Silicone Therapy

Scars and skin graft donor sites need regular creaming (moisturisation) to prevent the area from drying, cracking and becoming sore. The oil glands in your skin which usually provide moisture can be damaged or destroyed by the injury. The surface layer of the skin which prevents water loss is damaged. Therefore, the healed skin lacks the moisture needed. Silicone works by sealing in the moisture and hydrating the scar. Through providing occlusion (covering) and hydration to the outer layer of the epidermis evaporation of water is reduced from the skin. Silicone treatment aims to flatten, soften and reduce the redness and discomfort of your scar over time. Silicones possess many skin-friendly properties; they are easy to use and remove, painless, can be worn for long periods, are resistant to microbial growth, and are waterproof.

Your scar specialist can advise you on the most appropriate type of silicone for your scar:

• Silicone sheets: these are sheets of silicone; they are soft and rubbery of varying thickness and size; they stick to the skin. Silicone sheets are often reusable (daily cleaning is needed) or are single use (less risk of skin infections!). Silicone doesn’t provide pressure, but it may cause a slight increase in body temperature which may lead to greater collagenase activity which can have a positive effect on scarring.
• Silicone liquid (gels): most suitable for immediate postoperative care and areas where wearing a sheet is not easy e.g., on the face. Gels are applied twice a day.
• Silicone spray (good for bigger areas) or stick is also available.

Some people are sensitive/allergic to silicone. Therefore, it is important to increase how long you wear silicone for. You can try silicone for 4 hours on the first day and increase by 4 hours each day, or as recommended by your scar specialist/product instructions. During this time check your skin frequently for irritation or rashes. If there are signs of irritation (usually redness), stop the silicone and discuss with your scar specialist. If you have sensitive skin, test the silicone on your non-scarred skin before you try it on your scar.

Beneficial effects on scar:

• Reduced redness
• Improved pliability
• Improved pigmentation
• Reduced height

• Before silicone application your wound should be healed and clean
• Unless otherwise recommended by your scar specialist, apply silicone gel twice a day after your moisturising cream has been fully absorbed.
• Only a small amount of silicone should be applied. Apply a thin layer, more is not better! Too much silicone won’t allow it to dry fully which reduces its effectiveness.

Reported adverse effects: 

• skin irritations
• redness
• itching
• burning sensations and sensory symptoms

• Cut the sheet to the size which covers the scar with a slight overlap onto surrounding skin.
• Depending on the location and the ‘stickiness’ of the sheet, something else such as a pressure garment or tape may be needed to keep the sheet in place.
• Wash your sheet twice a day with mild non-oily soap, rinse in warm water, allow to dry, then reapply. You could use two sheets and rotate between them while the washed sheet is drying, or the sheet can be patted dry with a non-fluffy cloth.
• Before reapplying, cleanse and dry your skin as normal, moisturise and make sure the cream is fully absorbed.
• Wear your sheet for at least 12 hours a day, where possible up to 20 hours a day.
• When the sheet begins to deteriorate, and cleaning becomes difficult replace your gel sheet (one piece may last for 2 months).
• Silicone sheets are expensive, please take care of them and use them as advised.

Reported adverse effects:

• Scar maceration (the skin gets too moist, and looks white and loose) or breakdown (with prolonged use)
• Persistent itching and a bad smell (due to poor hygiene)