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Abstract  To evaluate the efficacy and safety of onion extract (OE) gel on scar management, a systematic review was performed by searching Embase, PubMed, Medline, and the Cochrane Library databases, and a meta‐analysis was conducted according to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement guidelines. Finally, 13 randomised controlled trails were enrolled for meta‐analysis. OE gel increased the total improvement scores assessed by investigators ( P  &lt; .00001) and patients ( P  &lt; .00001) than no treatment, but no differences were detected between OE gel and other commonly used topical treatments assessed by investigators ( P  = .56) and patients ( P  = .39). Moreover, OE in silicone gel increased the total improvement scores assessed by investigators ( P  &lt; .00001) and patients ( P  = .0007) than other treatments. OE gel increased the incidence of total adverse effects compared with no treatment ( P  &lt; .0001) and other treatments ( P  = .008) by a fixed‐effects model, and increased the incidence of dropping out caused by intolerance of treatments ( P  = .0002). OE gel not only has no superiority to commonly used topical treatments, but also has the potential to increase the incidence of adverse effects on scar management; OE in silicone gel might be the optimal topical choice for scar treatment; however, more evidences are needed to strength these conclusions.

Onion extract gel is not better than other topical treatments in scar management: A meta‐analysis from randomised controlled trails