# Pediatric Facial Lacerations: Evidence-Based Over-the-Counter Wound Care and Scar Prevention for Clinicians and Caregivers

## TL;DR

This review provides evidence-based guidance for managing pediatric facial lacerations to minimize scarring and improve healing outcomes.

## Contribution

The paper synthesizes recent evidence to guide clinicians and caregivers on effective over-the-counter wound care and scar prevention strategies for children.

## Key findings

- Topical anesthetics like LET gel and petrolatum-based moist wound care improve healing and reduce pain.
- Silicone therapy and sun protection are more effective for scar prevention than OTC products like onion extract or vitamin E.
- Systemic antibiotics are unnecessary for clean facial wounds, and caregiver education is critical for optimal outcomes.

## Abstract

Pediatric facial lacerations are common injuries that carry important cosmetic and psychosocial implications. Prompt, evidence-based management focusing on optimal wound closure, early wound care, and scar prevention is essential to achieving favorable long-term outcomes. This review summarizes findings from a comprehensive literature review conducted from 2010 to 2025, drawing from randomized controlled trials (RCTs), meta-analyses, systematic reviews, and clinical guidelines addressing pediatric facial laceration repair, wound care practices, scar prevention, and caregiver involvement. Practical interventions accessible over the counter (OTC) were emphasized. Evidence supports the use of topical anesthetics such as lidocaine-epinephrine-tetracaine (LET) gel to reduce procedural pain, copious irrigation with potable water, and wound closure methods tailored to the injury’s characteristics, including tissue adhesives and absorbable sutures. Routine systemic antibiotics are not indicated for clean facial wounds. Early moist wound care with petrolatum promotes faster healing, while scar prevention measures such as silicone therapy, sun protection, scar massage, and tension offloading techniques significantly improve cosmetic outcomes. Over-the-counter products such as onion extract and vitamin E offer minimal benefit compared to silicone-based therapies. Parental education on wound care, emotional reassurance, and scar management plays a pivotal role in optimizing healing and minimizing the psychosocial impact of facial scars in children. Through collaboration between clinicians and caregivers, excellent functional and aesthetic outcomes can be achieved, helping children heal both physically and emotionally.