Silicone Scar Therapy
Topical silicone treatments can improve the appearance and feel of new and old scars. Silicone’s effectiveness has been proved by many scientific studies and is beyond doubt.
Traditionally these treatments have come in the form of sheeting. Silicone sheets are effective but can be cumbersome and difficult to use, particularly on facial scars. Typically doctors recommend use for 12 hours a day, often for a few months.
Dimethicone silicone gel is as effective as silicone sheeting, is a lot easier to use, and has been certified as safe. It is simply massaged-in. Since there are no sheets to deal with, sun block, make-up, or any other skin regimen is easily applied over the treatment.
Independent scientific studies (listed below) show that silicone gel:
- is as effective as silicone sheeting in improving scar appearance
- relieves scar redness, pain and itching
- improves scar elasticity
- can treat and prevent hypertrophic scars
- decreases production of “pro-inflammatory” substances like TGFβ2
InviCible contains the highest quality Dimethicone silicone gel which has been certified as safe.
Silicone gel (Dimethicone) is as effective as silicone sheeting as a treatment for scars. This comparison examines the efficacy of silicone sheeting and silicone gel.
Silicone gel (Dimethicone) helps soften scars and increase scar elasticity. Silicone gel is effective in the treatment and prevention of hypertrophic scars.
Silicone gel (Dimethicone) significantly softens scars and decreases scar redness, pain and itching. Silicone gel also flattens scars significantly making them less visible.
Burn patients forming hypertrophic scars have high levels of TGFβ2 in their blood. TGFβ2 plays a significant role in scar formation.
Silicone may improve scar appearance by decreasing TGFbeta2 (TGFβ2). Silicone gel and silicone sheeting may aid in reducing hypertrophic scarring (extra production of scar tissue).
Silicone-based products are widely used in the management of hypertrophic scarring and keloids. This review discusses the range of products available and the clinical evidence of their efficacy in preventing excessive scarring and improving established scars. Silicone gel sheeting has been used successfully for more than 20 years in scar management. A new formulation of silicone gel applied from a tube forms a thin flexible sheet over the newly epithelialized wound or more mature scar. Results from clinical trials and clinical experience suggest that silicone gel is equivalent in efficacy to traditional silicone gel sheeting but easier to use. The mechanism of action of silicone therapy has not been completely determined but is likely to involve occlusion and hydration of the stratum corneum with subsequent cytokine-mediated signaling from keratinocytes to dermal fibroblasts.
Editorial note: this article describes how silicone gel is as effective as silicone sheeting in the treatment of scars.
We studied the effects of a silicone gel bandage that was worn for at least 12 hours daily on the resolution of hypertrophic burn scar. In a second cohort, the prevention of hypertrophic scar formation in fresh surgical incisions by this bandage was also evaluated. In 19 patients with hypertrophic burn scars, elasticity of the scars was quantitated serially with the use of an elastometer. An adjacent or mirror-image hypertrophic burn scar served as a control. Scar elasticity was increased after both 1 and 2 months compared with that in controls. There was corresponding improvement clinically that persisted for at least 6 months. In the other cohort, scar volume changes in 21 surgical incisions were measured before and after 1 and 2 months. Gel-treated incisions gained less volume than control incisions after both intervals. Clinical assessment corroborated this quantitative demonstration of a decrement in scar volume. We concluded that topical silicone gel is efficacious, both in the prevention and in the treatment of hypertrophic scar.
Editorial note: this article describes how silicone gel softens scars and increases scar elasticity. Silicone gel is effective in the treatment and prevention of hypertrophic scars.
3. Chan KY, Lau CL, Adeeb SM, et al. A randomized, placebo-controlled, double-blind, pro-spective clinical trial of silicone gel in prevention of hypertrophic scar development in median sternotomy wound. Plast Reconstr Surg2005;116:1013–1020.
Hypertrophic scarring caused by sternotomy is prevalent among Asians. The effectiveness of silicone gel in scar prevention may influence the decision of surgeons and patients regarding its routine use during the postoperative period.
The authors conducted a randomized, placebo-controlled, double-blind, prospective clinical trial. The susceptibility to scar development varied among patients; therefore, sternal wounds were divided into the upper half and the lower half. Two types of coded gel prepared by an independent pharmacist were used on either half. Thus, selection and assessment biases and confounders were eliminated.
One hundred wounds in 50 patients were randomized into two arms, 50 control and 50 silicone gels. The median age was 61 years and there were 34 men and 16 women. Ethnic distribution was 28 Malays, 18 Chinese, and four Indians. No side effect caused by the silicone gel was noted. Ninety-eight percent of patients had moderate to good compliance. The incidence of sternotomy scar was 94 percent. At the third month postoperatively, the silicone gel wounds were scored lower when compared with the control wounds. The differences were statistically significant in all parameters, including pigmentation (p = 0.02), vascularity (p = 0.001), pliability (p = 0.001), height (p = 0.001), pain (p = 0.001), and itchiness (p = 0.02).
The effect of silicone gel in prevention of hypertrophic scar development in sternotomy wounds is promising. There are no side effects and patients’ compliance is satisfactory. This study may popularize the use of silicone gel in all types of surgery to minimize the formation of hypertrophic scars in the early postoperative period.
Editorial note: this prospective, randomized, double-blind study shows that silicone gel significantly softens scars and decreases scar redness, pain and itching. Silicone gel also flattens scars significantly making them less visible.
To clarify the significance of the role of the immune system in the formation of proliferative burn scars, this study attempted to identify differential production of cytokines between patients with burn injuries with and without hypertrophic scars. Mononuclear cell fractions were isolated from the peripheral blood (PBMC) of each patient and incubated with and without antigenic or mitogenic stimulation. The resultant supernatants were then assayed by ELISA techniques for production of various cytokines. The production of IL-1, IL-6, TNF-alpha, and TGF-beta2 by unstimulated PBMC was elevated significantly in patients with proliferative scar compared to control patients. Production of TGF-beta2 by stimulated PBMC also was elevated significantly in patients with proliferative scar. This study suggests that an increase in the production of TGF-beta and of proinflammatory cytokines by mononuclear cells may play a significant role in the processes that lead to excessive scar formation after burn injury.
Editorial note: this study illustrates how burn patients forming hypertrophic scars have high levels of TGFβ2 in their blood. TGFβ2 plays a significant role in scar formation.
Fibroproliferative disorders, which include hypertrophic scars and keloids, represent deviations from the normal process of wound healing. The fibrogenic cytokines have been associated with excessive scarring. It has been proposed that placing silicone in contact with hypertrophic scars may prove to be an effective form of treatment. This may be a result of downregulating fibroblasts and/or decreasing the fibrogenic cytokines. An in vitro model to study wound contraction is a fibroblast populated collagen lattice (FPCL). This study used FPCL as a method to study the effect of silicone sheeting on hypertrophic scar fibroblasts.
Fibroblast cultures were obtained and collagen lattices were prepared. Silicone sheeting was placed over the collagen matrix versus Saran wrap used as a treatment control. The amount of gel contraction was measured every 24 hours for five days. The supernatant obtained from the culture medium following completion of the FPCL portion of the experiment was then used in an immunoassay for TGFbeta2.
A statistically significant decrease in amount of FPCL contraction occurred between three of the four brands of silicone sheets used compared to untreated control or Saran wrap treated FPCL. The immunoassay for TGFbeta2 showed a statistically significant decrease with all four types of silicone sheeting.
FPCLs populated with burn hypertrophic scar fibroblasts exposed to silicone sheeting have decreased contraction compared to an unexposed control and Saran wrap treated control. In addition, TGFbeta2 is downregulated in the silicone exposed group. It appears that silicone sheeting may act by downregulating fibroblasts and decreasing fibrogenic cytokines.
Editorial note: this study shows how silicone may improve scar appearance by decreasing TGFbeta2 (TGFβ2).