Silicone Products for Keloid Scars: Sheets, Gels and Tape Options

Keloid scars present significant challenges for many individuals, extending beyond the boundaries of the original wound and often causing both physical discomfort and emotional distress. Silicone-based products have emerged as a first-line, non-invasive treatment option for these stubborn scars. This comprehensive guide examines the effectiveness of various silicone products, including sheets, gels, and tapes, providing evidence-based insights into how these treatments can help manage and improve keloid scarring.

silicone products for keloid scars - sheets gels tape

Understanding Keloid Scars and Their Challenges

Keloid scars represent an abnormal healing response that extends beyond the original wound boundaries.

Unlike normal scars or hypertrophic scars (which remain within the original wound area), keloids can spread to surrounding skin and rarely improve without intervention. These raised, often reddish or dark pink scars can cause significant physical and emotional impact through symptoms like pain, itching, and cosmetic disfigurement110.

Keloids develop after various skin injuries, including surgery, trauma, or even minor wounds like acne. They affect both sexes and can occur at any age, though certain populations have higher susceptibility. Their persistent nature makes them particularly challenging to treat, as conventional approaches may yield temporary improvement or potentially worsen the condition110.

A surgeon consulted in one study specifically warned against surgical removal of keloids, noting that this approach might remove the scar temporarily but could lead to larger keloid formation over time4. This treatment challenge highlights why non-invasive options like silicone products have become increasingly important in keloid management.

How Silicone Products Work for Keloid Treatment

Despite being used for scar management since 1983, researchers are still working to fully understand exactly how silicone helps improve keloid scars12. Current evidence suggests several potential mechanisms:

Hydration Enhancement: Silicone creates a semi-occlusive barrier that increases stratum corneum hydration, facilitating regulation of fibroblast production and reducing excessive collagen deposition in scar tissue212.
Protective Barrier Formation: The silicone layer shields the scar from bacterial invasion, preventing bacteria-induced excessive collagen production that can worsen keloid appearance2.
Cell Signaling Modulation: Silicone may alter the communication between fibroblasts and keratinocytes, affecting cytokine-mediated cellular responses that influence scar development12.
Gentle Pressure Application: When used as sheets or tapes, the mild pressure may help regulate collagen production, minimizing excessive scar tissue formation.

The resulting effects typically include softening and flattening of keloid scars, with potential improvements in color, texture, pain, and itching occurring gradually over months of consistent use112.

Silicone Gel Sheets for Keloid Scars

Silicone gel sheeting (SGS) consists of medical-grade silicone reinforced with a silicone membrane backing. These soft, flexible sheets have become one of the most commonly used treatments for keloid scars37.

Key Features and Benefits

SGS products provide several advantages for keloid treatment:

Established Efficacy: Considered by many experts to be the "gold standard" non-invasive therapy for both prevention and treatment of keloid and hypertrophic scars.
Adaptability: Most sheets can be cut to precisely fit the scar area, overlapping by at least 1cm for optimal effect7.
Extended Protection: Can be worn for extended periods (up to 23 hours daily) to provide continuous treatment.
Reusability: Quality sheets can be washed and reused multiple times, offering economic benefits for long-term treatment.

Application Process

For optimal results with silicone gel sheets:

Thoroughly clean and dry the scar area before application7.
Cut the sheet to overlap the scar by at least 1cm on all sides7.
Remove the protective backing and apply directly to the scar.
If necessary, secure with medical tape or bandages, especially on high-movement areas7.
Gradually increase wearing time: Start with 2-4 hours on day one, 4-8 hours on day two, building to 12-23 hours daily7.
Continue use for at least 3-6 months, the typical time needed for scar maturation.

Notable Products

Several silicone sheet products have gained recognition for their effectiveness:

Cica-Care by Smith & Nephew: Known for strong adherence, flexibility, and ability to reduce scar size and discoloration.
Kelo-cote C-Section Silicone Scar Sheets: Feature a curved design for comfort and can be cut to fit individual scar sizes.
Mederma Silicone Scar Sheets: Offer UPF 50 protection, helping prevent additional pigmentation issues in the scar area.

Self-Drying Silicone Gels

Self-drying silicone gels emerged as an alternative to sheets, addressing limitations in certain applications. These gels contain long chain silicone polymers (polysiloxanes), silicone dioxide, and volatile components that form an invisible protective layer when applied to the skin212.

Advantages Over Sheets

Silicone gels offer specific benefits that complement or sometimes surpass sheets:

Application Versatility: Easier to apply on challenging body areas such as the face, scalp, joints, or irregular surfaces where sheets may not conform well12.
Cosmetic Acceptability: Once dry, they're virtually invisible, making them suitable for visible areas where sheets might be cosmetically undesirable122.
Convenience: Can be used under makeup or sunblock after drying completely8.
Targeted Treatment: Allows precise application to irregularly shaped scars2.

The self-drying technology typically allows these products to dry within 4-5 minutes, after which they form a protective barrier that works continuously, though some users report longer drying times in certain conditions2.

Application Guidelines

For effective use of silicone gels:

Clean and completely dry the scar area8.
Apply a very thin layer of gel—using more does not increase effectiveness and may extend drying time8.
Allow 4-5 minutes to dry completely before dressing2.
Apply twice daily (morning and evening) for continuous protection8.
Once dry, makeup or sunblock can be applied over the treated area8.

Clinical Efficacy

Research has demonstrated promising results with silicone gels. One study of 30 patients with various scar types found that after treatment with self-drying silicone gel, 60% of scars were graded as normal, while 20% were classified as mildly hypertrophic. Only 20% remained in the more severe hypertrophic or keloid categories2.

Silicone Scar Tapes

Silicone scar tapes combine the benefits of silicone gel with adhesive properties for secure application. These products are essentially pre-sized adhesive strips containing or backed by silicone gel.

Benefits and Features

Silicone tapes offer unique advantages:

Convenience: Pre-cut strips eliminate the need to measure and cut sheets to size.
Enhanced Adhesion: Better staying power on areas with frequent movement.
Protection: Some products offer additional benefits like UV protection (UPF 50).
Discretion: Lightweight design allows them to be worn unobtrusively under clothing.

Clinical Evidence and Effectiveness

The clinical evidence supporting silicone products for keloid treatment varies by product type and study quality:

Research Findings

A 2023 Cochrane systematic review examined silicone gel sheeting specifically for keloid scars and expressed uncertainty about whether SGS improves scar appearance more than no treatment, non-silicone gel sheeting, or triamcinolone acetonide injections110. The review noted limitations in available studies, including small sample sizes and methodological concerns.

In contrast, a meta-analysis published in 2016 found a significant difference between silicone gel sheeting and placebo groups in preventing hypertrophic scars, with a risk ratio of 0.70 (95% confidence interval, 0.49-0.99)6. However, this review also acknowledged that many trials had high or uncertain risk of biases in study design or conduct6.

Effectiveness of Silicone Products for Keloid Scars

Real-World Effectiveness

Patient experiences with silicone products vary considerably:

Some users report dramatic improvements, such as one individual who claimed a 75% reduction in 20-year-old keloids after three years of consistent use of ScarAway sheets4.
Others report little or no visible improvement after several months of application. One Reddit user shared: "I've used scaraway and cica-care silicone sheets for about 5 months... I didn't see any visible improvements after using them. My keloid scar is still the same size after so many years and I kinda just live with it now."4

This variability suggests that individual responses differ significantly based on scar characteristics, consistency of application, and possibly genetic factors.

Best Practices for Optimal Results

For the best outcomes with silicone products, following proper application techniques and treatment protocols is essential:

When to Start Treatment

For maximal effectiveness, silicone treatment should begin as soon as possible after the wound has fully closed:

For surgical scars: Start after suture removal and when any scabs have disappeared.
For existing keloids: Can still be beneficial, though results may take longer to achieve4.

Treatment Duration

Consistency and patience are crucial for success:

Most manufacturers recommend continuous use for at least 3-6 months.
Significant improvements often require at least 12 weeks of regular application2.
For some users, particularly with older keloids, treatment may need to continue for years to achieve optimal results4.

Combining Treatments

Several users and some studies suggest enhanced results when combining approaches:

Massage therapy: One user emphasized that massage during application is "ESSENTIAL!" for improving results4.
Complementary topicals: Some report better outcomes alternating silicone sheets during the day with specialized scar creams like Mederma PM at night4.
Professional treatments: For severe keloids, silicone products might work best as part of a comprehensive approach including medical interventions like steroid injections.

Managing Expectations and Side Effects

While silicone products can significantly improve keloid scars, setting realistic expectations is important:

Potential Limitations

Gradual improvement: Visible changes typically take months rather than weeks.
Variable results: Not all keloids respond equally well to silicone therapy4.
Maintenance requirement: Benefits may diminish if treatment is discontinued prematurely.

Possible Side Effects

Although generally considered safe, some users experience:

Skin reactions: Allergic reactions to silicone gel were reported in one case study, and mild skin desquamation (peeling) occurred in two cases2.
Application challenges: Some users report difficulties with drying time or maintaining adhesion in humid conditions or high-movement areas2.

Conclusion

Silicone products represent one of the safest and most accessible first-line treatments for keloid scars. Whether in sheet, gel, or tape form, these non-invasive options have demonstrated effectiveness in improving scar appearance and reducing associated symptoms like itching and discomfort for many patients.

The choice between sheets, gels, or tapes should be guided by the scar location, lifestyle considerations, and personal preference. While sheets may offer better occlusion for larger, flatter areas, gels provide superior versatility for facial or irregularly shaped scars. Tapes combine convenience with effective treatment for linear scars.

For optimal results, treatment should begin as early as possible after wound healing, continue consistently for at least several months, and potentially incorporate complementary approaches like massage. Though silicone products may not completely eliminate keloid scars in all cases, they offer a valuable, evidence-based tool in scar management with minimal risk and good cosmetic acceptability.

Individuals with severe or treatment-resistant keloids should consider silicone therapy as part of a comprehensive approach developed in consultation with a dermatologist or plastic surgeon, who can recommend additional interventions when necessary.

Silicone Treatment for Scars

Monday, March 31, 2025

Keloid Scars: Which Is Better - Silicone Sheets, Gels, or Tape?