Silicone cream is primarily used to prevent and treat raised scars, including hypertrophic scars and keloids. It’s one of only two treatments with strong clinical evidence for scar management, alongside steroid injections. But unlike injections, silicone cream works as both a preventive tool (applied to fresh surgical wounds) and a treatment for existing scars. Beyond scar care, silicone-based ingredients also appear in everyday moisturizers, cosmetics, and skin protectants.
How Silicone Cream Works on Scars
Silicone isn’t absorbed into the skin. Instead, it forms a thin, breathable layer on the surface that traps moisture and reduces water loss through the skin. This is the key to how it works: when a healing wound loses too much water, the sodium concentration in the surrounding tissue rises. That spike in sodium triggers a chain reaction of inflammatory signals that ramp up collagen production, which is what causes scars to become thick, raised, and discolored.
By keeping the skin hydrated, silicone cream essentially turns down that inflammatory response. Researchers have identified a specific sodium-sensing channel in skin cells that controls the entire signaling cascade. When silicone keeps the wound moist, sodium levels stay normal, the inflammatory signals stay quiet, and collagen production stays closer to what healthy skin would produce. The result is a flatter, softer, less noticeable scar.
Scar Prevention After Surgery or Injury
The most common use of silicone cream is preventing problem scars from forming in the first place. Dermatologists and plastic surgeons frequently recommend it after surgery, burns, or traumatic wounds. Treatment can begin as early as the day of surgery when using silicone sheets, though most people start applying silicone gel or cream about two to four weeks after the wound has closed.
For best results, the cream needs to be applied consistently over a meaningful stretch of time. A two-month course is sometimes recommended, but a systematic review of clinical trials found that silicone gel’s effects on surgical scars may not become significant until six months of use. If you’re using silicone sheets rather than cream, the standard recommendation is at least 12 hours of wear per day for three to four months, with a maximum total treatment window of six months (longer use may actually hinder healing).
Treating Existing Raised Scars
Silicone cream also improves scars that have already formed. Clinical studies report an 86% reduction in scar texture, 84% improvement in color, and 68% reduction in scar height. In one study of hypertrophic and keloid scars treated with silicone gel, 60% were graded as normal-looking by the end of treatment, and another 20% had improved to only mildly raised. The remaining 20% still showed significant scarring but had not worsened.
Older, more established scars tend to respond more slowly than fresh ones, and the improvements are generally less dramatic. Still, silicone cream is considered safe and effective enough for both new and mature scars that it remains a first-line recommendation in clinical guidelines.
Silicone Cream vs. Silicone Sheets
Silicone sheets were developed first and are the most studied format. They create a nearly complete moisture barrier over the scar and have strong clinical evidence behind them. The downside is practical: they’re hard to keep in place for 10 to 12 hours a day, they can cause itching and skin irritation from excessive moisture trapping, and they’re conspicuous on visible areas like the face or neck.
Silicone creams and gels were developed to solve those problems. They dry into an invisible film, work on irregular body contours, and are easier to incorporate into a daily routine. Studies show their effects are comparable to sheets despite providing slightly less occlusion. The trade-offs are a longer drying time after application, a somewhat shiny appearance on the skin, and higher cost when treating larger scars. For small or visible scars, most people find the cream format far more convenient.
Silicone in Everyday Skincare Products
Outside of dedicated scar products, silicone compounds are common ingredients in moisturizers, primers, sunscreens, and cosmetics. The most widely used is dimethicone, which creates a thin, nongreasy layer that smooths the skin’s surface by filling in gaps between damaged or uneven skin cells. It acts as a moisture barrier and emollient without feeling heavy.
Dimethicone is permeable to water vapor, meaning sweat can still evaporate through it. This makes it unlikely to cause heat rash or trapped moisture problems. Cyclopentasiloxane, another common silicone, evaporates after application and gives products a dry, silky feel. You’ll find it in antiperspirants, makeup removers, and long-wear cosmetics because it dissolves oils effectively and helps products glide on smoothly.
For people concerned about breakouts, silicone-based ingredients are generally well tolerated. They sit on the skin’s surface rather than penetrating into pores, and most formulations are noncomedogenic. Dimethicone in particular is used in products designed for sensitive and acne-prone skin because of its lightweight, breathable barrier properties.
How to Apply Silicone Cream for Scars
Start by making sure the wound is fully closed. Open or weeping wounds are not candidates for silicone cream. Once the skin has healed over, clean the area gently and let it dry completely before applying a thin layer. The cream needs direct contact with the scar to form its protective film, so don’t layer it over other products.
Apply it once or twice daily. Let the cream dry fully before putting on clothing or sunscreen over the area. Consistency matters more than quantity: a thin, even layer applied every day for several months will outperform heavy, sporadic use. Most people begin seeing noticeable softening and color improvement within the first two to three months, but meaningful flattening of raised scars often takes longer. Plan on continuing for at least three to six months to give the treatment a fair chance to work.
If you have a history of keloids or hypertrophic scarring, starting silicone cream early, ideally within a few weeks of wound closure, gives you the best shot at preventing a raised scar from developing in the first place.