Silicone sheets are a popular non-invasive treatment often recommended by medical professionals for managing scars. These sheets are specifically designed to address raised, thickened scars, such as hypertrophic scars (staying within the wound boundary) and keloid scars (growing beyond the injury site). Many people wonder if this treatment remains effective once the scar has matured, perhaps months or even years after the injury occurred. Understanding the underlying science and clinical evidence is necessary to determine the potential for improvement on these older scars.
The Science of How Silicone Sheets Work
Silicone sheets function primarily by creating a localized environment that influences the skin’s healing response. The material forms an occlusive barrier over the scar, which significantly reduces transepidermal water loss. This sealing effect traps moisture, resulting in increased hydration of the stratum corneum, the outermost layer of the skin.
The resulting moist environment regulates the activity of fibroblasts, the cells responsible for producing collagen. In a healing wound, collagen overproduction leads to the formation of a raised scar. By hydrating the tissue, the silicone sheets help suppress the overactivity of these cells, normalizing their function.
This modulation of fibroblast activity reduces excessive collagen deposition, which causes scars to become thick and raised. The moist, occlusive environment encourages a shift in the type of collagen produced. This process helps replace the thick, disorganized Type I collagen characteristic of a problem scar with the more flexible, organized Type III collagen found in healthy skin, resulting in a softer, flatter, and less noticeable scar over time.
Efficacy and Realistic Expectations for Mature Scars
The effectiveness of silicone sheets is highest when treatment begins early, ideally within the first few weeks after a wound has fully closed. However, clinical evidence indicates that silicone sheets can still provide significant improvement on scars that are months or even years old. Studies have shown treatment effectiveness on scars older than 12 months, with some research including scars up to 62 years old.
For a mature scar, improvement is typically slower and requires a longer treatment duration compared to a new scar. Patients with established hypertrophic and keloid scars can still see improvements in key aesthetic features, including color, thickness, and elasticity. Continued application helps to flatten the scar, reduce redness or discoloration, and soften the tissue.
It is important to maintain realistic expectations when treating an older scar, as the goal is improvement, not complete elimination. Mature scars often require consistent use for four to six months or longer to achieve significant results, whereas new scars may show results sooner. The degree of change depends on the scar’s age, severity, and the individual’s healing response. Patients often report additional benefits such as a reduction in common scar-related discomforts like itching and pain.
Practical Application, Timeline, and Usage Tips
Achieving optimal results with silicone sheets, especially on older scars, depends heavily on consistent and correct application. The sheets should be worn for a minimum of 12 hours per day. Continuous wear of 20 to 24 hours daily, with brief breaks for cleaning, is generally recommended for the best outcomes, as longer contact increases effectiveness.
Before applying the sheet, the scar area must be clean and completely dry, since lotions or oils prevent proper adhesion. The sheet should be trimmed to cover the entire scar, extending slightly past the edges by about half an inch to ensure full coverage. Press the sheet firmly onto the skin to release any trapped air and create the necessary seal.
Silicone sheets are reusable and require daily maintenance to remain hygienic and adhesive. They should be removed and gently washed by hand using a mild, non-oily soap and warm water. After washing, the sheet must be air-dried with the adhesive side facing up, as using a towel can cause particles to stick to the surface. For mature scars, the recommended treatment duration is typically at least three to six months, and continued use is advised as long as improvement is observed.