Mederma vs Silicone Scar Gel: What Works for Scars After 45?

You're standing in the chemist with two small tubes in your hands. One is the familiar green and white Mederma your sister-in-law swears by. The other is a silicone gel a friend showed you on her phone. Both promise to improve scars. The small print on the back of one of them lists fragrance and alcohol; the other doesn't. You're not sure which is the right call, especially since whatever you used to slap on at thirty doesn't suit your skin the same way at fifty-three.

You're not imagining the difference. Skin in perimenopause and menopause is thinner, drier and more reactive. The label that used to be a footnote is now the most important paragraph on the box. This guide compares both products on the same evidence terms.

Why Mederma Became a Familiar Scar Brand

Mederma has been on Australian chemist shelves for decades. It's well known, widely stocked and reasonably priced, which is part of why it sits in so many bathroom cabinets. The brand built its reputation on a once-daily routine and a botanical-feeling story around onion bulb extract. For many women over 45, Mederma was the first scar product they ever bought, often after a c-section or a mole removal. None of that history is wrong, and any like-for-like comparison should start by acknowledging it.

What's Inside Mederma and What Each Ingredient Does

According to the published ingredient list, Mederma Advanced Scar Gel contains: water, PEG 200, alcohol, xanthan gum, allium cepa (onion) bulb extract, allantoin, lecithin, methylparaben, sorbic acid, panthenol, sodium hyaluronate, and fragrance.

The two ingredients doing most of the active work are onion bulb extract and allantoin. Onion extract contains bioflavonoids and is intended to modulate inflammation in scar tissue. Allantoin is a soothing agent. Sodium hyaluronate is a humectant that draws water into the surface of the skin. For skin that has become thinner, drier or more reactive during perimenopause or menopause, fragrance and alcohol may be harder to tolerate.

What the Research Says About Onion Extract for Scars

A 2021 meta-analysis published in the International Wound Journal reviewed randomised trials of onion extract gel and concluded that it did improve scars compared with applying nothing, but did not outperform other commonly used topical scar options including silicone. A 2024 systematic review in the Journal of Burn Care & Research reached a similar conclusion: results are inconsistent and study quality is limited.

Where onion extract appears most useful is in combination with silicone, not on its own. The research is reasonably consistent that silicone is the active ingredient doing the heavy lifting in any combined product.

How Silicone Gel Works on Scars in Menopausal Skin

Silicone gel works through a different mechanism. A thin layer dries to a flexible, breathable film over the scar, holding in moisture and calming the signals that drive itch and overgrowth. It contains no estrogen, hormones or active drug. The Cochrane review on silicone for scar prevention and a 2021 meta-analysis in the International Wound Journal both show silicone outperforms placebo for scar height, pigmentation and pliability when used for at least six months.

Comparing Mederma and Silicone Gel for Mature Skin

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Why Silicone Gel May Suit Mature Skin Better

Skin in perimenopause and menopause loses about 30 percent of its collagen in the first five years and becomes more reactive to applied ingredients. Research summarised in Maturitas describes this shift in detail. Two implications follow. First, fragrance and alcohol on an ingredient list carry more weight than they once did. Second, products that sit as a film rather than absorb into the skin are easier to tolerate long term. Silicone fits the second category cleanly.

How to Choose Between Mederma and Silicone Gel After 45

1. Check the scar age. For fresh scars under 12 months, silicone gel has the stronger evidence base and is the safer default.
2. Read the ingredient list. If your skin reacts to fragrance or alcohol, silicone gel is the lower-risk choice.
3. Consider the routine. Mederma is once daily, silicone gel is twice. Pick what you'll actually do.
4. Patch test either product on a small area of skin near the scar for 48 hours before regular use.
5. Give the option you choose at least 12 weeks before judging the result.
6. Add daily SPF 50+ over either product if the scar is exposed to sun.

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Who Silicone Gel Suits for Women After 45

It may suit you if:

• Your scar is fully closed and under 12 months old
• Your skin reacts to fragrance, alcohol or strong actives
• You're in perimenopause or menopause and notice scars taking longer to fade
• You want the option with the strongest peer-reviewed evidence base
• You'd rather buy from an Australian brand with a focus on mature skin

It may not suit you if:

• You strongly prefer a once-daily routine and tolerate fragrance well
• You're hoping for visible results within a week or two
• Your scar is decades old and has already fully flattened
• The wound is still open, weeping or infected
• If a scar is raised, painful, rapidly spreading, very itchy, changing colour, or limiting movement, seek advice from a GP, dermatologist or surgeon.

Frequently Asked Questions About Scar Care After 45

Is Mederma bad for scars?

Not bad in any general sense. The published evidence shows onion extract gel improves scars compared with no product, but does not outperform other topical options including silicone. For menopausal skin, the fragrance and alcohol listed as ingredients are worth weighing.

Can I use Mederma and silicone gel together?

Some studies suggest combination therapy may help, but layering two products on thin menopausal skin increases the chance of irritation. Most women see clearer results from silicone gel on its own.

Why does Mederma sometimes sting on my skin now?

Mederma's ingredient list includes alcohol and fragrance, both of which are more likely to provoke a reaction on the thinner, drier skin of perimenopause and menopause. A stinging or itching sensation is your skin telling you the formulation isn't suiting you, even if it once did.

How long until I see a difference with silicone gel?

Most women notice a change in itch and texture by week 4 to 6 of consistent twice-daily use. Visible flattening and colour change usually become clearer at 3 months, with the most settled appearance at 6 to 12 months.

Is silicone gel worth the higher price?

Per tube, silicone gel costs more than Mederma. Per month of use, the two are closer because a small amount of silicone goes a long way. The deciding factor is usually evidence base and skin tolerance, not price.

Can silicone gel help an old scar that Mederma didn't fix?

It may still soften texture and reduce itch on a mature scar, but no topical product can fully reverse a scar that has finished remodelling. The biggest gains for either product are on scars under 12 months old.

References for Scar Care After 45

• Wang, F., Li, X., Wang, X., & Jiang, X. (2020). Efficacy of topical silicone gel in scar management: A systematic review and meta-analysis of randomised controlled trials. International Wound Journal. DOI: 10.1111/iwj.13337.
• Yuan, X. et al. (2021). Meta-analysis of onion extract gel for scar management. International Wound Journal, 18(4).
• O'Brien, L. and Jones, D.J. (2013). Silicone gel sheeting for preventing and treating hypertrophic and keloid scars. Cochrane Database of Systematic Reviews, Issue 9.
  
• Lephart, E.D. (2018). Skin aging and oxidative stress. Maturitas, 113.
• Mederma Advanced Scar Gel ingredient listing, manufacturer-published label.

Both products have a place. If you've used Mederma before and your skin tolerates it, that's a reasonable choice. If your scar isn't shifting, or your skin has changed in ways that make fragrance and alcohol harder to wear, silicone gel is the option the research backs most clearly. Either way, give what you choose 12 weeks before you decide. Your scar is only one part of what's going on, and it gets quieter with time and a steady routine.

This article is for general information only and is not a substitute for advice from your surgeon, GP or skin specialist. Genova Silicone Scar Gel is a cosmetic product designed to support scar appearance. Mederma and any other product names are the property of their respective owners and are referenced here for comparison purposes only. Individual results vary.