Why can silicone reduce keloid?

Question

I heard people use silicone sheet for reducing raised scars (i.e., keloids). I was wondering what is the rational behind it, and whether it actually works.

Answer 1

Keloid scars are formed when the scar tissue extends beyond the margin of the original wound and is the most extreme type of scarring. When this scar type occurs, a small wound such as an insect bite or piercing can result in the formation of a much larger elevated area of tissue which even after surgical revision can reform. Keloid scars are not to be confused with hypertrophic scars which are raised and often discolored, but do not extend beyond the boundary of the initial wound. This article discusses in great detail all the biological properties and mechanisms of scar formation and how silicone enhances the recovery.

Role of silicone in scar reduction

The epidermis may take around 2 weeks to sufficiently regenerate after a full-thickness wound has occurred due to it penetrating through the epidermis and into the dermis layers. During this time, intervention with scar development will have little to no effect as high collagen levels are required at this early wound healing stage.12 After this period, the new immature stratum corneum allows abnormally high levels of transepidermal water loss. This dehydration of the stratum corneum signals the keratinoctyes to produce cytokines, which signals to fibroblasts to synthesize and release collagen. The newly formed collagen rushes to the scar site and is the cause of many undesirable physical and aesthetic properties associated with scarring. The application of SGS replicates the stratum corneum's occlusion properties, normalizing hydration of the scar site to that of healthy skin, perhaps inhibiting the instruction sent to the fibroblasts to produce excess collagen cells.

Answer 2

I cannot say the mechanism, but I can confirm it works, and can say that is generally accepted as working, not as some weird dubious treatment. I had surgery to install a rod in my leg after a broken bone. On the advice of my physical therapist, I purchased "Scar Away" brand silicone oil with roller applicator. Placing a thin layer and massaging with the applicator twice a day for four weeks turned my giant cheloids into small sections of skin which were distinguishable only by their smoothness and lack of hair, not color. He said he used to work for some basketball team and it was common practice to be used in professional basketball.

Answer 3

According to several papers (Sawada and Sone, 1992; Wong et al., 1996), increased hydration appears to be the main mechanism by which silicone oil acts on raised scars. Combined with an occlusive dressing, this preparation would increase hydration of the scar site. Sawada and Sone (1992) compared silicone oil treatment to vaseline treatment and found significantly improved healing with silicone oil, concluding that it was the hydrating action of silicone oil that led to improvement.

Sawada Y, Sone K. 1992. Hydration and occlusion treatment for hypertrophic scars and keloids. Br J Plast Surg 45(8):599-603.

Wong TW, Chiu HC, Chang CH, Lin LJ, Liu CC, Chen JS. 1996. Silicone cream occlusive dressing--a novel noninvasive regimen in the treatment of keloid.. Dermatology 192(4):329-33.