The Use of Silicone Adhesives for Scar Reduction

Abstract

Significance: This article discusses the history and developments of silicone gel sheeting (SGS) scar therapy. Furthermore, we review a breadth of literature to gain an insight into how and why topical silicone gels remain the favored treatment of medical experts in scar management. We also analyze an ever increasing number of alternative therapies claiming to provide enhanced scar reduction performance. Recent Advances: Topical silicone gel treatments seem to remain the first point of clinical recommendation in scar management. SGS has been used in scar therapy for over 30 years, during which its efficacy has been the subject of numerous clinical evaluations. Critical Issues: While the exact mechanisms by which SGS improves hypertrophic scars, keloid development and recovery are yet to be fully agreed upon, its ability to do so remains largely undisputed at present. However, there still is ongoing deliberation over the exact mechanism of action of silicone in improving a scar. At present it is likely that through occlusion of the scar site and hydration of the wound bed, the overactivity of scar-related cells is suppressed, and their activity normalized. Future Direction: The clinical support of topical silicone gel products, relative to all alternative scar therapies, is considered the internationally recommended first-line form of scar management, and favored by consensus among healthcare professionals. However, there still remains the need for further clinical evidence and a better understanding of the mechanism behind the benefit of silicone gel for use in the prevention of abnormal scarring. SCOPE AND SIGNIFICANCESilicone gel sheeting (SGS) has been used in scar therapy for over 30 years, during which its efficacy has been the subject of numerous clinical evaluations. While the exact mechanisms by which SGS improves hypertrophic scars, keloid development and recovery are yet to be fully agreed upon, its ability to do so remains largely undisputed. As such, topical silicone gel treatments seem to remain the first point of clinical recommendation in scar management. This article aims to review a breadth of literature to gain an insight not only into how, but also why topical silicone gels remain the favored treatment of medical experts in scar management. We also analyze an ever increasing number of alternative therapies claiming to provide enhanced scar reduction performance as a comparison. TRANSLATIONAL RELEVANCESilicone has been used for more than 30 years in the treatment of cutaneous scars.1 New formulations and formats of silicone gel products are becoming available for use in the treatment of scarring resulting from surgery, burns, and other skin injuries requiring hospital treatment.

Evidence‐based therapy in hypertrophic scars: An update of a systematic review

“…Silicone gel treatment and intralesional injection of immunomodulatory drugs have recently emerged as the most promising treatment regimens, with high quality, randomized, (placebo‐)controlled studies, still being scarce. The exact mechanism of action of silicone sheeting is still inconclusive; increased temperature, 18 increased hydration, 19 polarized electric charge leading to scar shrinking, 20 and others are being discussed 21,22 . The mechanisms of immunomodulatory drugs are studied more intensively.…”

Medical Needling – Effekt auf hypertrophe Verbrennungsnarben hinsichtlich der Hautspannung und -elastizität

“…Letztere werden häufig von postoperativen Komplikationen begleitet und können mit einem längeren Krankenhausaufenthalt und entsprechendem Monitoring verbunden sein [8][9][10][11]. Eine optimale Wirkung von Silikongelen ist mit einer dauerhaften Applikation verbunden und scheint für großflächige Narben nach Verbrennungen weniger geeignet [12]. Bei der Behandlung mittels ablativer Laser kommt es zu einer Ablation der Epidermis sowie der Basalmembran bei gleichzeitiger Fibrose der Dermis mit dem Resultat einer dünneren und vulnerableren Epidermis [13].…”

Adjuncts to Improve Nasal Reconstruction Results

“…It has been used widely to minimize the size, induration, erythema, pruritus, and extensibility of preexisting hypertrophic scars and to prevent the formation of new ones. [1][2][3] Although the exact mechanism is unknown, most researchers believe that silicone acts by creating a hydrated, occluded environment that decreases capillary activity, thereby reducing excessive collagen formation and scar hypertrophy. [4][5][6] Most authors recommend starting silicone application as early as the second week after surgery and continuing use for the next 3 months.…”