The single most effective thing you can put on a healing scar is a silicone-based product, either as a gel sheet or a squeeze-tube gel. Silicone has the strongest clinical backing of any over-the-counter scar treatment, and it works best when you start early and stay consistent. But silicone isn’t the only thing worth your time. Keeping the scar moisturized, protected from the sun, and physically massaged all contribute to a flatter, less noticeable result.
When to Start Treating a Scar
Timing matters more than most people realize. A wound goes through three overlapping phases: inflammation (the first several days), proliferation (lasting several weeks as new tissue fills in), and remodeling, which starts around week three and continues for up to 12 months. That remodeling phase is when your body reorganizes collagen fibers and the scar gradually softens and fades. It’s also the window where topical treatments have the most influence.
The key rule: don’t apply scar treatments to an open wound. Wait until the skin has fully closed. If you had stitches or staples, that typically means waiting until they’re removed and the surface is sealed. Memorial Sloan Kettering Cancer Center advises most patients can begin scar care about four weeks after skin surgery. If you’re unsure whether your wound is ready, look for a continuous layer of new skin with no scabbing, oozing, or gaps.
Silicone Gel and Sheets
Silicone is the gold standard for scar management, and it works through a surprisingly simple mechanism: occlusion and hydration. By sitting over the scar and mimicking the barrier function of normal skin, silicone normalizes the moisture level in the outer skin layer. This reduces the overactivity of the cells responsible for producing collagen, which is exactly what causes scars to become raised, thick, or ropy. Silicone sheets also redistribute tension away from the wound edges, which helps prevent the scar from widening.
There’s even evidence that the friction between silicone and skin creates a mild static electric field that may help collagen fibers align in a more organized pattern, flattening raised scars over time. Silicone also appears to reduce the formation of excess blood vessels at the scar site, which can cut down on redness.
You have two main options. Silicone gel sheets are adhesive strips you place directly over the scar. They’re reusable (wash and reapply) and work well on flat, accessible areas like the chest or abdomen. Silicone gels in a tube dry into a thin film after application, making them more practical for joints, the face, or areas where a sheet won’t stay put. Both forms are available without a prescription at most pharmacies.
The catch is commitment. To see meaningful results, you need 6 to 12 months of near-constant wear. Current sheet products are designed for up to 24 hours of continuous use per day. If that sounds like a lot, even consistent overnight use is better than skipping it entirely. The earlier in the remodeling phase you start, the more pliable the collagen is and the more responsive it will be to treatment.
Petroleum Jelly for Basic Moisture
Before your scar is mature enough for silicone, plain petroleum jelly is your best friend. In the early days after wound closure, keeping the area moist prevents the hard, dry scabbing that can widen a scar. A clinical comparison of petroleum jelly and antibiotic ointment found no difference between the two for healing outcomes: redness, swelling, and skin regrowth were equivalent at every time point measured. The antibiotic ointment actually caused more burning at the one-week mark, and one patient developed allergic contact dermatitis from it.
In other words, you don’t need antibiotic ointment on a clean, closed wound. Petroleum jelly provides the same moisture barrier without the risk of a skin reaction. Apply a thin layer and cover with a bandage to keep the area protected during the early weeks of healing.
Sun Protection
New scars are highly vulnerable to UV damage. The freshly formed skin lacks the pigment distribution of mature skin, so sun exposure can cause lasting dark or light discoloration that takes months to years to resolve. This is especially pronounced in darker skin tones, where post-inflammatory hyperpigmentation can become more visible than the scar itself.
Use a broad-spectrum sunscreen that covers both UVA and UVB rays. For scars on exposed skin, a mineral sunscreen containing zinc oxide offers visible-light protection as well. Reapply every two hours when outdoors. Physical coverage is even more reliable: clothing, medical tape, or silicone sheets all block UV completely. Plan to be diligent about sun protection for at least the first year, which conveniently overlaps with the entire remodeling phase.
Scar Massage
What you do with your hands matters as much as what you squeeze from a tube. Scar massage breaks up adhesions where the scar tissue binds to deeper layers, improves the glide of soft tissue underneath, and can reduce hypersensitivity in scars that feel tender or tingly. Hand therapists surveyed in a clinical study reported that improving soft tissue glide was their primary reason for prescribing scar massage (98% of respondents), followed by reducing hypersensitivity (92%).
The most commonly used techniques are deep and superficial transverse friction, meaning you rub across the scar line (not along it) with moderate pressure. The most frequently prescribed home routine is three times daily, five minutes per session, for about 12 weeks. You can use your silicone gel, petroleum jelly, or any unscented moisturizer as a lubricant while massaging. Start gently and increase pressure as your comfort allows. You should feel firm resistance but not sharp pain.
What About Vitamin E?
Vitamin E oil is one of the most popular home remedies for scars, but the evidence is weak. A systematic review that screened for high-quality studies found only six that met inclusion criteria. Three showed improvement when vitamin E was used, but two of those used it combined with other treatments, making it impossible to credit vitamin E alone. The remaining three studies found no benefit. Two of the six studies reported adverse reactions, including contact dermatitis and increased itching and rash. The review concluded there is not yet sufficient evidence that vitamin E alone significantly improves scar appearance. If you want to try it, patch-test on nearby skin first, but don’t count on it as your primary treatment.
Onion Extract Gels
Products containing onion extract (sold under brand names like Mederma) are widely marketed for scars. However, a controlled clinical trial that split surgical scars down the middle, treating one half with onion extract gel and leaving the other as a control, found no statistically significant difference in redness, pliability, or overall cosmetic appearance at any evaluation point. At the 12-week mark, the vast majority of both treated and untreated scar halves were rated as showing no improvement. This doesn’t mean onion extract is harmful, but the data suggests it doesn’t add much beyond whatever moisturizing effect the gel base itself provides.
Hyaluronic Acid
Hyaluronic acid shows some promise for scar remodeling, partly inspired by the observation that fetal wounds heal without scarring in an environment naturally rich in it. A clinical study using a hyaluronic acid sponge with zinc on breast surgery scars found measurable changes in collagen density and fiber organization compared to placebo on biopsy. The treated skin showed denser, more organized collagen bundles with fewer clusters of scar-producing cells. Hyaluronic acid is available in many over-the-counter serums and creams, though most consumer products haven’t been tested specifically for scar outcomes. It’s a reasonable addition to your routine, particularly layered under silicone gel.
Putting It All Together
A practical scar care routine looks like this. In the first few weeks after wound closure, keep the area moist with petroleum jelly and a bandage, and protect it from the sun. Once the skin is fully sealed (around the four-week mark for surgical wounds), transition to silicone gel or sheets as your primary treatment, worn as close to around the clock as you can manage. Massage the scar three times daily for five minutes, using your silicone gel or a plain moisturizer. Apply sunscreen to any exposed scar tissue before going outside.
Stick with this for the full remodeling phase, up to 12 months. Scars continue to change and soften throughout that entire period, so improvement at month two doesn’t mean you’ve hit your ceiling. The combination of silicone, massage, and sun protection gives your scar the best chance of becoming as flat, soft, and close to your natural skin tone as possible.