Enhancing Patient Compliance in Scar Therapy via a Combined TRPM8 Agonist and Silicone Ointment: A Pilot Study

Background: Silicone-based scar therapies are widely used for hypertrophic scar management. However, their occlusive properties frequently cause heat sensation and pruritus, resulting in decreased patient compliance. To alleviate such adverse effects, the authors developed a topical ointment combining 0.4% eucalyptol, a transient receptor potential melastatin 8 agonist, with 20% silicone. This study evaluated the scar prevention effects, cooling sensation, and patient compliance associated with this combined ointment.Methods: A prospective comparative pilot study was performed in 30 adult patients with split-thickness skin graft donor-site scars. Patients were allocated to either a 20% silicone-only group or a 20% silicone with 0.4% eucalyptol group. Evaluation parameters included cooling sensation, irritation, Vancouver Scar Scale (VSS), pruritus Visual Analog Scale (VAS), and treatment adherence assessed by missed applications per week. Scars were evaluated at 3 months by two blinded evaluators.Results: All 15 patients in the eucalyptol-combined ointment group perceived immediate cooling sensation after application, and no irritation or pain was reported. At 3 months, total VSS scores were comparable between the silicone-only group (4.3±1.2) and the combined ointment group (4.0±1.1). However, pruritus VAS scores were significantly lower in the combined ointment group (2.8±1.0 vs. 5.1±1.4). Treatment adherence was also significantly improved, with fewer missed applications per week in the combined ointment group (1.8±1.0 vs. 4.2±1.5).Conclusion: Addition of eucalyptol to silicone-based scar therapy may improve cooling sensation, reduce pruritus, and enhance treatment adherence while demonstrating comparable scar outcomes.