The prophylactic use of a topical scar gel containing extract of Allium cepae, allantoin, and heparin improves symptoms and appearance of cesarean-section scars compared with untreated scars

J Drugs Dermatol. 2014 Feb;13(2):176-82.


Background: Abdominal Cesarean sections (C-sections) are frequently associated with an increased risk of excessive or unpleasant scarring. A topical scar gel containing extract of Allium cepae, allantoin and heparin (Contractubex®; Merz Pharmaceuticals GmbH, Germany), has shown efficacy in improving the appearance of various scar types.

Objective: To investigate the efficacy of the topical scar gel, Contractubex, in the early treatment of C-section scars.

Materials & methods: A total of 61 females, aged ≥18 years, who had given birth by elective C-section for the first time within the last 5-10 days, were included in this prospective, randomized, single-center study. Patients were advised to apply the topical scar gel twice daily (treatment group), or received no treatment (control group). Efficacy was evaluated at 6 and 12 weeks after a baseline visit using the Patient and Observer Scar Assessment Scale (POSAS), a validated scar assessment tool comprised of a Patient Scale and an Observer Scale.

Results: Analysis revealed a significant change in the POSAS Patient Scale total score, with a 14.2% improvement in the treatment group compared with a decline of similar magnitude (-14.8%) in the control group at week 6. Significant improvements were also seen for POSAS Patient Scale sub-items in the treatment group compared with the control group for scar color (13.6% vs -18.5%, respectively, P=0.0284), stiffness (12.5% vs -34.6%, respectively, P=0.0029), and irregularity (29.4% vs -46.2%, respectively, P=0.0140) after 6 weeks of treatment. No significant changes were observed for the POSAS Observer Scale total score or its subitems after treatment with the topical scar gel, although there was a strong overall trend in favor of the treatment group. No significant adverse events were observed during the study.

Conclusion: Contractubex represents an efficacious and well-tolerated preventative treatment that rapidly and significantly improves the color, stiffness and irregularity of C-section scars.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Cutaneous
  • Adolescent
  • Adult
  • Allantoin / administration & dosage
  • Allantoin / therapeutic use*
  • Cesarean Section / adverse effects*
  • Cicatrix / etiology
  • Cicatrix / prevention & control*
  • Drug Combinations
  • Female
  • Gels
  • Heparin / administration & dosage
  • Heparin / therapeutic use*
  • Humans
  • Plant Extracts / administration & dosage
  • Plant Extracts / therapeutic use*
  • Pregnancy
  • Prospective Studies
  • Treatment Outcome
  • Young Adult


  • Drug Combinations
  • Gels
  • Plant Extracts
  • allantoin, heparin, onion extract drug combination
  • Allantoin
  • Heparin