Silicone strips and sheets are a common, non-invasive treatment method widely used in dermatology for managing the appearance of scars. These pliable, self-adhesive dressings are made from medical-grade silicone and are applied directly over a healed injury site. They are often recommended as a first-line therapy to minimize the visibility of scars resulting from surgery, burns, or other trauma. This approach aims to improve the texture, color, and height of raised scars.
The Science Behind Scar Reduction
The primary mechanism by which silicone strips work involves creating an occlusive barrier over the skin. This barrier prevents excessive transepidermal water loss (TEWL), which is characteristic of new scar tissue lacking a fully developed outer layer. By trapping moisture, the silicone sheet increases hydration in the scar tissue. This condition signals to the underlying cells that the skin barrier is intact.
This increased hydration helps to regulate the activity of fibroblasts, the cells responsible for producing collagen. In abnormal scar formation, fibroblasts overproduce collagen, leading to a raised and thickened scar. By normalizing hydration levels, the silicone reduces this overactivity, decreasing the rate of collagen synthesis and deposition. This process helps to soften and flatten the scar tissue over time.
A secondary mechanism is the physical effect of the sheet on the wound site. Silicone strips provide gentle, continuous pressure and can reduce mechanical tension across the wound. Reducing this tension is beneficial because high skin tension stimulates fibroblasts to produce more collagen, worsening the scar’s appearance. Some theories suggest that the friction may generate a static electric charge, influencing the alignment of collagen fibers into a more organized pattern.
Practical Application and Duration
Silicone treatment should begin only after the wound has completely closed and any scabs or stitches have been removed, typically a few weeks after the injury. Applying the strips to an open wound can interfere with natural healing and potentially cause irritation. The sheet should be cut to fully cover the scar and extend slightly onto the surrounding healthy skin to maximize the occlusive effect.
Consistency in wear is paramount to achieving noticeable results, with a minimum daily wear time of 12 hours recommended. Dermatologists advise aiming for 12 to 24 hours of continuous wear each day, removing the strip only briefly for cleaning and bathing. Reusable strips require daily cleaning with a mild, non-oily soap and water to maintain hygiene and preserve adhesive quality.
The overall treatment period for scar improvement is lengthy, often requiring several months of consistent use. For many scars, a duration of two to four months is suggested to achieve significant softening and flattening. More severe or older scars, such as established keloids, may require an extended treatment period of six to twelve months or longer.
Types of Scars That Benefit Most
Silicone therapy is most effective on scars that are raised, thickened, and often red, categorized as pathological scars. These include hypertrophic scars, which are elevated and confined strictly to the original wound boundary. The therapy works well on these scars by regulating the excessive collagen that caused the elevation.
Silicone is also used as a first-line treatment for keloid scars, which are more aggressive and grow beyond the edges of the original injury. While keloids are more difficult to treat than hypertrophic scars, silicone sheets can significantly improve their color, thickness, and associated symptoms like itching and pain. Scars resulting from surgery, burns, and other traumatic injuries that lead to a raised appearance are the primary targets.
The strips may offer some improvement in color and texture for older, mature scars and atrophic scars, which are indented or pitted below the surrounding skin level. However, the flattening mechanism works best on raised tissue, making the effect less pronounced on depressed scars. For all types of scars, the sooner treatment is started after complete wound closure, the better the potential outcome.