Silicone Gel / Sheeting (Scar Management)

How it works

Silicone is thought to act mainly by occlusion and hydration of the stratum corneum, normalising the scar microenvironment and modulating fibroblast activity and collagen deposition rather than through any systemic drug action.

Prescribing in practice

• Apply only to fully healed, closed skin, not to open or broken wounds, to avoid maceration and irritation.
• Consistent, prolonged daily use over weeks to months is needed for benefit, and skin should be kept clean and dry under sheeting.
• Select silicone products and timing in line with scar-management and tissue-viability guidance.

Monitoring

Review the maturing scar periodically for colour, height and pliability, and check the underlying skin for irritation or breakdown.

Counselling the patient

• Explain that silicone is used on healed skin to flatten and soften scars over time.
• Stress that regular, prolonged use is essential for it to work.
• Advise stopping and seeking review if the skin becomes irritated or breaks down.

Evidence & guidelines

Silicone gel and sheeting are first-line non-invasive options in international scar-management guidance for preventing and treating hypertrophic and keloid scars.