A Review of the Biologic Effects, Clinical Efficacy, and Safety of Silicone Elastomer Sheeting for Hypertrophic and Keloid Scar Treatment and Management

Abstract

Silicone elastomer sheeting is a medical device used to prevent the development of and improve the appearance and feel of hypertrophic and keloid scars. The precise mechanism of action of silicone elastomer sheeting has not been defined, but clinical trials report that this device is safe and effective for the treatment and prevention of hypertrophic and keloid scars if worn over the scar for 12 to 24 hours per day for at least 2 to 3 months. Some of the silicone elastomer sheeting products currently on the market are durable and adhere well to the skin. These products are an attractive treatment option because of their ease of use and low risk of adverse effects compared to other treatments, such as surgical excision, intralesional corticosteroid injections, pressure therapy, radiation, laser treatment, and cryotherapy. Additional controlled clinical trials with large patient populations may provide further evidence for the efficacy of silicone elastomer sheeting in the treatment and prevention of hypertrophic and keloid scars. The purpose of this article is to review the literature on silicone elastomer sheeting products and to discuss their clinical application in the treatment and prevention of hypertrophic and keloid scars.

Pressotherapy of a postoperative scar with the application of non-sterile silicone dressings in a 56-year-old woman treated for breast cancer in the Holycross Cancer Centre in Kielce

“…Silicone dressings in the form of plasters or gel are used in the treatment of hypertrophic scars and keloids [20,21]. The use of silicone dressings is recommended as a safe, non-invasive, simple, and effective method of prophylaxis [18,[22][23][24].…”

Comparison of the effectiveness of topical silicone gel and corticosteroid cream on the pfannenstiel scar prevention — a randomized controlled trial

“…Various mechanisms have been proposed as possible modes of action for silicone-based agents and corticosteroids in the wound healing processes including: 1) an increased temperature or oxygen tension increasing collagenase activity and leading to collagen breakdown shrinking the scars [3,7], 2) occlusion and hydration of wounds [7,13]; reduction in transepidermal water loss decreases stimulation of keratinocytes which stops cytokine production [13], and 3) polarization of the scar tissue caused by a negative static charge between silicone and skin [14] and the modulation of growth factors [9,15,16].…”

“…Several studies have suggested topical silicone gel to be the first-line option for prevention of HS and keloids [7,[15][16][17]. In the study by Chan et al [7] of 50 patients, sternal wounds were divided into two halves; one half was treated with silicone gel and the other half with placebo gel for 3 mon- ths.…”

Management of Earlobe Keloids in Lokoja, Nigeria: A review of twelve cases

“…Besides cosmetic complaints, others include pain, numbness and itching. [3][4][5] These nodular skin lesions may appear like neoplasms and capable of causing much physical disfigurement that borders on the patient's cosmetic and psychological trauma 6 . Whereas keloids grow beyond the original borders of the wound, hypertrophic scars do not extend beyond the original borders of the wound or injury 7 as shown in figures 1& 2.…”