Silicone Scar Treatment | My Experience With Silicone for Scars

Confirming my own findings, Wikipedia also states silicone gel sheeting having the most widely accepted role in general scar treatment together with steroid injections. Compared to steroid injections silicone scar sheets and gels are considered less invasive, easier to use and with lower risks of side effects.

Wikipedia also says: "Silicone sheeting technology is used by plastic surgeons and burn centers to provide patients with optimal results. In the past, silicone gel sheets were thick and uncomfortable and susceptible to cracking and breakdown, but newer technologies have improved performance."

Another great benefit of silicone scar treatment is that it reduces the risk of developing hypertrophic or keloid scars. When it comes to scar treatment products, silicone sheets really are the best buy.

There is scientific proof silicone sheets (or patches as they are called also) work. When searching the Internet for "the international clinical recommendations on scar management" some studies can be found.

A scar is a wound inflicted area where the normal skin is replaced by fibrous tissue. This tissue exists of collagen fibers that are produced as part of the repair process. When an injury of the skin results in a scar it either leaves a pigmented mark or an increased amount of tissue, so called scar tissue.

Scars can be roughly divided into the following types:

• hypertrophic scars; red, thick and raised.


• keloid scars; grow beyond the original wound, can be painful or itchy


• Atrophic scars are skin depressions or indentations, often a result of acne


• contracture scars; tightening of the skin

Not only according to my experiences but also clinical trials show the best way to treat scars at home are silicone sheets. They really work. A marginal note though; getting rid of scars completely is almost impossible. Scars can be improved.

You can talk about reducing or fading scars or smoothing scars but most of the times a scar will never disappear completely. Although I have to admit that one scar on my cheek has healed that much that it almost can't be seen anymore. Not even from very close distance.

As far as doctors and scientists know there are 4 factors that play a mayor role in effective scar treatment:

• moisture


• oxygen


• silicones


• warmth

Read how to make use of these factors in the best scar treatment tips further on this page.

One part of the 20 cm long vertical scar on my chest was problematic from the beginning. It seems this is a very delicate and vulnerable part of the skin on the chest. When I bend my head on my chest its the part just below my chin touching my chest.

Some scars, particularly in the sternum, shoulder, shinbone (tibia), jawbone, and earlobe heal slower. They also tend to become more prominent.

It started with not healing appropriate. Where the rest of the wound was already healed this part stayed an open wound for a much longer time. Later on when the scar was improving this part stayed thicker and more red. The technical name for this is hypertrophic. I considered a steroid injection but eventually decided not to. (Actually I forgot about my appointment, unconsciously being aware of the risk I guess)

About a year later I noticed the scar had healed pretty well and was nice flat and the color was better, more skin like. So after all I am glad I didn't opt for the steroid injection because it seems many times it doesn't work or can even make it worse. The scar will heal itself every time it is messed with so leaving it will eventually be the best solution.

Sheets / patches
Silicone sheets (patches) are solid. I myself used A4 sized sheets which could be cut into the precise proportion I needed for the particular scar. Advantage of silicone sheets is that they can cover a big area at once. Apart from that my own personal finding was that the sheets worked more efficiently.

Gels
Silicone gels are liquid. The gel lays a minuscule silicone film over the scar.
I used the Zeraderm brand. It comes in a little tube that looks like a little glue tube. Advantage of the silicone gel is that it can be applied on scars that are exposed when you are out in public. Or when it is difficult to attach sheets to some parts of the body like joints and the face. In these cases gel can be a good alternative or actually more like an addition to the sheets. Because like I said, I found out that the sheets worked better for me.

So let's say you have a scar in your face and you don't want wear a silicone patch in public. I would wear the patch at night and use the gel during the day. Depending how many hours a day you want to apply the silicones. I chose to use them about 16 hours a day.

I used the sheets for the bigger scars on my body. I cut them to the appropriate size and applied the sheet with silk tape. I treated the smaller scars with the Zeraderm scar gel. Since Zeraderm isn't available in the States I guess Kelo Cote would make a good alternative. This is also a silicone based scar gel.

"The use of silicone cream alone compared with silicone cream with occlusive dressing showed 22% and 82% scar improvement, respectively, with respect to erythema, tenderness, pruritus, and hardness. These results supported that occlusion may be synergistic in wound healing and suggested that silicone gel alone may not be as effective as silicone sheeting." *

* Source: Topical treatments for hypertrophic scars. Joanna M. Zurada, AB, David Kriegel, MD, and Ira C. Davis, MD

It is important to apply the sheets consistently. I used them every day for about at least 12 hours. Mostly about 16 hours during the day. At night I gave my scars time to 'breathe'. Some manufacturers however, advice to wear the sheet 24 hours a day. Although I didn't do this the sheets worked fine for me and the result turned out to be satisfying. It always seemed a bit unnatural to me to wear the sheets continuously.

I did this for about 4 months for the biggest scars. I attached the sheets with silk tape. But you can also use compression garments to keep the sheet attached closely to the scar. Sometimes the sheets didn't stick very well because I had already used them for a while or because of transpiration. I made sure to reattach the sheet or replace it with a new one.

• direct upon the skin


• make sure the skin and sheet are clean and dry


• attach with silk tape or micropore tape (3M) (or a compression garment) if necessary


• wear them consistently

Another benefit of wearing silicone sheets had to do with the most problematic scar of mine. The part of the scar on my chest that was widened, raised, stiff, and purple colored. There's not much tissue there. In fact it's very delicate skin almost directly on the sternal bone. I guess this combination of delicate skin and the stiff scar placed on the bone is what made it so sensitive.

Also the location, there's much friction with clothes, zippers from jackets, buttons, and seat belts made this hypertrophic part of my scar very annoying. Sometimes it did hurt but mostly it just was a very unpleasant feeling. I don't really know how to describe it. My point is that wearing the silicone scar sheets offered relief. It formed a buffer between the sensitive scar and the things frustrating it. In my opinion this is another benefit of wearing the sheets.

The concentration of silicones used in the sheets varies. Some brands offer sheets with higher concentrations of silicones. Also important is the transparency of oxygen and moisture. Medical grade sheets should be breathable.

I used a European doctor-level silicone sheets brand. ScarAway (the former Neosporin Scar Solution) and Biodermis are such doctor-level brands. They consist of a higher percentage silicones from better quality, and seem to be more durable than for example an over-the-counter brand like Mepiform. They seem to stick better to the skin as well.

Thats why I think ScarAway is one of the better brands, if not the best brand, at the moment. Customer reviews on Amazon and forums confirm this. ScarAway sheets are made of professional grade silicones, the sheets are larger and have a better adhesion. As far as I know Biodermis also makes high quality scar fading sheets.

One of the conclusions of this prominent study comparing several treatments: Topical Treatments for Hypertrophic Scars. (Zurada, Kriegel and Davis) source

"The most accepted treatment for old and new hypertrophic scars is silicone gel sheeting. Silicone ointment or gel alone, however, is less effective than silicone sheeting."

Personally I liked to use the gel as an addition for the moments wearing sheets was less convenient.

• Scar Treatment Tip 1 | Start treating the scar as soon as possible.
  The fresher a scar, the more efficient treatments will be. So after the wound is closed scar treatment can be applied immediately. But never before the wound is healed completely. Proper wound care will also benefit scar appearance. Keep the wound moist and clean.



• Scar Treatment Tip 2 | Focus on non invasive / DIY methods
  Over time scars will improve. Make use of non invasive methods and avoid the more intrusive methods as steroid injections and surgery as much as possible. The scar has to heal again and new scar tissue will come into existence.



• Scar Treatment Tip 3 | Moisturize
  Make sure the scar doesn't get dehydrated. Use a lotion or cream to keep it moist. In my opinion any moisturizing cream will do.



• Scar Treatment Tip 4 | Heat Application
  Higher temperatures increase of the activity of the enzyme that breaks down scar tissue. Paraffin wax or heat application devices can be beneficial in scar reduction



• Scar Treatment Tip 5 | Make sure the scar can 'breathe'
  Oxygen is essential for every living being. I made sure my scars were exposed to the air as much as I could. When I was treating my scars I was given the advice to exercise. This way the blood flow will improve thus supporting the skin's own recovering ability



• Scar Treatment Tip 6 | Always keep the scar out of the sun
  Never expose fresh scars to the sun. It is very important to keep your scar, as long as it is not in it's final state, out of the sun because the solar radiation will damage the tissue or cause hyperpigmentation. Also other external influences such as extreme cold and the sauna are best avoided when the scar is still immature.



• Scar Treatment Tip 7 | Wait until the wound is closed
  Never start with scar improving until the wound has been healed completely. You'll want to treat a scar not a wound. Otherwise you will only make things worse.



• Scar Treatment Tip 8 | Massage therapy
  Perform scar massage. By softly manipulating the tissue the blood circulation will improve and the tissue will get softer. Only when the wound has been healed completely. Make use of a cream to your liking. In my opinion it doesn't matter if you choose onion cream or a vitamin B based lotion but some people swear with some kinds of scar creams.
  
  

I got the scars 8 years ago. I have 7 scars in total, the biggest about 9 inches long. One scar on my cheek is almost invisible. This is mostly due to the fact that the skin on the face has a big healing power. A scar in my neck is visible also because there is no hair growth at that particular place but the silicone sheets helped flatten the scar which improved the convenience of shaving. Before that the thickness of the scar made it difficult to shave without cutting myself. ( I will add some photo's when I have a digital camera available)

I am glad that they are improved. They will never leave completely but the sheets helped me with improving them a lot and eventually learning to cope with their existence.

If I had to treat my scars from scratch again I would use Scaraway sheets in combination with Kelo-cote gel (or the ScarAway serum) and a manuka honey based moisturizing cream or instead of the latter certified UMF20+ manuka honey.

Update:
Something I was just thinking about. The small scar from the stab wound on my lower back is the only scar I did not treat with silicones. (I couldn't reach it very well) It also is the only scar that reacts when seasons change. At those times it gets a little itchy now and then. It furthermore is still a little elevated so in this particular case it shows that scars will not always flatten in time on their own. Don't know if there's a causal link but I thought it was worth mentioning.

Doctors also say that many products you can buy on the internet don't work. Fortunately the only risk with these products is you will be disappointed and you will have lost some money. Although some over the counter scar products in fact can do harm.

But with more radical solutions like laser resurfacing, steroid injections or dermabrasion there also is the risk of making the scar worse. Every time the skin is frustrated by a surgical scar treatment it will produce new scar tissue. Of course when your scar problematic these treatments can be a relief. But I would only go for these options if home remedies didn't satisfy.

I didn't know this up front because all I wanted was to get completely rid of my scars but I now see them as a last resort. Time, taking good care by massage, moisturizing, applying silicone sheets and an additional silicone gel like Zeraderm or Kelo-cote can do a lot.

Many people say that the onion based scar cream Mederma, Bio Oil or the scar lotion with vitamin E they use works like a charm for them. I am not convinced at all. Actually I would not recommend to use those products.

Some scientific studies have shown that these products not only don't work but in some cases even can do damage. (I'm talking about topical use of vitamin E capsules here) Again from the dermatology website article:

Bottom Line: Although many patients believe vitamin E speeds wound healing and improves the look of a scar, current evidence from the literature does not support this idea. In fact, studies report adverse effects with use of vitamin E. Because of this, discourage your patients from using topical vitamin E on healing wounds and scars.

"Because of its ability to inhibit collagen synthesis, the use of vitamin E early in scar therapy may reduce scar tensile strength and, hence, lead to the development of widened scars." Source: Topical Treatments for Hypertrophic Scars

Check out this page for more extended info about the best scar removal products There are links to scientific reports and clinical trials on effective scar treatments.

Like I mentioned before, I have tried many scar creams and they didn't turn out to be effective for me. The main benefit of using any cream (or lotion) is that it needs to be physically massaged into the skin.

It is just not clear if it is the massage which is beneficial or the ingredients in the, most of the times very cleverly marketed and sometimes hyped, products. So while I can not say these products do not work with complete certainty, there is no evidence they do work because of their ingredients. I keep saying that massage alone can be very beneficial and there are far better products available.

New wound care product might also work on scar reduction.

The world renowned Professor Peter Molan of the Waikato University in New Zealand has invented a technology to turn honey into rubbery sheets.
"It's like a sheet of rubber, you can touch it without it being sticky at all."

Dr. Molan thinks this product might also work on reversing scars. Considering the extraordinary health benefits of Manuka honey

When applying Manuka honey on wounds it is strongly advised to use medical grade Manuka honey which is sterilized by gamma irradiation. Medical grade Manuka honey is available in jars and in wound dressings. Visit this page for more info about brands and places to buy.

It still is not known exactly how silicone sheets reduce scars. According to Dr Elisabeth Shim, a Santa Monica, California, dermatological surgeon, some of the effects probably come from applying gentle pressure to the area.

The silicone itself may also release some compounds into the skin that alter the way fibroblasts in the dermis generate collagen, Shim said.

Doctors also theorize that the silicones improve scar healing by keeping the area moist and warm. Higher temperatures are thought to increase the activity of collagenase, an enzyme that breaks down collagen.

So when warmth and moist are important factors in scar reduction a qualitative moisturizing cream and heat packs might add a lot to improving scars. Read more about this via the link to the page below.

• Q: Can silicone sheets be applied to the cheek?


• A: Yes they can but sometimes they didn't stick very well to my neck and face. My advice would be: use the sheets as much as possible and in addition silicon gel like Kelo-cote or Zeraderm when for example you are out in public or when for some reason the sheets don't stick well.



• Q: Do silicone sheets make indented scars worse?


• A: I recently heard from a dermatologist that silicone sheets will not make an indented scar more indented.



• Q: Does the use of silicone sheets have side effects?


• A:This research report shows there are no side effects. See the conclusion at the end. Although I have heard of someone who didn't like the feeling of the material on his skin of a specific brand and switched to another brand.



• Q: When can I take a steroid injection for my scar?


• A:It's best to wait for the natural healing process to end. If you have a problematic scar I would visit a medic to ask for an opinion.



• Q: How long should I keep my scar out the sun?


• A:Wait until the scar is not red anymore and more like the color of your skin. Later on sunshine can even improve the appearance of the scar. The color of the scar will hopefully blend into the surrounding skin tissue. But be cautious.

Poster Bri pointed the existence of polyurethane dressings out to me. (thanks for that Bri) I didn't know about them until then. Some research tells me that the opinions on the effectiveness of these dressings compared with silicone sheets differ.

Conclusion of one study is that silicone and non-silicone gel dressings are equally effective in the treatment of keloids and hypertrophic scars.
Read more about this clinical trial here: Silicone versus nonsilicone gel dressings: A controlled trial.

Another study (done by the manufacturer of polyurethane dressings) shows that polyurethane dressings are more effective than silicone patches. Read more about the outcomes of this study here: polyurethane dressings vs silicone sheeting

As there are relatively little studies done which compare silicone
and non-silicone dressings on scars, it is recommended that a larger, more rigorous randomized controlled trial be performed to determine which product really is more effective.

Reading the different reports I do think these dressings also are able to improve scars and especially in case of keloid, hypertrophic and burn scars. I will get back on this subject later.

According to a research report I obtained from the American Dermatology Association: "Polyurethane dressings have equivocal effects on the development of new hypertrophic scars but may improve the appearance of mature scars."

Soon more on my scar treatment blog.

As I have mentioned before silicones have traditionally been used by hospitals and burn care centers. Since I have no experience with burn scars (luckily) I can't share my findings. I did find reports on clinical trials supporting the efficacy of silicone sheets on burn scars. Here's one abstract of such a study: Silicone gel: a new treatment for burn scars and contractures

Some people ask me where they can buy the silicone patches. Recently I got a question from someone in the United Kingdom. For English people and people in many other countries it isn't possible to order these products via Amazon or eBay.

But recently Drugstore.com has expanded its shipping range to a major part of the world. So UK residents can now buy their silicone products online at Drugstore.com. (Drugstore.com offers free shipping for the first non prescriptive order above 25$.)

Click the picture or the link below of the specific product to be guided to the particular product page at Drugstore.com.





ScarAway 1.5 X 3 Fabric-Backed Silicone Scar Sheets

ScarAway 1.5 X 7 Fabric-Backed Silicone Scar Sheets

ScarAway 100% Silicone Gel Serum for Scars

Vitamin E and Bio Oil are supposed to be a great remedy for scars. Or onion extract (Mederma). And in a lesser amount Emu oil which is a popular product at the moment. However there is no evidence supporting claims these products work. I have used a vitamin E cream but it didn't do much for me. As far as I know these products don't add to improving scars.

But when I was writing this page I stumbled upon a product that should be working. It's called Hans Schreuder Scar Treatment Cream and is a soy based scar cream.

Japanese research has proved that a high soy consumption delays the obsolescence of the human body. Furthermore; soy extract is known to even out skin texture and tone.

Now as far as I know this cream isn't available in the USA but maybe there are other soy based scar creams on the market.