The effect of topical use of hypericum perforatum on prevention and treatment of hypertrophic scar formation

Hypertrophic scar is a dermal scarring process characterized by disturbance of cellular regulatory mechanisms seen in delayed wound healing. The disturbance of balance between anabolic and catabolic cytokines in favour of anabolic pathway in hypertrophic scars results in excessive amount of extracellular matrix deposition. There is no effective standart treatment in hypertrophic scars. Treatment is based on random approaches and specific modalities are chosen for appropriate patients. Recently, extractum cepae has become the most famous pharmacological agent for treatment of hypertrophic scars. Extractum cepae is a gel obtained from onion extract. It contains one of the best described flavonoids, quercetin. Extractum cepae and hypericum perforatum have similar contents and both have quercetin as the active compound.An excisional defect was created on the back of fourty rats. The rats were randomly seperated into 4 groups as control, olive oil group, heparin, allantoin and extractum cepae mixture group and hypericum perforatum group and these were applied on the wound site twice a day for 1 minute for a period of 3 months. With olive oil, there was no significant increase in inflammation, fibroblast and mast cell numbers, however a statistically significant decrease in collagen amount was achieved. With E.cepae+heparin+allantoin group, there was no significant change in inflammation or collagen amount, whereas the decrease in mast cells and fibroblasts was statistically significant. In the hypericum perforatum group, as well, a statistically significant decrease in fibroblast and mast cells was observed.