Guide · Recovery
Silicone scar sheets: how to use them
Quick answer
International scar guidelines recommend silicone gel sheeting for managing raised scars. Start once the wound has fully closed, wear the sheet at least 12 hours a day, and continue for at least two to three months. The evidence base has weaknesses, so expect gradual, modest change rather than a scar that disappears.
- International scar guidelines recommend silicone sheets and gels for managing raised scars.
- Start only after the wound has fully closed. Never use on open wounds.
- Wear at least 12 hours a day for at least two to three months.
- A Cochrane review rated the evidence as weak, so results vary.
Why athletes end up with scars
Road rash from a bike crash, a fall on a technical trail descent, a slide on an obstacle course or surgery after an injury all leave scars. Most fade on their own, but some become raised, red and itchy (hypertrophic scars), especially over joints like knees and elbows where skin stretches constantly.
What the guidelines say
International recommendations on scar management published in 2002 named silicone gel sheeting as one of only two treatments with enough evidence for evidence-based recommendations.[1] An updated international expert panel in 2014 described silicone sheets and gels as the “gold standard, first-line” non-invasive option.[2]
The 2013 Cochrane review is more cautious: across 20 trials, silicone was linked to less hypertrophic scarring in people prone to it and to thinner, better-colored scars, but the trials were of poor quality and the review described the evidence as weak.[3] Silicone is low-risk and widely recommended; the size of the benefit is uncertain.
When to start
Only once the wound has completely closed: no scabs, no open areas and stitches removed. Silicone sheets aren't designed for open skin and can irritate a healing wound.[4] After surgery, ask your surgeon when to begin.
How long to wear silicone scar sheets (and how to apply them)
Wear silicone for at least 12 hours a day, building up to as much as 23, for at least two to three months, and longer while the scar is still changing.[5]
- Cut the sheet to cover the scar with about 1/2 inch (1 cm) to spare.
- Apply to clean, dry skin with no cream underneath.
- Start with a few hours a day and build up to at least 12 hours, up to 23 hours a day.[5]
- Wash the sheet daily with mild soap and let it air-dry.
- Continue for at least two to three months, and longer if the scar is still changing.
When to see a doctor
See a clinician for a scar that keeps growing beyond the original wound, is very painful, restricts movement over a joint, or any wound that shows signs of infection.
FAQ
Do silicone scar sheets work on old scars?
They are mostly studied on newer, raised scars. They are low-risk to try on older scars, but expect smaller changes.
Silicone sheet or silicone gel?
Both are recommended. Sheets suit flat areas and overnight wear; gels suit joints, the face and visible areas in the day.
Sources
- International clinical recommendations on scar management. Mustoe et al., Plastic and Reconstructive Surgery, 2002.
- Management of scars: updated practical guidelines and use of silicones. Meaume et al., European Journal of Dermatology, 2014.
- Silicone gel sheeting for preventing and treating hypertrophic and keloid scars. O'Brien & Jones, Cochrane Database of Systematic Reviews, 2013.
- An evaluation of evidence regarding application of silicone gel sheeting for the management of hypertrophic scars and keloids. Journal of Clinical and Aesthetic Dermatology.
- Silicone gel sheeting (patient information). Queensland Health, Metro North.
