Medical Device / Topical Scar Treatment Pregnancy: Safe for topical use — no systemic absorption.

Silicone Gel / Sheeting (Scar Management)

Brand names: Mepiform, Cica-Care, Dermatix, NewGel+E

Adult dose

Dose: Silicone gel: apply thin layer to healed wound twice daily; silicone sheeting: apply for 12–24 hours/day; commence once epithelialisation complete and wound fully healed

Route: Topical

Frequency: Twice daily (gel) or continuously (sheeting — minimum 12 hours/day)

Max: Continuous use for 3–6 months minimum (scar maturation period)

First-line non-invasive scar treatment in burns — British Burns Association and NICE recommend as initial treatment for established/developing hypertrophic scars and keloids. Mechanism: hydration, temperature increase, and static electricity reduce collagen synthesis. Most effective when started early (2 weeks post-healing) and used consistently.

Paediatric dose

Route:

Frequency: 12–24 hours/day (sheeting); twice daily (gel)

Max: As per adult schedule

Safe in all paediatric age groups — commence as soon as wound is fully re-epithelialised. Paediatric burns scar treatment: silicone gel + compression garment combination is BBA standard of care.

Dose adjustments

Renal

Not applicable — topical use only.

Hepatic

Not applicable.

Clinical pearls

BBA Scar Management Guidelines 2019: silicone therapy is Grade A evidence for hypertrophic scar prevention and treatment. Commence within 2 weeks of wound healing; use for minimum 3–6 months. Combine with compression garment (24–23 mmHg pressure) for burns covering joint surfaces
Keloid vs hypertrophic scar distinction: hypertrophic scars remain within wound boundaries and may spontaneously regress; keloids extend beyond wound margins and rarely regress without treatment. Silicone effective for hypertrophic — less effective for established keloids which require additional intralesional therapy (triamcinolone, bleomycin, 5-FU, verapamil)
Adherence is critical: 12–24 hours/day wear for 3–6 months is required for efficacy; poor adherence (common) leads to treatment failure. Silicone sheets can be washed and reused for 2–3 months before replacing. Gel formulation preferred for facial areas, joints, and paediatric patients

Contraindications

Open or incompletely healed wounds (risk of maceration and delayed healing)
Active infection at application site
Known silicone allergy (rare)

Side effects

Skin maceration (if wound not fully healed)
Pruritus at application site
Contact dermatitis (uncommon)
Folliculitis (under sheeting — ensure daily cleaning)
Malodour under sheeting (poor hygiene)

Interactions

No pharmacological interactions — topical medical device

Monitoring

Scar assessment (Vancouver Scar Scale or Patient and Observer Scar Assessment Scale — POSAS)
Wound integrity under sheeting (daily skin check)
Adherence to daily wear schedule
Signs of contact dermatitis or folliculitis

Reference: BNFc; British Burns Association Scar Management Guidelines 2019; NICE NG24 (Burns); Mustoe et al. Plast Reconstr Surg 2002 (International Advisory Panel on Scar Management); BNFc. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators