Silicone scar sheets are a non-invasive, topical treatment used to improve the appearance of scars resulting from injury, surgery, or burns. Made from medical-grade silicone, they are applied directly to the affected skin. The goal is to soften, flatten, and lighten scars, making them less noticeable over time. Silicone sheets work by creating a controlled healing environment that helps regulate the skin’s natural repair processes.
The Biological Basis of Scar Formation
Scarring is the final phase of the body’s natural wound healing process following a deep skin injury. Specialized cells called fibroblasts migrate to the site to repair the damaged tissue. Fibroblasts produce collagen, a protein that provides structure and strength, laying it down in a dense, disorganized pattern to quickly close the defect.
In a normal healing response, collagen production slows down, and the tissue matures into a flat, pale, and pliable scar. Abnormal healing occurs when fibroblasts continue to produce excessive collagen, leading to raised and thickened scars, categorized as hypertrophic scars or keloids.
Hypertrophic scars are raised and red but remain confined within the boundaries of the original wound. Keloids grow beyond the edges of the initial injury, forming firm, sometimes painful masses. Silicone sheets help prevent this overproduction of collagen, addressing the skin’s propensity for disorganized repair.
The Primary Mechanism of Action: Occlusion and Hydration
The effectiveness of medical-grade silicone sheets stems from occlusion and subsequent hydration. The sheet forms a sealed barrier, known as an occlusive dressing, over the scar tissue. This barrier significantly reduces transepidermal water loss (TEWL), which is the natural evaporation of water from the skin’s surface.
Scar tissue often has an immature outer layer, leading to abnormally high TEWL. This excessive water loss signals to the underlying skin cells, the keratinocytes, that the wound is compromised and dehydrated. The silicone sheet corrects this imbalance by trapping moisture, stabilizing the skin’s barrier function, and reducing TEWL.
The resulting increase in hydration creates a normalized microenvironment for the healing tissue. This optimal moisture level signals the keratinocytes to slow down their inflammatory response. The sheets physically manipulate the scar environment to interrupt the chemical signaling cascade that drives abnormal healing.
Regulating Collagen Production and Scar Maturation
The normalized, hydrated environment directly influences the behavior of cells deep within the scar. When keratinocytes are no longer stressed by dehydration, they reduce the release of signaling molecules, such as cytokines. These cytokine signals typically activate dermal fibroblasts, prompting them to synthesize and release high levels of collagen.
By reducing these pro-scarring signals, silicone sheets modulate fibroblast activity, decreasing the overproduction of collagen. This biochemical fine-tuning helps prevent the excessive, disorganized collagen deposition that results in raised scars. This process can also decrease pro-scarring transforming growth factor-beta (TGF-β) levels, which are implicated in excessive scar formation.
The consistent hydration and mild pressure also promote the reorganization of existing collagen fibers, helping them align in a more uniform and pliable pattern. This remodeling process causes the scar to soften, flatten, and lighten in color, making it less conspicuous.
Guidelines for Effective Application
To maximize the therapeutic benefit, proper and consistent application of silicone scar sheets is necessary. Treatment should only begin once the wound is completely closed and fully re-epithelialized, meaning all sutures are removed and scabs have fallen off. Applying the sheet to an open wound can cause irritation.
The sheet should be trimmed to cover the scar and extend about one-half to one inch onto the surrounding healthy skin to ensure full occlusion. For best results, the sheets must be worn for 12 to 24 hours daily. The total treatment period typically lasts a minimum of two to four months, though longer use may be recommended if the scar remains raised or red.
Both the scar area and the silicone sheet must be cleaned daily with a mild, neutral soap and water to maintain hygiene and adhesive quality. After cleaning, the sheet must be allowed to air-dry completely before being reapplied.