Category Archives: Studies

Mederma or Silicone Scar Sheets? Here’s What Studies Say About Silicone vs Mederma

which is better, Mederma onion extract cream or silicone scar sheets?

You worry about people staring at your scar. You remember exactly how it got there or you don’t but you’re still anxious to know how to remove it.

You’ve looked for ways to make the scar fade so it’s not so noticeable, but how can you sort out the good information from the pure marketing efforts and questionable products?

Should you buy Mederma, get silicone sheets, or order yet another scar removal product?

After all, there are so many products and brands available and the advice given is even more divers.

To make matters even worse,  even people you should expect would know, such as medical personnel and store owners, don’t know what helps and what doesn’t.

If you were to ask various individuals their thoughts on how to remove a scar you would probably get different answers of which most don’t make any sense.

The result? Confusion galore.

I know what you are going through since I have been there myself.

I have tried many of these so called effective remedies. Not only am I amazed there are still so much misconceptions but I also am displeased about the fact that many professional medical practitioners such as my doctor, the nurses, and even the surgeons did not know what to prescribe or advice to someone who wants to treat his or her scars.

In my case, I was first recommended to use Biodermal PCLE cream and Calendulan cream.

Now, maybe these work for fine lines and wrinkles but they are certainly not appropriate to treat my surgical scars and scars from cuts.

After some research you have limited your choice to two of the most popular products and now you are wondering, shall I use Mederma or silicone scar sheets?

 

Scar Treatment Misinformation

scar treatment fairy tales are abundant sadly enough
scar treatment fairy tales are abundant sadly enough

Yep it’s true, scar treatment fairy tales, sadly, are abundant.

For example you better forget about rubbing vitamin E capsules onto your scar. This is a typical scar removal myth.

Vitamin E capsule use is actually discouraged by dermatologists because they did show to cause skin rash and other irritations in study subjects.

In some cases these bad reactions might actually make a scar worse.

Another common myth is that scar creams have to be expensive to work.  Aloe vera gel and Palmer’s Cocoa butter are commonly thought to be proven effective scar remedies but they are not. (there’s limited research on aloe vera showing some benefits.)

One more misconception, it is commonly thought that sunshine helps fade scars which is not true because immature scars (approx. up to 1,5 to 2 years) should be kept out of the sun because the radiation will worsen them.

Back to the Mederma or silicone sheets dilemma.

Should you use Mederma or silicone gel sheets for your scar?

Mederma cream is an onion extract based cream which is claimed to work on old and new skin marks resulting from injury, surgery, burns, and stretch marks.

As the company says itself the cream is the #1 doctor- and pharmacist-recommended brand.

Lets take a closer look at what Mederma cream is.

Mederma ingredients:

  • Cepalin – Onion Extract  ( allium cepa)
  • Hyaluronic Acid – Hydrating Agent
  • Centella Asiatica – Leaf Extract

 

Here’s what studies say about Mederma for scars

Mederma scar creamSome animals and limited human studies have shown it to have some benefits.

Onion extract gel has shown to have little benefit in one study on rabbits.

One 2008 human clinical trial among patients with surgical scars from keratosis removal found that:

..onion extract gel significantly improved scar softness, redness, texture, and global appearance.

And another study demonstrated that

onion extract gel is safe and significantly improves scar appearance after four weeks of once-daily application.

However, a 1999 study among MOHS surgery patients found that:

Topical onion gel extract was ineffective in improving scar erythema and pruritus in our patients.

Note: scar erythema is redness and pruritus means  itch.

Another study, conducted in 2007, examined the effects on onion extract on keloid and hypertrophic scars and specifically focused on elevation, redness, hardness, itching and pain.

The researchers concluded that:

Onion extract improved hypertrophic and keloids scars via multiple mechanisms. However, it was statistically ineffective in improving scar height and itching. For this reason, onion extract therapy should be used in combination with an occlusive silicon dressing to achieve a satisfying decrease in scar height.

What’s more..

A in 1996 conducted study into the therapeutic values of onion and garlic found that they may act as an anti-inflammatory and bacteriostatic agent. Reducing inflammation is what is thought to help reduce scar thickness and elevation.

Another study conducted in 2002 showed Mederma improved collagen organization after injury in rabbits. Additional studies however have shown topical onion extract unable to improve scars.

To make matters more confusing, some sources state that “products containing onion extract or allium cepa should not be considered as an effective scar treatment. But one study showed Mederma improved collagen organization after injury in rabbits.”

This might be an indication it could work on stretch marks since these are most commonly the result of a disruption of collagen. Fact is, that, as far as I know, there are no independent studies proving this claim.

Mederma vs Vaseline

Vaseline is cheaper and shows to be at least just as good at hydration (which appears to be what makes scars improve).

A randomized, double-blinded, split-scar study showed no more improvement after the use of Mederma as the onion extract gel on scars compared to a petroleum based ointment (such as Vaseline).

It concluded that:

“the onion extract gel did not improve scar cosmesis or symptomatology when compared with a petrolatum-based ointment.”

Another study actually showed petroleum jelly to be beneficial in scar improvement.

Petroleum jelly / Vaseline’s ability to lock in moisture is what is theorized to be its method of action. (similar to the way silicone sheets work). In other words, it has potent  hydrating properties which is what scar appearance seems to benefit from.

 

“a significant reduction in scar erythema (redness) was demonstrated in control patients who used a petrolatum-based ointment for 1 month, possibly because of the effects of petrolatum on scar hydration.”

Do you still get it? So many studies. So many conclusions.

 

Wrapping it up, the pros and cons of Mederma

Research on Allium cepa, or onion extract, the active ingredient in Mederma cream has not shown undisputed clinical efficacy in scar treatment but also no side effects have been reported.

  • Mederma® Advanced Scar Gel is a more concentrated, advanced, onion extract gel formulation than some onion extracts used in the clinical trials.
  • Mederma scar cream is one of the most popular scar removal products and appears to have some clinical evidence behind it.
  • There have been only two randomized comparison trials of Mederma, with a combined total of 38 participants.
  • Mederma has Centella Asiatica as active ingredient which has been documented to aid wound healing in a large number of scientific reports. Its most beneficial effect appears to be:

the stimulation of maturation of the scar by the production of type I collagen and the resulting decrease in the inflammatory reaction and myofibroblast production.

  • Mederma scar gel is very well-reviewed, popular and sells for about 17$ making it one of the most affordable scar products.
  • If you let customer ratings and reviews and sales numbers decide, Mederma Cream with SPF 30 is an Amazon bestseller with a rating of 4 stars out of 5 making it one of the most popular scar removal products available.

 

Here’s what research indicates about Silicone scar sheets

silicone scar sheetsVarious studies on this over the counter treatment have been done. Again, some are positive while others do not indicate any benefits of using silicone gel.

Some studies indicate silicone helps increase scar elasticity, reduce elevation, itch and pain and help prevent hypertrophic and keloid scarring.

Other researchers have concluded that silicone gel creams and sheets are not beneficial and speak of weak evidence and poor quality of research.

According to Wikipedia (as well as many other sources) it is in fact the only non-invasive option for which evidence-based recommendations have been made for both scar treatment and prevention.

“Overall, the success rate (somewhat improved to greatly improved) for the treatment of hypertrophic and keloid scars is high (95%).”

And another study found that:

Topical silicone gel is safe and effective treatment for hypertrophic and keloidal scars. It is easy to apply and cosmetically acceptable.

A Cochrane review however concluded:

Trials evaluating silicone gel sheeting as a treatment for hypertrophic and keloid scarring showed improvements in scar thickness and scar colour but are of poor quality and highly susceptible to bias.

In addition to the Cochrane review some more research did not find any scar improvement upon silicone gel therapy.

One study examined silicone gel sheeting combined with vitamin E. The study reported that the combined action of vitamin E and silicone gel sheets was more succesful than silicone gel alone.

Wrapping it up, the pros and cons of silicone sheeting

I have always been positive about silicone scar sheets and promoted them since I know from personal experience what they do.

At the same time I have been critical about creams such as Mederma because there’s less clinical evidence for their efficacy.

In all honesty and although more research needs to be done, several studies on onion extract seem to indicate this may work too. I still keep favoring sheets over any cream but I’m not as biased anymore as I have been.

I do think that when you take a look at many user experiences and customer reviews it seems like people generally use Mederma for less obtrusive (i.e. flatter) scars than those who use silicone gel. This may cause users to be more positive quickly since such scars fade faster on their own. This however is just a hunch of mine.

when a scar improves after months of  OTC treatment, it’s hard to know whether the treatment or just time made the difference

  • Silicone gel is often called the clinical gold standard in OTC scar treatment.
  • Silicones have been used by burn centers and some hospitals since the 1980’s and are often referred to as the only clinically proven effective home treatment.
  • I have used silicone gel sheets and I noticed my scars getting smoother, less itchy, flatter, softer already after a few days. Redness took longer to improve but eventually did fade too as a result of wearing the sheets. (I noticed that initially the redness disappeared but came back when not wearing the sheets. Prolonged use resulted in permanent toning down. In other words, I saw relatively quick improvements upon applying silicone sheets.
  • ScarAway is one of the most popular silicone sheeting brands on Amazon. It scores a 3,5 out of 5 stars review rating.
  • At about 27$ it is slightly more expensive than Mederma.

 

Mederma or silicone scar sheets, my recommendation

Honesty compels me to say that I have not used Mederma myself. I do hear and read a lot of positive reviews about this product which makes me hesitate  in dissmissing it as utterly useless.

Maybe it could work for me too. Maybe it does work for you..

Study findings contradict each other and there’s also the practice that studies may be paid for by commercial companies. This of course, is the case with any product, also silicones.

All considered, I myself would stick with silicone scar sheets. Just because I know for sure these work and seem better at shrinking raised scars.

  • Another aspect that makes me favor silicones over Mederma is that occlusion is what is thought to play a role in making scars softer, flatter, and less discolored.
  • Studies indicate that scar occlusion:

was able to decrease dermal fibrosis by hydrating the epidermis and altering the pro- and antifibrotic signals produced following injury.

  • Silicone gel, by creating a thin film, and more so, silicone sheets offer occlusive therapy whereas Mederma does not.
  • Other reasons I favor silicone scar sheeting is that these are used by  many burn centers and cosmetic surgery clinics and because there’s research proving their efficacy.
  • Key in proper wound and scar healing is moisture. Make sure to keep your wound as well as the scar moist.

 

What do you think? Which one will you try? Mederma or silicone scar sheeting?

If you want to use both as complementary remedies, keep in mind that you can’t use them at the same time. I can imagine you’d wear the sheets during the night and Mederma at daytime.

I would love to know about your experiences so let me know what you think or how the scar healing process goes for you.

 

Image credit: Mizunoryu | Wikimedia Commons

 

 

 

7 Home Scar Removal Remedies – Proven Effective Remedies To Fade Your Scar

Here are some over the counter scar removal remedies based on studies and clinical trials. No old wives tales or snake oil potions here. You may know what I am talking about but for the sake of clarity, lets give an example.

Vitamin E oil.

Rubbing this on your scar is commonly believed to improve its appearance. It’s a persistent rumor that roams the internet, birthday parties, and the minds of many disinformed home scar treaters.

Studies show it does not help and caused skin irritation in a large part of test persons which worsened scar healing en cosmetic outcome.

If you do a quick search online for information on how to fade your scar you will find the most divergent advice.

From lemon juice, to potato and tomato extract. From olive oil to slices of cucumber. Even ice cubes, seriously, ice cubes, are said to be scar remedies.

It’s sad there’s so much disinformation.

Enough about what does not work. Here is what works.

Research backs these claims and my own experiences as well as those of others who did side-by-side comparisons.

These home scar removal remedies do not only consist of topical applications (e.g. creams, ointments, and strips or patches but also of things you can do. Actions that will help fade your dreaded scar.

 

Remedy 1. Optimal wound care is very likely to reduce scar tissue.

Obviously this cure can only be used in case of a new scar but if you do have the chance make sure to keep your wound moist and clean.

Moist wound healing environments lead to up to 30% faster wound healing and preventing infections helps reduce scar tissue creation.

Dr. George D. Winter found that, contrary to the conventional wisdom that wounds should be allowed to dry out and form scabs to promote healing, wounds instead healed faster if kept moist.

A wound that heals quickly without infections or other complications will scar less.

My favorite way to care for a wound you worry may scar is to use Medihoney dressings. Especially after surgery but also in case of other serious wounds this powerful stuff will boost the healing process and prevent complications.

Apart from that it also reduces inflammation which are all major factors in scar creation.

Other wound care tips:

  • If you don’t want to use Medihoney dressings you can also apply petroleum jelly or another moisturizer and very gently massage it in a few times a day. This will keep the wound moist while it is healing. Or just keep it covered with bandaids or hydrogel strips.
  • Vitamin C plays an essential part in wound healing. Taking additional vitamin C can be helpful as an indirect scar remedy. The vitamin, also called ascorbic acid helps the body make collagen and enhances the wound healing process as indicated by studies.
  • Hydrogen peroxide and antibacterial creams like Neosporin help preventing wound infection but you should avoid using it on large or deep wounds or on burns. If you do use them, use them as scarcely as possible since these are harsh substances that interfere with natural healing too.

 

Remedy 2. Start scar treatment as soon as possible

The sooner you start the younger the scar tissue is and the more efficient remedies will be. It is at this stage when your skin cells are forming collagen responsible for unsightly scars.

Right after wound closure, meaning when the scab has gone, you should ideally start scar treatment of your choice.

 

Remedy 3. Use silicones

Okay, you know it’s recommended to start a remedy right after the wound has closed.

What should you do? Which of the many products is best?

The answer is short and simple. Use silicone sheets.

They are clinically proven to work and are often refered to as FDA class 1 medical devices.

The only downside is that they work on raised and discolored scars only. (there may be some exceptions but don’t count on it).

“The Golden Standard” in home scar remedies as well as in hospitals and burn centers requires being used for weeks on end and to be worn for 12 to 24 hours a day.

Silicone scar gel comes in liquid gel that dries up to a thin film on your skin or in patches. Studies indicate that liquid silicones are less effective than the patches but in some cases it’s more convenient to use the gel.

For example in case of scars on the face or in the neck. Area’s where patches are difficult to keep attached.

Here’s more info on the best silicone scar sheets to buy.

 

Remedy 4. Go for non-invasive treatments first

You may have heard that (cortico-)steroid injections and laser therapy work which may have convinced you to start with such an invasive treatment. They do work, however, I would strongly advice not to do this.

The reason?

Because these treatments are known to have side effects whereas silicones do not (except for the very exceptional skin irriation).

Steroid injections may cause the surrounding tissue to become depressed and sometimes discolored. Also laser therapy may cause ugly cosmetic side effects.

Surgical revision or surgical excision are procedures designed to make your scar less obvious. As with all remedies, no scar will disappear completely. In case of restorative surgery there’s also the new incisions that will cause skin injury and subsequently, scar tissue.

Side effect free scar remedy..

If silicones turn out not to work for you (they work for most people but there’s always exceptions) you can always opt for an invasive treatement such as steroid injections, laser, cryotherapy or surgical excision.

Here’s an overview of all the different types of scar treatments.

 

Remedy 5. Natural extracts, oils, and other botanical therapies

Some limited evidence exists for a few complementary and alternative medicine therapies, also called CAM therapies.

These modalities appear to have some evidence for potential benefit. CAM therapies that may be beneficail include bromelain, honey, propolis, arnica, vitamin C and bioflavonoids, chamomile, aloe vera gel, grape seed extract, zinc, turmeric, calendula, chlorella, lavender oil, and gotu kola.

These substances have been reported to promote wound healing, reduce redness (edema ) or purpura (purple color), and provide anti-inflammatory effects however,

most published studies have been small and often have design flaws

If you would opt for one of these I would personally go for one of these since they seem to be most convincing.

Grape seed extract, a popular health supplement that evidence shows may build new blood vessels and help vitamin C enter cells, strengthening cell membranes and prevent scarring in tissue.

Turmeric has been used for centuries in India to provide glow and luster to the skin. It has antimicrobial, antioxidant, astringent, and other useful effects that help to heal wounds and reduce scarring (Chaturvedi 2009).

Several case reports and animal studies demonstrate that aloe vera decreases burning, itching, and scarring associated with radiation dermatitis (Klein and Penneys 1988).

However, effects are often subtle and it’s not for no reason professional institutions commonly use silicone scar sheeting as the preferred modality and not CAM therapies.

 

Remedy 6. Scar massage

Gently massaging your scar may help improve it. Start only when your wound has closed completely and start out very carefully. The scar tissue is still very delicate.

Scar massage will stimulate blood circulation in the tissue making it softer.  To make the process more pleasant and avoid friction, use an ointment or cream of your liking.

It doesn’t matter whether you choose an onion cream such as Mederma or a vitamin B based lotion.

 

Remedy 7. Take precautions

If you want to reduce the chance on an ugly scar forming you should be cautious. Things to keepin in mind are:

  • Avoid exposure to UV rays. Protect your scar from sunlight and other forms of ultraviolet light since it irritates the scar making it worse. Wear sunscreen or patches or take other measures to block sunlight because solar radiation will damage the tissue or cause hyperpigmentation (discoloration). Keep doing this until your scar is mature meaning in its final state. This may take up to 18 months.
  • Do not pick your wound or its scabs while it is healing. As a matter of fact, try to prevent scabbing all together. Scabs interfere with the healing process. See remedy 1.
  • Keep tension on the wounded area as limited as possible. This means refrain it from moving as much as possible because this can aggravate and widen the wound. For this reason SteriStrips are often used. They keep the wound borders close and reduce stress.

 

What Is Scar Tissue?

Scar tissue is basically any tissue that grows over an injury. It is made up of fibrous connective tissue, generally thicker, paler and less functional than the original tissue. It allows for less range of movement, has a reduced blood supply and is more vulnerable to damage from UV rays than normal tissue.

Damage to the skin can produce types of scars: Contracture scars that are common after burns and can interfere with normal motion, hypertrophic scars that stay grow abundantly but within the boundaries of the original wound, and keloid scars, which can keep growing even after the wound is covered and form a growth similar to a tumor.

Different Scars, Different Treatments

The scar types I just mentioned (contracture, hypertrophic, and keloid) can be improved with silicone gel pads and/ or silicone gel ointments.

Other types, such as indented ones, are harder to fade. It must be noted that keloids are very hard to remove effectively and most home remedies just don’t work. (silicones may help prevent keloids but once they have formed even silicones often don’t effectively remove these tough scars. Then more invasive procedures are necessary.)

Minor cuts and scrapes like skinning your knees generally don’t create much in the way of scar tissue. Serious injuries, surgery, and certain diseases produce more obvious scarring.

For more advice, read my silicone scar sheet review.

 

 

 

Scar Treatment, What Are Your Options?

Many misconceptions circulate about (over the counter) scar treatment. I know from experience it can be very hard to find the information you need. Both online and offline.

Emblematic for this segment of health care is the lack of knowledge of both medical professionals as well as among patients. This often leads to inappropriate choices of treatment which may, in some cases, worsen scar appearance.

I did a lot of research when I wanted to treat my own scars which, eventually, led to a rather successful treatment. Had I known then what I know now I could have gained better results in the end.

Another reason I deliberately use the word ‘rather’ is because scars will almost never disappear. Their appearance can be made less prominent though. And problematic scars can be avoided and treated.

This article is about what I know about scar treatment. With appropriate, unbiased, information at hand, and if necessary, consulting a good dermatologist who can offer support and, possibly, more invasive treatment, various things can be done to improve scar appearance.

Why Scar Treatment?

How a scar looks depends on a number of factors, including the type of trauma/ injury causing the wound, the wound site, the primary treatment and possible complications later on.

In an ideal situation a healed scar is flat, even with its environment, shows no difference in color and runs in relaxed skin lines or natural anatomical transitions. The optimal scar is also short and without unnatural straight sections.

In reality though many scars do not form this way. The skill of the surgeon, whether or not the surgery is performed under stress and hurry in case of emergencies, the overall health and lifestyle of the patient, genetic predisposition, and other factors all play a role in how a scar will form.

Apart from these aspects a scar is more or less likely to form excess scar tissue. Such scars are called problematic scars and a common reason for scar treatment.

Over The Counter Scar Treatment vs. Invasive Scar Treatment

Scar treatment can be divided into two areas. The first is non-invasive scar treatment also referred to as natural scar treatment.

It is strongly recommended to indulge in this type of treatment first. This because, as the word says it already, it’s non or less invasive. Over the counter scar treatment which is another denotation has little to no risks on side effects and worsening scar appearance.

This in contrary to invasive scar treatment. Effective non-invasive scar treatment exists of:

  • pressure therapy (compression)
  • silicone therapy
  • scar massage
  • hydrating ointments

Scar surgery, laser therapy, steroid injections, cryotheraphy (freezing), and radiotherapy are lined among invasive scar treatment.

Only opt for these kinds of treatment if non invasive treatments have no or not sufficient effect. This because there are risks of worsening scar appearance but also because in general this kind of therapy is far more expensive. Examples of invasive treatments:

  • laser therapy
  • surgery
  • steroid injections
  • cryotherapy (freezing scars)
  • radiation therapy

Effective Topical Scar Treatment

first line scar treatments backed by science

Evidence supports silicone sheeting, silicone gel ointments (several studies indicate ointments to be less effective than sheets) pressure dressings, and corticosteroid injections as first-line treatments.

Cryotherapy may be useful, but should be reserved for smaller lesions. Imiquimod cream, and ointments based on the the herb Centella asiatica (also known as Gotu kola) have demonstrated some benefits but more research is needed.

These are the only proven effective scar treatments. There is no evidence creams based on onion extract (such as Mederma), calendulan, vitamin E, or Palmer’s Cocoa butter are effective.

The popular and widespread topical use of vitamin E is discouraged by many dermatologists because this use has shown to cause side effects such as skin irritation and did worsen scar appearance in some cases.

Types of Scarring

different scar tissue types and their characteristics

In order to determine the appropriate treatment for certain scar tissue it is necessary to be aware of the type of scar. A description of the various scar types:

Flat, Pale Scars

This type is most common and these scars are the result of the natural healing of the body. In the beginning it is possible that they are red or dark and that they protrude above the normal skin level. Over time, these scars paler and thinner until finally a white, flat scar remains. This process can take up to 2 years and almost always a visible “memory” of the wound will remain.

Red, Raised Scars – Hypertrophic scars

Hypertrophic scars are red and thick/ raised and may itch or hurt. These scars generally from relatively quick after the skin trauma. They don’t extend beyond the injured site. If situated near a joint, they might hinder movement.

Young people (below 30 years of age) and people with dark skin are more susceptible to this kind of scars. Inherited factors determine whether or not people are prone to developing these scars.

It is not possible to completely prevent these scars but treatments such as silicone sheeting, and in lesser amount compression, ensure a hypertrophic scar to be converted into a flat, white scar faster.

Thick, Lumpy Scars – Keloid scars

As hypertrophic scars, keloid scars also are the result of unbalanced, excessive production of collagen in a healing wound. Unlike hypertrophic scars, keloid scars grow out of the borders of the original wound and continue to grow indefinitely. That way relatively large areas of skin can get covered. They are thick and can be itchy and painful. It is even possible they will not improve.

Keloidal scars may result from any type of injury; scratches, injections, insect bites and tattoos included. Anyone can get keloid scars and they can exist anywhere on the body but are very rare on eyelids, penis, and breast areola.

Yet young and people with dark skin are more sensitive to these scars. Especially the skin above sternum (chest), abdomen, shoulders, upper arms, back, earlobes, the neck and face are most susceptible to developing these scars.

Indented, Depressed, Sunken Scars – Atrophic scars

In these scars, there is a very thin layer of scar tissue. The scars are sunk into the skin also referred to as a “cigarette paper’ texture. They arise when the healing process of the skin is broken and as such lack of new skin fibers are formed.

They can also be caused by the skin itself. By the loss of underlying fat, but are generally the result of skin lesions after viral or fungal infection (Viral, fungal), immunity diseases (such as lupus erythematosus) and radiation therapy.

Scars after Acne or Chickenpox

Acne  and chicken pox are often the cause of depressed/ sunken scars. This often results in deep wells in the skin. It is important to know that these scars can develop to keloid scars. These scars are not always atrophic.

Stretched Scars

These scars form when the skin surrounding the scar has been under tension. In the beginning the scar is similar to a normal scar, but the constant tension the scar expands and dilutes it for the next weeks or months, until a stretched scar is formed.

This happens for instance when the scar is close to a joint is located and is tensioned during movement. Once stretched will the scar never narrow. The most common causes are injuries and operations. Another cause is the poor healing due to a poor general health or poor nutrition.

Contracture scars

These scars occur in case of large wounds. The skin quickly heals up and uses an inelastic tissue instead of normal skin tissue to close the gap. These scars can even deform the underlying muscle impeding movement.

Sometimes they even attack the nervous system. This type of scars can be very severe and  difficult to treat. Many can only be improved by surgery.

Stretch marks

This type of scarring occurs when the skin is stretched rapidly, e.g during pregnancy or sudden rapid growth of an adolescent. Also hormonal changes seem to influence the formation of stretch marks. In the beginning, these stripes appear red or purple, but they get paler over the years.

Raised, Hypertrophic Scar Treatment

In general, hypertrophic scars develop soon after the trauma or surgery. A distinction between linear hypertrophic and widespread hypertrophic scars is made.

This type of scarring is the result of an overproduction of collagen which leads to the raised appearance of hypertrophic scars. Other characteristics are redness, itch, and sometimes pain.

Widespread scars commonly develop after burn wounds. They are also red and elevated but are wider. Also overstretching can result in widespread scarring.

“Hypertrophic scars may increase rapidly in size for 3-6 months and then, after a static phase, begin to regress. Mature to have an elevated, slightly rope-like appearance with increased width. Full maturation can take up to two years.”

Recommended treatment: silicone sheeting, possible in conjunction with steroid injections when sheeting doesn’t have effect.

Red, Purple Scars

hyperpigmented scars

Fresh or immature scars generally are red or purple colored. Causes for this hyperpigmentation are increased blood flow, inflammation, and the presence of broken blood vessels. Mature scars commonly are paler than the surrounding skin because of limited blood circulation and pigmentation.

Keloid Scar Treatment

benign scar tissue treatment and side effects

Contrary to hypertrophic scars keloids may not develop for many months after after initial trauma ( injury or surgery). Keloids are more prevalent in individuals with darker skin.

Data from the National University of Singapore indicate that keloid scars are three times more common in Chinese patients than among Caucasian patients. Healthcare professionals make a distinction between minor and major keloids.

A minor keloid is a focally raised, itchy scar that extends over normal tissue. It may develop up to one year after injury and does not regress without treatment. A major keloid extends over normal tissue and can continue to spread over many years. In general, keloids are less responsive to treatment than hypertrophic scars.

Results of silicone sheeting treatment are variable. Some keloids are reduced in size while in other cases silicone sheeting has little to no effect on keloid scars.

In those cases (cortico)steroid injections (also referred to as intralesional steroids) might offer a solution. Although this treatment is relatively safe it can be slightly painful. There are also some possible side effects.

The scar may become depressed (skin atrophy), discolorization, and increased scar redness might occur. Steroid injections are usually given each 4 to 6 weeks until the desired appearance (flattening of the keloid)

Sometimes steroid injections are administered in conjunction with laser treatment and cryotherapy (freezing). Cryotherapy is done with liquid nitrogen. This treatment may flatten keloid scars but often darkens the tissue.

“Citrus limon (lemon). Lemon’s role as an antimicrobial agent has been widely reported. However, despite numerous anecdotal reports, there is only one case report in the medical literature involving the use of lemon juice on keloids.”

(Rueter, G. Treatment with lemon juice in the prevention of recurrences of keloid. Zentralbl Chir. 1973;98(16):604-6. )

Also see Aldara iquimod cream further on this page. It has shown to be effective in reducing keloidal scar tissue in some cases.

Surgical keloid treatment involves risks because the incision can cause the keloid to grow back (est. 80%) and the operation might cause an even bigger keloid scar to form. In some cases the surgery is combined with steroid injections, radiation, and pressure dressings immediately after the surgery. Surgical excision is often followed by recurrence.

“When used in combination with steroids the recurrence rate is much better – less than 50%.” (Berman and Bieley, 1995, Urioste, Arndt and Dover, 1999).

Here’s good keloid treatment info based on a study on earlobe keloids but provides good info on general treatment as well.

Painful and Itching Scar Treatment

Additonal positive effect of silicone sheeting is that is prevents and reduces pain and itching in hypertrophic and keloid scars.
Other ways to reduce pain and itching are massage, and the use of anti-itch creams such as antihistamine cream, and creams containing hydrocortisone which is a type of steroid.

All OTC anti-itch creams contain 1% hydrocortisone, also those labeled as maximum strength. Prescription creams may contain more.

Old Scar Treatment

Although over the counter scar treatment works both on and new scars it is recommended to start treatment as early as possible. Older scars will generally take longer to improve. Scar treatment with the use of aforementioned measures can be started right after the wound has closed but certainly not before. There must be no open areas, scabs, or oozing.

Contracture Scar Treatment

Scar contractures cause a permanent tightening of the skin (tissue shrinkage) and are generally the result of burn wounds. Contractures may hinder movement of joints and muscles. These are very problematic scars which generally need intensive treatment in order to achieve improvement. Some studies indicate silicone sheeting treatment improves contracture scars.

Evidence That Use of a Silicone Sheet Increases Range of Motion Over Burn Wound Contractures.  Wessling N, Ehleben CM, Chapman V, May SR, Still JM Journal of Burn Care and Rehabilitation 1985/6, p503-5

Silicone Gel: a New Treatment for Burn Scars and Contractures. Perkins K, Davey RB, Wallis KA Burns 1982; p 201-204

Types of Treatments

Silicone Gel Scar Treatment

topical treatment and prevention of problematic scars

Silicone gel sheets were developed in the 1980's. Initially used exclusively by hospitals, burn centers, and other medical practitioners they are now used worldwide as the most effective over the counter scar treatment available.

It is a painless method of treatment and is now routinely used to treat hypertrophic and keloid scars that arise from thermal burns, surgical procedures and traumatic events (Perkins, Davey and Wallis, 1983, Sawada and Sone, 1990, Carney et al., 1994).

This over the counter scar treatment works both curative as well as preventive. It has demonstrated to prevent problematic scars such as hypertrophic and keloid scars from developing. For an optimal preventive effect in surgical scars the sheets should be applied right after the sutures/stitches are removed.

Silicone gel sheets are both waterproof and flexible and look and feel like transparent gelatin. They can be cut into the shape of the scar and are marketed as comfortable and easy to apply even in difficult places. But in reality this isn’t always true. Although they are sticky they can be hard to keep attached. Many times additional tape is necessary to keep the sheets sticking. Especially on moving parts of the body or on the face it can require some dedication to keep wearing the sheets.

The exact mechanism remains disputed but research suggests that silicone gel sheets work by hydrating the scar area and the exit. Researchers also think the gel sheets decrease fibroblast activity (the process responsible for excessive scar tissue growth.) This helps reduce the scar and the color and improve its elasticity. Research also indicates that these improvements are permanent.

“The results from a number of randomised, controlled clinical trials clearly demonstrate that silicone gel sheeting is a safe and effective management option for hypertrophic scars and keloids.” (Mustoe et al., 2002).

“The application of silicone gel improves the redness, itching, texture and thickness of hypertrophic and keloid scars in 60% to 100% of cases.” (Poston, 2000).

Medical Grade Silicone Scar Treatment

It is recommended to silicone strips as a first attempt at treatment. They are non-invasive so there are no side effects. The strips can be washed and reused, sometimes for an entire course of treatment which makes them relatively affordable.

Opt for well-reviewed, reputable manufacturer dimethicone silicone, medical grade, doctor approved products. Not all brands contain the same quality silicones.

Read this post to see which brands I recommend.

Scar Treatment Creams and Lotions

The only scar treatment creams with some data behind them as effective topical treatment options for scars are silicone gel creams and ointments containing the botanical ingredient Centella asiatica (Gotu Kola). The latter is not available in the USA.

Silicone Gel Ointments

“Silicone gel has also shown to soften and reduce hypertrophic scars much faster than pressure therapy without affecting pressure, temperature or oxygen tension. While silicone gel sheeting is suitable for some parts of the body, it cannot be easily used on the face and other places where the contours of the body make it difficult to ensure adequate contact and coverage.”

Creams vs. Dressings

Interestingly, 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.

Silicone gel in a tube makes it possible to use silicone gel on scar located on area’s where sheets are difficult or otherwise inconvenient to attach. For example on the face where the gel from tubes doesn’t appear as prominent as sheets.

This type of home treatment is relatively easy to use, sheets or gel are self-drying and can be used on old and new scars. Gel often dries to an invisible sheet and once dry will also accept cosmetics. It is particularly valuable in softening the skin and reducing the dragging sensation which many patients report following the removal of stitches after eye, lip or nasal surgery.

Scar Treatment with Hydrating Ointments

hydrating scar tissue with oils, creams, and lotions

Some studies show that scar hydration is beneficial to scar healing. They point out that keeping scars hydrated for long periods of time is what appears to improve the appearance of scar tissue.

Damaged skin will lose water more rapidly then healthy skin. Hydration is believed to reduce water vapor loss and to restore the homeostatic process in the scar.

“We have found that the provision of support and hydration and especially in addition with an enhanced wound healing constituent acts together to provide surprisingly improved scar management and maturation” source: patentstorm.us

Other clinical studies show that scar hydration is effective in decreasing scar symptoms (i.e., pain, itching, and tightening), but their efficacy in improving scar appearance (i.e., size, color, and texture) is unclear. One of theses trials involved hydrocolloid dressing treatment so a conclusion on hydrating ointments can’t be made based on this particular trial. Source:plasticsurgery.org

The notion that, according to the most recent scientific insights, the mechanism of silicones is assumed to be due to the control of scar hydration contradicts the theory that hydration only influences symptoms and not appearance.

Pressure (Compression) Scar Treatment

after-surgery and burn scar treatment

Scar treatment by compression has been used since the 1960's. This type of treatment is carried out either by using compression garments or by taping to reduce skin tension. These garments, a sort of elastic, tight fitting clothing need to be worn day and night for extended periods of time. Sometimes up to more than a year in case of burn scars.

Pressure speeds up the formation of collagen, flattens the scar, and reduces the number of cells in a given area. Compression therapy is commonly performed direct after surgery (e.g. tummy tuck surgery) to keep the pressure off the wound. In this case the tape and or garments are worn for several weeks or if necessary longer.

Scars older than 6-12 months do not respond to pressure therapy, or respond poorly. Pressure garments used in conjunction with silicone sheeting seem to be more effective.

Since silicone gel treatment has shown to soften and reduce hypertrophic scars much faster than pressure therapy this is the recommended therapy.

“Pressure therapy is used primarily to control hypertrophic scar formation after burns but can also be used to treat keloids.” (Rayner, 2000, Mustoe et al., 2002).

Scar Massage Treatment

Scar massage is commonly used as an additional treatment. Goals are to increase scar pliability, suppleness, blood circulation and thus oxygen supply, and desensitization. Scar pain and itch can be reduced by regular scar massage.

Only a few limited clinical studies have been done but currently there’s no scientific evidence to proving the benefits of scar massage. Many anecdotal reports, as well as the fact that scar massage is commonly recommended by health care professionals, indicate the positive effects of massaging scar tissue.

Microporous, Hypoallergenic Paper Tape Treatment

Commonly used direct after surgery. Can also help reducing tension of the scar tissue and thus prevent scar widening. This type of treatment has modest evidence to support its efficacy.

Supposed mechanism of adhesive microporous hypoallergenic paper tape are semi-occlusion, hydration, and pressure.

Paper tape treatment is useful in treating fresh surgical incisions and scars several weeks out, but its efficacy was less than that of “more established treatments such as silicone gel.” (meta-analysis by Mustoe et al, source:Journal of American Society of Plastic Surgeons)

Non-Silicone Occlusive Scar Treatment Dressings

Various studies show silicone sheeting to be more effective than non-silicone sheeting. However, studies concluding the opposite also exist. Nonetheless silicone sheeting remains the most recommended and accepted treatment commonly referred to as the Golden Standard in Scar Treatment.

“Results from a meta-study of 27 separate trials indicate that silicone is more effective than other occlusive dressings such as polyethylene or polyurethane.”

Additional Scar Treatment Measures

pressure, oxygen, and warmth

Studies have shown that silicone sheets do not change pressure, temperature, or oxygen tension at the wound site. But, according to scientific research these factors seem to influence scar treatment in a positive way.

This leads me to think optimal scar treatment can be expanded by meeting this criteria. Application of pressure, raising temperature, and boosting oxygen supply e.g. by massage might be beneficial.

Invasive Scar Treatment

surgical treatments, laser treatments, steroid injections,

If over-the-counter treatments won’t work, surgical treatments might offer a solution. Collagen and steroid injections, as well as laser treatment, can all help improve the appearance of scar tissue.

When indulging in invasive treatments a dermatologist, cosmetic surgeon or other type of health care provider is the right person to help decide which invasive therapy is appropriate.

Surgical Scar Treatment

Scar surgery is also referred to as incisional scar revision or surgical excision. Its goal is to minimize scar tissue for cosmetic or functional reasons. For the most problematic scars which are hard to treat with other types of therapy surgical intervention will be the last solution. Examples of such scars are wide (widespread) scars, hypertrophic scars, and keloids.

Types of surgical intervention are excision, scar narrowing, and Z- or W-plasty (objective: change the tension of the scar). procedures.

Although surgery can remove the scar tissue recurrence occurs. Even worse, many times a larger keloid will form. Because of this counterproductive element scar surgery is often combined with silicone sheeting, surgical taping, compression, radiotherapy, and intralesional steroid injections.

“Surgical excision is the most longstanding, simplest, and only definitive way of removing keloid tissue and reducing the width of the scar. However, its effectiveness as a single mode of treatment is limited and sometimes counterproductive. In fact surgery for the treatment of keloid scars has been relegated mainly to a second-line therapy for lesions unresponsive to steroids or pressure, and for large lesions requiring debulking.” (Mustoe et al., 2002).

Redevelopment of keloids within the first two years after surgical scar revision (in case of single mode treatment) has been reported to be over 80%. (Berman and Bieley, 1996, Darzi et al., 1992).

When used in combination with steroid injections recurrence has shown to be significantly lower, (less than 50%). (Berman and Bieley, 1995, Urioste, Arndt and Dover, 1999).

Reduction of tension on the wound bed and scar tissue is recommended although the recurrence rate won’t drop considerably.

Surgical revision of hypertrophic scars consists of two approaches: excision and narrowing of scars, as is done for widespread scars, and Z- or W-plasty designed to change the tension of the scar.

Surgical excision combined with surgical taping and silicone gel sheeting can be successful for the treatment of hypertrophic scars resulting from excessive tension or wound complications.

 

More Info on Surgical Scar Treatment Techniques

A variety of different approaches exist to achieve cosmetic improvement for existing scars. While no scar can be completely erased, dermatologic surgeons can operate to achieve more esthetically pleasing scars. Classification of a scar abnormality guides the choice of surgical treatment technique.

Examples of such techniques based on the classification: Geometric broken line closure (GBLC), punch excision, punch elevation, subcision, Z-plasty, W-plasty, fusiform/elliptical excision, and serial partial excision are all specific surgery techniques to reduce scar appearance.

More info on which surgery for which scar type is recommended here: Surgical Techniques for Scar Revision

Steroid Injection Scar Treatment

Steroid injections are either used alone or in conjunction with other treatments. (Mustoe et al., 2002). Corticosteroids are derived from a substance naturally produced in the human adrenal cortex. Topical use of steroids (e.g. creams) seems to be less or not effective. Depending on the strength of the ointment.

Steroid injections are a first-line therapy for the treatment of keloids and a second-line treatment for hypertrophic scars that have not responded to other treatments (Rockwell et al., 1989, Urioste et al., 1999).

Kenalog injections

Steroid injections reduce excessive scar tissue and offer relief from the pain caused by scar inflammation. Reports on the pain caused by the injection vary from minimal tot really painful. This has, for a large part, to do with the scar location and of course ones sensitivity to pain. Sometimes local sedation can be administered. Otherwise taking a painkiller previous to the procedure might help.

Steroid injections are an effective way of reducing excessive scar tissue. Recurrence rates after steroid injections vary from 10% to 50%. The injections are typically administered with intervals of 4 to 6 weeks depending on how well the skin responds. Some patients respond to steroid injections very quickly whereas others require more extended treatment.

Possible side effects are pain on injection, depression in the skin caused by thinning of one of the top two skin layers (skin atrophy), fatty plaque deposition, loss of skin color (hypopigmentation), and telangiectasia (small dilated blood vessels near the surface of the skin). Appearance of the latter complication can be diminished by laser treatment.

Hypopigmentation from Corticosteroid Injections

loss of skin color

Hypopigmentation is the loss, or lightening of skin color. (the opposite of hyperpigmentation where skin color gets darker) This lightening of the scar tissue and possibly surrounding skin can be caused by steroid injections. This results of this side effect can be hard to treat.

Laser Scar Treatment

The potential of laser therapy has always been confined by the limitations of laser technology. The past years technological advancement and refinements have resulted in more effective laser scar treatments with less adverse effects.

The principle of laser scar treatment is using high-energy light to reshape or remove scar tissue. Various types of laser treatment exist. Each individually suited for a specific type of scar.

Hypertrophic (raised and red), and keloid scars are best treated with pulsed dye laser. Laser treatment of hypertrophic scars typically takes about 2 to 4 sessions whereas improvement of keloids in general takes 2 to 6 treatments.

The chance on optimal results are generally higher if laser therapy is conducted in conjunction with other types of therapy such as steroid injections, cryotherapy, and or compression. Silicone sheeting is commonly used to reduce the risk of recurrence.

Dermabrasion Treatment

Dermabrasion can be administered by needling or chemical peeling. The purpose of (Micro)dermabrasion is to resurface the tissue by gradually peeling/ needling off the top layer of the tissue.

Chemical Peeling

By applying a chemical solution to the skin, mild scarring may be treated. The procedure enables new, regenerated skin to appear, improving the appearance of the condition.

Chemical peels are generally recommended for discoloration, not for depressed scars. Commonly used chemical peels are glycolic and lactic acid, which are also available for home use.

Useful Scar Treatment Links

Review of Over-the-Counter Topical Scar Treatment Products

Postsurgical, traumatic, and burn scars can be painful, red, itchy, raised, and cosmetically unacceptable. Although a number of over-the-counter products are available to treat symptomatic scars, the peerreviewed data on the clinical efficacy of these products are limited and/or controversial.

Physician and patient choice of which product to use is often based on historical practice or anecdotal evidence. The aim of this review is to evaluate the evidence from published controlled clinical trials in humans on some of the most commonly used over-the-counter products for treatment of symptomatic scars.

Bottom line. What works? To summarize, silicone gel has the most data behind it as an efficacious topical, over-the-counter treatment option for scars, and is an option for patients who want something they can buy themselves.

Also, there is probably not any harm, and possibly some benefit, to rubbing honey onto healing wounds and scars. Further quality studies involving human subjects are needed for topical, natural preparations for scars, so in the meantime, encourage your patients to not waste their time or money on other natural products out there that claim to improve the look of their scars.

 

 

Do Silicone Scar Sheets Really Work? Studies and Experiences

Question; Do silicone scar sheets really work?

Answer, yes they do. Not on all types of scars but for the right type of scar they are the best non-invasive, over the counter option you got. (Non invasive treatments are not only more affordable but there are also less risks on complications involved)

Since the early 1980’s numeral clinical studies have demonstrated the effectiveness and safety of silicone scar sheeting.

More controlled clinical trials have been performed on silicones than on other methods. A few conclusions:

“The silicone gel sheets resulted in moderate improvement in scar thickness, scar color and was noted to be effective to some degree in all tested. The material was easy to use and painless. Topical silicone gel sheeting is an effective method for the treatment of hypertrophic and keloid scars.”

source: Topical silicone gel sheeting in the treatment of hypertrophic scars and keloids

“silicone gel has the most data behind it as an efficacious topical, OTC treatment option for scars, and is an option for patients who want something they can buy themselves.”

source: this article on skinandaging.com

This type of OTC scar treatment is also referred to as the clinical gold standard for scar treatment and scar prevention.

According to the International Advisory Panel on Scar Management it has

“demonstrated clinical efficacy over all other forms of topical treatments”

and

“is recommended by many experts such as dermatologists and cosmetic surgeons as the first line therapy for several types of scars”

And another study examining the effectiveness of silicone gel sheeting in the prevention and/or reduction of evolving hypertrophic scars and keloids concluded:

“Daily treatments with silicone gel sheeting should begin as soon as an itchy red streak develops in a maturing wound. The dressing is effective in reducing the bulk of these lesions.”

source: PubMed.

 

Small study on keloid prevention

Keloid scars often appears after median sternotomy (chest surgery involving a vertical incision). Because of little tissue and delicate skin this part of the human body is prone to ugly (excessive) scar tissue in general.

Nine median sternotomy patients wearing silicone sheets for 24 weeks were examined. At the end of the study all patients were free of keloid scars. Conclusion of the study:

“A silicone gel sheet is safe and effective for the preventing the formation of keloid scars after median sternotomy.”

Source: PubMed.

Apart from the various clinical trials and other studies I know these really work because I have used them myself.

Click the link to read more about my experiences. For more study abstracts and other scientific info check out the links at the bottom of this page.

On Which Scars Does Silicone Scar Sheeting Work?

In general, on raised and or discolored scars. Mostly they are used for surgery and burn scars but other scars can be treated effectively too as long as they are raised and discolored.

Another benefit is that they prevent ugly, excessive scars such as keloids, from developing.

So what about depressed scars?

Well, as far as I know this product does not work on these scars. I did hear from someone who mailed me his story once that he used CicaCare sheets which were very sticky and he theorized that his indented scar, which improved, did so because of the stickiness.

He thought that it lifted his scar up and thus improved its appearance.

Types of scars silicone sheets have shown to be effective:

Silicone sheets are the first-line therapy for various types of scars. Scars that can be successfully treated are:

  • keloids (keloidal scars) keloids are firm, rubbery lesions or shiny, fibrous nodules, and can vary from pink to flesh-colored or red to dark brown in color.
  • hypertrophic (hypertrophic (raised, thickened and stiff)
  • burn scars
  • (plastic) surgery scars such as; breast augmentation and reduction scars, tummy tuck scars, caesarian section scars, etc..
  • Mastectomy scars
  • Hysterectomy scars
  • body piercing scars
  • tattoo removal scars
  • cleft lip scars

Apart from successfully treating these types of scars the strips also prevent prominent scars from developing.

Some people even use them for treating wrinkles but as far as I know there’s no clinical evidence supporting its efficacy.

Did you use silicone for scars? Any success? Would love to hear your experiences. You can share your story below.

Studies on Silicone For Scars

Traditional methods for treating hypertrophic and keloid scars have historically included techniques such as intralesional injection of corticosteroids, radiation, laser treatment, surgical excision, cryotherapy, and pressure therapy. These methods can be complex and have problematic or adverse effects, so they have usually required the involvement of a physician or medical specialist throughout treatment (Berman, Brian, et al., November 2007).

Beginning in 1982, a new therapy was reported in a journal report by Perkins, Wallis, and Davis about using silicone gel sheets on burns ranging from newly healed wounds to mature scars. These researchers developed treatment regimes for 42 children recovering from burn injuries, in both newly injured patients and for those with scars up to 12 years old. They reported positive results in all 42 patients (Farquhar, Kathy, June 1992).


Silicone Gel Sheets are Effective

Silicone has been proposed as the main form of treatment for both hypertrophic and keloid scars, and has demonstrated significant improvements, even in patients who are prone to abnormal scarring. Silicone sheeting has been shown to reduce symptoms of pruritis and pain associated with scars, and can be used to soften, flatten, and blanch scars to reduce their appearance and increase range of motion by improving scar elasticity (Berman, Brian, et al., November 2007).

In another study, the application of silicon gels showed improvements in redness, itching, texture, and thickness of both hypertrophic and keloid scars in 60% to 100% of the cases (Borgognoni, Lorenzo, March 2002).

Silicone elastomer sheeting can be used for the treatment of scars resulting from many types of wounds, including burns, accidental injuries, or surgical incisions. Silicone sheeting is well suited for both scar-prevention and treatment because it exposes the patient to very little risk of adverse effects, which have an infrequent and mild occurrence with this therapy (usually, easily resolvable skin breakdown or rashes). This contrasts with more complex treatments such as surgical scar-removal, radiation, intralesional corticosteroid injections, and laser therapy. Further, unlike more complex scar treatment therapies, silicone sheeting requires only minimal monitoring by a physician for safe and effective use (Berman, Brian, et al., November 2007). More on silicone for scars here.


In all, researchers have found that treatment with silicone gel sheets led to decreased pain associated with movement, increased mobilization, decreased drying of the scar tissue, earlier separation of necrotic and infected tissues, and a decreased need for surgical intervention (Farquhar, Kathy, June 1992).

More Silicone for Scars Studies

Recommended reading. Study reports showing clinical effective remedies and disproving popular but non-effective remedies.
Silicone Elastomer Sheeting for Hypertrophic and Keloid Scar Treatment and Management
A Review of the Biologic Effects, Clinical Efficacy, and Safety of Silicone Elastomer Sheeting for Hypertrophic and Keloid Scar Treatment and Management – BERMAN – 2007 – Dermatologic Surgery – Wiley Online Library
Silicone gel sheets relieve pain and pruritus with… [J Dermatolog Treat. 2003] – PubMed result
Thus, silicone gel sheeting is effective and safe, especially with more severe symptoms of pain and itching possibly induced by mediators derived from increased mast cells.
Review of over-the-counter topical scar treatment products.
Shih R, Waltzman J, Evans GR. Review of over-the-counter topical scar treatment products. Plast Reconstr Surg. 2007; 119(3):1091-1095.