The body’s response to injury is intended to restore the skin’s protective barrier. A scar represents the natural, yet imperfect, result of this repair process when the deeper layers of skin are involved. Silicone gel is a widely accepted, non-invasive method for managing these visible outcomes, endorsed by dermatologists and plastic surgeons. This topical treatment modulates the environment of the healing tissue, encouraging a more organized and aesthetically favorable maturation of the new skin.
Understanding Scar Formation
Wound healing proceeds through overlapping stages, beginning with the inflammatory phase to stop bleeding and clean the injury site. This is followed by the proliferative phase, where specialized cells called fibroblasts migrate to the area to produce new connective tissue and collagen, which initially helps close the wound. The final stage is the maturation or remodeling phase, which can continue for months or years. During remodeling, Type III collagen is gradually replaced by the stronger, more organized Type I collagen found in normal skin. Scarring occurs when this process becomes dysregulated, leading to an excessive and disorganized deposition of Type I collagen fibers, resulting in a raised, thickened, or discolored patch of tissue.
The Primary Mechanism of Action
Silicone gel’s effectiveness stems primarily from its ability to create a semi-occlusive layer over the healing tissue. This barrier significantly reduces Transepidermal Water Loss (TEWL), increasing the hydration of the stratum corneum, the outermost layer of the skin. This moist environment regulates the activity of keratinocytes, the skin cells in the epidermis. Increased hydration causes keratinocytes to suppress the release of cytokines, signaling molecules that normally activate dermal fibroblasts. By reducing these pro-fibrotic signals, the silicone gel helps normalize fibroblast activity, curbing the overproduction of collagen that causes raised scarring and promoting a softer, flatter, and less erythematous (red) scar appearance.
Practical Application and Usage Timeline
Treatment should only begin once the wound is completely closed (scab gone and stitches removed), which usually occurs between one and three weeks post-injury. Applying the product too early to an open wound can interfere with the natural healing process. The gel should be applied in a very thin layer once or twice daily after cleaning, ensuring it dries completely to form a breathable, flexible sheet over the scar tissue. Consistent, continuous use is paramount, requiring the product to be in contact with the scar for 12 to 24 hours per day to achieve the necessary hydration effect. The duration of treatment is generally recommended to be between two and four months; while the gel is convenient for mobile areas, silicone sheeting offers a more robust occlusion, which may be preferred for scars on the torso or limbs.
Types of Scars Treated
Silicone gel is the primary non-invasive treatment for managing abnormal scarring, particularly raised scars like hypertrophic scars. Hypertrophic scars are raised, firm, and red, but remain confined within the boundaries of the original injury, and consistent silicone application helps them flatten and fade significantly over time. Keloid scars are more aggressive, extending beyond the margins of the original wound. While more challenging to manage, silicone therapy is a standard prophylactic measure used immediately after surgical procedures to prevent keloid formation. The treatment is also used to improve the appearance and pliability of surgical scars and scars resulting from burns.