Silicone Scar Sheets and Gels: Do They Work and How to Use

Silicone Scar Sheets and Gels: Do They Work and How to Use

Silicone scar sheets and gels can help raised scars become flatter, softer and less red, mainly by keeping the scar hydrated. They work best on healed skin, worn for at least 12 hours a day for two months or longer. The research is encouraging but low quality, so expect gradual improvement, not erasure.

This guide is for anyone healing from surgery, a burn, a cut or a piercing who wants to limit a raised scar, and for people already living with a thick or keloid scar.

Key takeaways

  • Silicone products are thought to work by hydrating scar tissue and reducing collagen production, which can leave scars flatter, softer and paler.
  • A Cochrane review of 20 trials with 873 participants found silicone gel sheeting reduced hypertrophic scarring compared with no treatment, but the studies were poor quality.
  • Hospital therapy guidance recommends wearing sheets at least 12 hours a day, and up to 23 hours, for a minimum of 2 months.
  • Only apply silicone to clean, dry, fully healed skin, never to open or weeping wounds.
  • Stop and seek advice if you get a rash, itching, swelling, peeling or white, soggy skin under the sheet.

What are silicone scar sheets and gels?

They are medical-grade silicone products you place on a healed scar. Sheets are thin, flexible, slightly sticky pads you cut to size, and gels are a thin layer you rub on that dries to a film.

They are mainly used for two kinds of raised scar. A hypertrophic scar is a thick, raised scar that stays within the edges of the original wound. A keloid is overgrown scar tissue that spreads beyond the original wound. MedlinePlus notes that keloids are most common in people under 30, occur more often in Black, Asian and Hispanic people, tend to run in families, and can follow acne, burns, piercings, surgery or even minor scratches.

Flat, sunken or pitted scars, such as many acne scars, are a different problem. If yours are indented, our guides to a clogged pore that left a hole in your skin and whether microneedling really renews skin are more relevant.

How do silicone sheets work on scars?

The leading explanation is hydration. Silicone covers the scar and holds in moisture, which seems to calm the overactive collagen production that makes a scar thick.

Patient guidance from Cambridge University Hospitals says silicone may hydrate scar tissue and reduce collagen production, and reports reduced redness and flatter, softer, paler scars. Therapists usually combine it with pressure and scar massage rather than using it alone. That's a similar idea to sealing in moisture with ointments, which we cover in our article on occlusive ointments.

Do silicone scar sheets actually work?

They probably help, but the evidence is weaker than marketing suggests. Most studies show some improvement, yet many were small or poorly designed.

A Cochrane review published in 2013 pooled 20 trials with 873 participants aged 1.5 to 81. For prevention, silicone gel sheeting reduced hypertrophic scarring in high-risk people compared with no treatment, but the authors called the evidence weak because of poor study quality. For existing hypertrophic and keloid scars, trials reported improvements in thickness and color, but again the studies were at high risk of bias.

Despite that uncertainty, silicone remains a standard first step in hospital scar clinics because it's low risk, non-invasive and easy to use at home. MedlinePlus lists silicone gel or patches alongside corticosteroid injections, freezing, laser, radiation and surgery as options for keloids.

FeatureSilicone sheetsSilicone gel
FormFlexible, slightly sticky pad cut to sizeThin layer massaged in, dries to a film
Best forFlat areas of the body such as the chest, abdomen and limbsFace, joints and areas where sheets won't stay put
How oftenWorn for long periods, often 12 or more hours a dayUsually applied morning and evening
Visible in publicYes, can be covered by clothingNearly invisible once dry
ReuseWashed and reused until it loses stickinessSingle use per application
Main drawbackCan trap sweat and cause rash or soggy skinEasy to apply too little or forget

The gel details come from the Cambridge guidance, which says a topical gel dries in 3 to 5 minutes and stays waterproof for 6 to 8 hours.

How do you use silicone scar sheets correctly?

Start only once the wound has fully closed, build up wear time gradually, and aim for most of the day. Consistency matters more than any particular product.

  1. Wait for full healing. Silicone should only go on clean, dry, healed skin, never on open or weeping wounds. If you had surgery, ask your surgeon or therapist when to begin.
  2. Clean and dry the skin. Remove moisturizer and any residue first so the sheet sticks. Skip alcohol wipes on fresh scars unless advised; our guide to proper use of alcohol prep pads explains when they're appropriate.
  3. Cut to size. Cambridge guidance suggests cutting a sheet with about 1 cm extra around the scar.
  4. Start short. Royal Devon guidance suggests a one-hour trial first. If the skin looks fine afterward, extend the time the next day.
  5. Build up to at least 12 hours a day. Metro North Health occupational therapy guidance recommends at least 12 hours a day and up to 23 hours, leaving an hour off for washing and scar massage.
  6. Wash the sheet daily. Use mild soap, rinse, then air dry or pat dry with a low-lint towel. Avoid paper towels, since fibers stick to silicone. Wash more often in hot weather or after exercise.
  7. Store it properly. Keep it in a clean plastic bag or container between uses.
  8. Replace it when it wears out. Metro North guidance says to replace a sheet once it loses its stickiness and turns cloudy, typically after 4 to 8 weeks depending on wear time.
  9. Protect the scar from the sun. MedlinePlus advises covering a forming keloid and using sunblock for at least 6 months after an injury or surgery in adults, and up to 18 months in children. Our guide to how often to reapply sunscreen covers the details.

How long does it take to see results?

Plan on at least two months of consistent use before judging, and often several months. Scars mature slowly, so changes are gradual.

Metro North guidance sets a minimum of 2 months at 12 hours a day and describes treatment lasting "several months." Cambridge guidance says most reusable products last about six to eight weeks, but you may need to keep going for several months depending on how your scar responds. Taking photos in the same light every two weeks is the most reliable way to see change, because day-to-day differences are too small to notice in the mirror.

Common mistakes

  • Starting on an unhealed wound. Silicone on open skin can cause irritation or infection. Wait until the wound has fully closed.
  • Wearing it only a few hours a day. Short wear times are a common reason people decide silicone "doesn't work."
  • Skipping the wash. Sweat and skin oils build up under an unwashed sheet and can cause rash.
  • Giving up after two weeks. Guidance calls for months, not days.
  • Using it on the wrong scar. Silicone targets raised scars. It won't fill in pitted acne scars or fix dark marks, which respond better to other treatments. For discoloration, see our guide to fading post-acne marks.

When to see a doctor

Stop using silicone and contact your doctor, surgeon or therapist if you notice side effects or signs the scar isn't behaving normally. Hospital guidance lists these reactions to watch for under a sheet: itch or rash, swelling, peeling, and maceration, which is skin that looks white, moist and wrinkled, as if it has been in water too long. Cambridge guidance advises removing the silicone, washing the area with cold water and not reapplying it until you've spoken with your therapist if redness appears. See a doctor promptly if:

  • The wound reopens, oozes or shows signs of infection such as spreading redness, warmth, pus or fever
  • A scar keeps growing beyond the original wound, which may be a keloid
  • A scar is painful, very itchy or limits movement over a joint
  • A scar changes color, bleeds or develops a new lump, especially an old scar that suddenly changes
  • You've used silicone consistently for three months with no improvement

A dermatologist can offer stronger options, including corticosteroid injections, freezing, laser and other treatments that MedlinePlus lists for keloids.

Frequently asked questions

Can silicone sheets remove old scars?

They won't remove a scar, but they can still soften and flatten an older raised scar. The Cochrane review found trials on existing hypertrophic and keloid scars reported improvements in thickness and color, though study quality was poor. Older, mature scars usually change more slowly than new ones, so give treatment at least a few months.

Should I wear silicone sheets overnight?

Yes, if you can. Overnight wear is an easy way to reach the recommended 12 or more hours a day. Some people wear sheets only at night when daytime wear isn't practical. Royal Devon guidance suggests trying it in the evening first to make sure your skin tolerates it.

Are silicone gels as good as sheets?

Both deliver silicone to the scar, and the choice often comes down to location. Gels suit the face, hands and joints where sheets peel off, and they're nearly invisible. Sheets suit flat areas and hold in moisture for longer. The best product is the one you'll actually use every day for months.

Can I use silicone on a surgical scar right away?

No. Wait until the incision has fully closed and any stitches or scabs are gone, so the skin is clean, dry and healed. Hospital guidance says silicone should never go on open or weeping wounds. Ask your surgeon when it's safe to start, since timing depends on the procedure and how you heal.

What to do next

  1. Check that your wound has fully healed, and ask your surgeon or doctor when to start silicone.
  2. Pick sheets for flat areas or gel for the face and joints, and do a one-hour skin test.
  3. Build up to at least 12 hours a day and set a two-week photo reminder to track progress.
  4. Book a dermatology appointment if the scar keeps growing, hurts or hasn't improved after three months.

This article is for general information and is not medical advice.

Sources

Last reviewed: October 2026.

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