Can You Use Coconut Oil to Help Treat Scarring? Understanding the Evidence

Coconut oil, extracted from the meat of mature coconuts, is a highly popular ingredient in both food and skincare due to its rich fatty acid content. Historically and anecdotally, it has been touted as a natural remedy for numerous skin issues, including the minimization and lightening of scars. The appeal lies in its moisturizing properties and natural composition. However, scientific evidence supporting its direct efficacy for scar reduction, compared to established medical treatments, is mixed.

Purported benefits

Advocates for using coconut oil on scars cite several mechanisms by which the oil might support skin healing and improve scar appearance.

• Moisturization and Hydration: Coconut oil is an excellent emollient, meaning it forms a protective layer on the skin's surface. This barrier helps trap moisture within the skin, keeping the scar tissue hydrated. Hydrated skin is more elastic, which can help soften and flatten the appearance of scars over time.
• Anti-inflammatory Properties: The primary component of coconut oil is lauric acid (a medium-chain fatty acid), which has known anti-inflammatory effects. By reducing inflammation in the surrounding tissue, it may help calm the redness and irritation often seen in new or raised scars (hypertrophic and keloid scars).
• Collagen Production Modulation: Scar tissue is composed primarily of abnormal collagen bundles. Some theories suggest that regular massage with coconut oil might help modulate the alignment and production of collagen during the skin's remodeling phase, potentially leading to a flatter, less noticeable scar.
• Antioxidant Content: Coconut oil contains vitamin E and other antioxidants. These compounds help fight free radicals, which contribute to tissue damage and aging, potentially supporting overall skin health around the wound area.

Research

While the theoretical benefits are promising, large-scale, controlled human studies directly comparing coconut oil to medical scar treatments (like silicone sheeting) are limited.

Animal and Wound Healing Studies

Most positive research has been conducted on animals or focuses on initial wound healing, rather than mature scar reduction:

• Enhanced Initial Healing: Studies on rats have indicated that virgin coconut oil application can accelerate wound healing by speeding up epithelialization (new skin formation) and increasing the production of collagen. However, accelerated collagen production does not automatically equate to less visible scarring, as scars are often defined by excessive or disorganized collagen.
• Antimicrobial Effects: Lauric acid and capric acid found in coconut oil exhibit strong antimicrobial activity. Using the oil on healing wounds may help reduce the risk of secondary bacterial infection, which can worsen inflammation and lead to more prominent scarring.

Human Scar Studies

Current evidence for established scars is inconclusive:

• Limited Clinical Data: No major clinical trial strongly endorses coconut oil as a primary treatment for reducing the appearance of keloid or hypertrophic scars (raised, thickened scars). The consensus among dermatologists is that silicone gel and sheets remain the gold standard for topical, non-invasive scar management.
• Anecdotal Success: Many users report improvement, particularly in softening scars and reducing associated dryness and itching. This benefit is likely due to the superior emollient qualities of the oil and the positive effects of regular massage, rather than a unique anti-scarring compound in the oil itself.

How to use

If you choose to use coconut oil for scarring, proper application technique and timing are essential to maximize any potential benefits.

Timing the Application

It is generally advised not to apply any oil or treatment to an open wound. Wait until the wound is fully closed and the scab has naturally fallen off. The scar should be in the maturation phase, which typically begins 2 - 3 weeks post-injury.

Application Technique

1. Choose the Right Type: Use virgin coconut oil, as it is less processed and retains more of the beneficial compounds, like vitamin E and antioxidants, than refined coconut oil.
2. Cleanse and Warm: Wash and dry the area gently. Scoop a small amount of oil onto your fingers (it will melt quickly upon contact with body heat).
3. Massage Deeply: Apply the oil to the scar and surrounding tissue. Massage the area gently but firmly for 5 - 10 minutes, two to four times per day. Massage itself is a vital part of scar therapy as it helps break down dense collagen fibers and improves blood flow.
4. Consistency is Key: Scar remodeling is a slow process, taking 6 - 18 months. Consistent, daily application and massage are necessary to see any long-term textural improvements.

Side effects and risks

While coconut oil is generally safe for topical use, there are a few potential downsides, particularly for certain skin types or scar locations.

• Comedogenicity: Coconut oil has a high comedogenic rating, meaning it can easily clog pores. If you apply it heavily to scars located on the face, chest, or back, it may trigger acne breakouts in the surrounding skin.
• Allergic Reactions: Though rare, some individuals may have a contact allergy to coconut oil, leading to contact dermatitis, characterized by redness, itching, and rash. Always perform a patch test on a small, inconspicuous area first.
• Oily Residue: The oil can leave a noticeable, greasy residue, which may stain clothing if not fully absorbed.
• Sun Sensitivity: Applying oil to scars can increase photosensitivity. Scar tissue is already highly sensitive to UV radiation, which can lead to permanent discoloration (hyperpigmentation). Always cover the scar or use a broad-spectrum sunscreen with an SPF of 30 or higher, even when using coconut oil.

Products

If you prefer a product that combines the benefits of moisturizing oils with proven scar-reducing ingredients, consider formulations that include both coconut oil and other scientifically-backed compounds.

• Silicone and Oil Blends: Look for products that combine the occlusive benefits of silicone (which works by increasing local temperature and hydration) with nourishing oils like coconut or vitamin E.
• Oils with Tretinoin: For older or more stubborn scars, some prescription treatments include retinoids (like tretinoin), which boost cell turnover and collagen production, often combined with an emollient base.
• Other Natural Alternatives: Similar oils such as shea butter, olive oil, and cocoa butter offer comparable emollient properties and may be preferred if coconut oil causes breakouts.

See your dermatologist

While home remedies like coconut oil can offer complementary moisturizing benefits, they should not replace professional medical advice for serious scarring.

• Types of Scars: A dermatologist can accurately diagnose the type of scar you have (e.g., atrophic, hypertrophic, keloid, contracture) and recommend the most effective treatment.
• Medical Treatments: Professional options for scar management are numerous and highly effective, including steroid injections, laser resurfacing, cryotherapy, microneedling, and surgical revision. These methods are proven to produce better outcomes for severe or disfiguring scars than topical oils alone.
• Preventative Care: For healing wounds, a dermatologist can advise on optimal wound care to minimize the initial scar, often prioritizing non-irritating moisturizers and rigorous sun protection.