Which is better for scar treatment? Silicone sheeting or silicone creams? Well it depends and studies are not entirely conclusive but I would recommend sheets over creams. However in some cases, a cream may be more convenient.
There are many names that refer to the same product. Silicone sheets for scar treatment are also called patches, pads, or strips. Then there are also ointments available. Since all these are made out of silicone gel confusion may occur.
Silicone Gel Sheets
Silicone gel sheets (patches) are solid. A scar silicone sheet actually is a mineral based gel membrane created from medical polymer materials. (Technical name; polysiloxane) The sheets are soft, transparent and sticky on one side so they can be attached easily to the skin. The material is capable of allowing moisture and oxygen pass trough.
I myself used A4 sized sheets which could be cut into the precise proportion I needed for the particular scar. Later on I used ScarAway.
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. Some studies confirm this.
Silicone Scar Creams
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 Which Are Better? Sheets or Creams?
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.”
“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
When to apply patches (sheets) and when gel?
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.
I often recommend Kelo-cote because:
“Kelo-cote is the most studied topical scar product, with more than 2,000 patients participating in a variety of published clinical studies.”
Whether you choose a sheet or cream, both are linically proven effective on old and new hypertrophic, keloid and burn scars. These products are often recommended by plastic surgeons and dermatologists.
“[Kelo-Cote ] is appealing because no fixation is required; it is invisible when dry; and sun blocks, makeup, or both can be applied in combination. These features suggest that [Kelo-Cote formulation] could currently be the most recommendable agent for scar treatment, especially in visible areas.”
Signorini M, Clementoni MT. Aesthetic Plastic Surgery 2007; 31: 183-187
Read this page for more studies on silicone scar sheeting.