:101-104.
26. Chanprapaph K, Tanrattanakorn S, Wattanakrai P, Wongkitisophon P, Vachiramon V. Effectiveness of onion extract gel on surgical scars in Asians. Dermatol Res Pract. 2012;2012:212945.
27. Jackson BA, Shelton AJ. Pilot study evaluating topical onion extract as treatment for postsurgical scars. Dermatol Surg. 1999;25:267-269.
28. Chung VQ, Kelley L, Marra D, Jiang SB. Onion extract gel versus petrolatum emollient on new surgical scars: prospective double-blinded study. Dermatol Surg. 2006;32:193-197.
29. Karagoz H, Yuksel F, Ulkur E, Evinc R. Comparison of efficacy of silicone gel, silicone gel sheeting, and topical onion extract including heparin and allantoin for the treatment of postburn hypertrophic scars. Burns. 2009;35:1097-1103.

Similar Articles

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)

1 2 3 > >>