Silicone gel sheets and self-drying silicone gel ointments are invaluable for wound healing and scar management. A silicone gel coating or sheet helps protect wounds from excessive moisture, drying out and infections, all of which can lead to the development of unsightly scar tissue. Silicone helps the healing process by modulating growth factors involved in collagen production and excess collagen breakdown that are essential for trouble-free wound healing.

Scar treatments and scar management methods have to keep pace with the growing popularity of surgical cosmetic procedures and the increased interest men and women have in enhancing their personal appearances. Although silicone has been used for many years to treat burns and using silicone sheets for scar healing is standard practice, self-drying silicone gels for scar treatment and management is relatively new.

What makes silicone gel useful?

A lot of research has focused on how silicone gel and the wound healing process works.

To heal properly, a wound needs an environment that is neither too dry nor too wet. Silicone gel provides such an environment. A silicone layer allows the skin to breathe without letting it dry out, helping with fibroblast production while keeping collagen production under control. Scar tissue is a result of excessive collagen during the healing process.

The silicone gel covering on the wound helps ward off bacterial infection, which can induce excessive collagen production and give rise to unsightly scar tissue.

Wound healing requires both the production and breakdown of collagen in the skin with the aid of natural chemicals called growth factors. Silicone is able to modulate the levels of different growth factors, controlling both collagen production and the breaking down of excess collagen. Silicone works by restoring the balance that is essential for healing the wound without excessive levels of scar tissue.

Silicone helps in a more obvious way too, by reducing the discomfort and itching that often occurs while the wound is healing. The natural reaction to itching is scratching, which can result in more scar tissue.

Silicone gel is effective for treating a variety of scars including keloids, hypertrophic scars and scars left by trauma or burns. General surgical scars, C-Section scars, scars from cosmetic surgical procedures such as abdominoplasty as well as non-surgical procedures can be treated effectively with silicone gel applications.

Silicone gel sheeting helps in the healing process by slightly increasing the skin temperature and applying continuous light pressure on the wound.

Silicone gel sheets should be removed when taking a shower. They can be reused after washing with soap and water. The sheets may need to be replaced after two to three weeks, when they begin to fall apart or have lost their self-adhesive properties. Typically the higher the silicone content (and, therefore, the fewer other ingredients), the more effective silicone gel sheets are.

Why use topical gels instead of silicone gel sheets?

As versatile as they are in helping wound healing and scar treatments, silicone gel sheets have a number of limitations.

• Gel strips are unsightly—nobody wants to go around 24/7 with strips of gel sticking to their body or face if there are less obtrusive, more attractive alternatives.
• Doctors and surgeons frequently observe that their patients do not comply with the instructions on the continuous wearing of gel strips, impeding scar treatment and wound healing.
• Gel sheets or strips used for covering wounds and scars can become loose and fall off. They do not stick securely in places where the skin stretches or where the scars are uneven. Using tape or bandaging defeats the whole purpose.

Self-drying silicone gel ointments have been developed to overcome most of these disadvantages.

There are a variety of silicone gel offerings in the scar treatment market. Scar Heal, Dermatix Ultra, Kelo-cote and NewGel+ are some of the silicone-gel-based products currently found in Australia.

Most topical silicone gel brands contain long chains of silicone polymer (polysiloxanes) and silicone dioxide, usually mixed in with a volatile compound that evaporates, drying up the skin’s surface within minutes of application. Once applied, they create a protective and transparent barrier that provides most of the benefits of silicone gel. They are easy to apply and safe even for sensitive skin and children. Unlike gel sheeting strips, gels can be easily applied on irregular skin surfaces or scars. Gel ointment can be used on scar surfaces, on the face and in wounds, which get disturbed by motion, such as at joints or flexures.

A 15-gram tube typically contains enough silicone gel to treat a 7.5-10 cm scar twice a day for three months.

Follow your surgeon’s instructions on wound care carefully after cosmetic surgery to avoid unnecessary risks and complications. Improper post-surgical care can lead to excessive scar tissue. Follow your surgeon’s word on how to cover the surgical wounds until they are sufficiently healed. Silicone sheeting or gels are not used until wounds have matured to a certain extent. Your surgeon will be the best judge of this.

Scarring occurs in three stages. In the inflammatory phase, the wound looks red or pink as the body tries to clean and seal up the incision. This phase can last for days or weeks depending on the incision or injury. Next comes the rebuilding phase, which lasts longer, often for weeks or months. During the rebuilding phase the skin regains about 85 per cent of its normal strength. When the maturation phase is reached, the redness and inflammation slowly disappear, and the scar looks pale, narrow and flat, leaving only traces of what the wound looked like at the beginning. Maturation can take months or, in some cases, even years. This is why surgeons advise waiting at least 6 months before thinking of scar revision surgery.

Once your wounds are healing properly, you may be advised to use silicone gel strips or a topical ointment, depending on the location. Discuss with your surgeon how to get the best of both silicone gel sheeting and topical gel ointments to protect and heal your surgical wounds without any complications.

If you are using silicone gel ointments in order to remove other types of scars, old scars or scars resulting from non-surgical cosmetic procedures, follow the instructions given by your dermatologist or cosmetic physician for best results.

Wound healing and scarring is complex and goes through many stages. While all sorts of measures can be taken to assist in healing, scarring varies with the individual. It is impossible to predict with certainty how a wound will look upon healing.