Scars represent the body’s natural biological response to injury, where the dermis is damaged and repaired with fibrous tissue. This process results in a visible mark that can be raised, discolored, or textured differently from the surrounding skin. While many interventions exist for improving a scar’s appearance, silicone-based products are a widely accepted, non-invasive treatment method. Silicone is recognized by medical professionals as a first-line therapy for managing the appearance of problematic scars.
How Scars Form: The Biological Background
The development of a scar is a coordinated biological process known as wound healing, which occurs in three overlapping phases. It begins with the inflammatory phase, where the body cleans the wound site and stops bleeding. This is quickly followed by the proliferative phase, which involves the creation of new tissue to bridge the gap left by the injury.
During the proliferative stage, specialized cells called fibroblasts migrate to the wound bed and begin synthesizing large amounts of collagen. This collagen forms the structural framework of the new tissue, initially consisting of disorganized fibers. The final stage is the maturation or remodeling phase, which can last for months or even years.
In this remodeling stage, the deposited collagen is reorganized and strengthened, though it never fully regains the strength or organization of unwounded skin. Problematic scars, such as those that are raised and red, form when this collagen deposition becomes excessive. An overproduction of Type I and Type III collagen by hyperactive fibroblasts leads to the bulky, elevated tissue.
The Mechanism of Silicone Action on Scar Tissue
Silicone’s effectiveness stems from its ability to create a semi-occlusive layer over the scar tissue. This layer functions as a physical barrier, which is the primary mechanism of action. The barrier reduces Transepidermal Water Loss (TEWL), the natural evaporation of water from the skin’s surface.
By minimizing TEWL, the silicone significantly increases the hydration of the stratum corneum, the outermost layer of the skin. This increase in moisture is believed to normalize the signals between the skin’s outer layer (keratinocytes) and the deeper layer (dermal fibroblasts). In a dehydrated scar, keratinocytes signal fibroblasts to maintain an inflammatory, overproductive state.
The restored hydration effectively “turns off” this signaling cascade, reducing the release of growth factors that stimulate fibroblasts. This signals fibroblasts to decrease the excessive production of collagen. This leads to a reorganization of existing collagen fibers, causing the scar to become flatter, softer, and more pliable. Maintaining this stable, hydrated environment also helps regulate local oxygen levels at the scar site, contributing to the overall normalization of the tissue healing process.
Silicone Treatment Options and Application Protocols
Silicone is delivered through two main product types: sheeting and topical gels. Silicone sheeting consists of flexible, medical-grade silicone pads that adhere directly to the skin, creating a continuous occlusive dressing. These sheets are often preferred for larger, flatter scars on the body and extremities where adherence is easily maintained.
Silicone gels and creams offer an alternative delivery method, drying quickly into a thin, transparent layer of silicone film. Gels are especially useful for scars on joints, the face, or other areas with high mobility where a sheet may be difficult to keep in place. Both forms are recommended for use only after the wound has fully closed and the sutures or staples have been removed.
Silicone products should be worn for a minimum of 12 to 24 hours per day. Consistent, prolonged contact is necessary to achieve the continuous hydration required to modify fibroblast activity. Silicone sheets are typically removed for bathing and cleaning of both the scar area and the sheet itself, which helps preserve the product’s adhesive properties and hygiene.
Realistic Expectations and Treatment Duration
Silicone therapy is particularly effective in addressing hypertrophic scars, which are raised and confined to the wound boundary, and keloid scars, which grow beyond the original wound area. Patients can realistically expect a noticeable reduction in scar thickness and an improvement in color, with the tissue becoming less red over time. Many users also report decreased itchiness and pain associated with the scar.
The duration of treatment is a commitment, typically requiring consistent use for a period between two and six months. More severe or older scars may necessitate a longer application period, potentially extending up to 12 months. The degree of improvement is directly related to adherence to the daily wear protocol.
While silicone can significantly improve the appearance and texture of a scar, it cannot completely erase the mark. Results vary based on individual factors, including the scar’s age and the person’s genetic tendency toward scarring. Consistency in application over the recommended multi-month period is the single most important factor for maximizing the treatment’s benefit.