The Science Behind Silicone Scar Tape

By Benedette Cuffari, M.Sc.Reviewed by Danielle Ellis, B.Sc.

What is silicone scar tape?
The science of silicone scar tape: How does it work?
Evidence supporting silicone scar tape
Silicone scar tape vs. other scar treatments: How does it compare?
Are there any side effects or risks? Safety considerations
References
Further reading

When an injury causes damage to the skin, a scar arises as part of the body’s healing process to recover any lost skin from this traumatic event. Infections, surgery, injuries, or inflammation of the tissue can cause a scar to develop at any location in the body.¹

In severe cases, hypertrophic scarring and keloids can occur after an injury, particularly severe burn traumas, which can be disfiguring and negatively affect the individual’s quality of life.

What is silicone scar tape?

Various treatments are currently available to support the wound-healing process and minimize the appearance of scars, the selection of which is dependent upon the type of scar. Silicon products, which are available as both sheets and fluid gels, have been used in the treatment of scars for over 30 years, with their clinical efficacy confirmed in numerous trials.

Silicone gel sheeting (SGS), which can otherwise be referred to as ‘scar tape,’ is currently designed to be worn for up to 24 hours, following which the sheet is washed and reused. Silicone tapes must be worn every day, often for several months, to treat the scar and/or prevent it from developing after surgery. Some of the different symptoms that can be mitigated with silicone scar tape include size, hardness, redness, swelling, itch, and stiffness.²

The science of silicone scar tape: How does it work?

The mechanisms by which silicone products reduce the appearance of scars and treat their associated symptoms remain unclear. However, several hypotheses have been proposed and investigated in clinical studies.

During the early wound healing process, immature stratum corneum allows excessive water loss to occur within the transepidermal layers. This dehydration signals keratinocytes to produce cytokines, which subsequently invites fibroblasts to synthesize and release excessive amounts of collagen needed for scar formation.³

Silicone provides occlusion and hydration to the wound, which allows the new and underdeveloped stratum corneum to retain more water, thereby reducing the amount of collagen produced in the affected region. Importantly, the hydration provided by silicone resembles that of normal skin, thereby normalizing the stratum corneum and preventing any detrimental effects that can be associated with an excessively moist barrier.

Silicone scar tape also transfers tension from the lateral edges of the wound bed to the sheet, which can reduce the rate of abnormal and keloid scarring. Additionally, silicone scar tape significantly increases the temperature of the covered area, which prevents blood flow to this region, thereby limiting excessive healing processes that are involved in scarring.

Evidence supporting silicone scar tape

Several clinical trials have demonstrated that silicone scar tape effectively reduces the appearance of hypertrophic and keloid scars. When applied for prolonged periods, silicone scar tape is particularly effective in reducing scar thickness, redness, and pain. As a result, silicone-based therapies are considered the first-line and gold-standard treatment for scars.

Nevertheless, some studies have produced conflicting results on whether silicone gel sheeting provided significantly better results in scar appearance than placebo or conventional pressure therapy. In 2020, researchers at the Phramongkutklao Hospital in Thailand compared the efficacy of silicone gel sheets to silicone gel in preventing the development of hypertrophic scars in patients with deep hand burns with skin grafts. Although both silicone gel and silicone gel sheeting were more effective than pressure garments (PGs) alone, no significant difference was observed between these two silicone products.⁴

Silicone scar tape vs. other scar treatments: How does it compare?

Silicone is an inert element that is biocompatible, resistant to microbial growth, noninvasive, and relatively low-cost. Furthermore, silicone gel sheets have been shown to significantly improve the size and appearance of scars and the scar elevation index (SEI), which measures the height of the scar tissue as compared to the surrounding skin.

Silicone gel sheets can treat a wide range of scars, the most common of which include hypertrophic and keloid scars. Nevertheless, depending on their severity and appearance, surgical, acne, and burn scars can also be treated with silicone tape.

In addition to silicone, several natural-based topical agents are also available for scar treatment. Some of these include aloe vera for its anti-itching properties and green tea and onion extracts for their anti-oxidant and anti-inflammatory properties.⁵ Despite clinical trials reporting reduced skin scarring following treatment with these natural agents, they are limited in their ability to provide long-term benefits.

Various types of lasers have also been investigated for the treatment of scars, some of which include pulse-dye laser (PDL), carbon dioxide (CO₂), and neodymium-doped yttrium aluminum garnet (Nd: YAG) lasers for erythema, ablation, and post-inflammatory pigmentation, respectively. Photodynamic therapy can also reduce the expression of both collagens I and III; however, further research is needed to confirm its efficacy in the treatment of scars. 

The clinical support of topical silicone gel products relative to all alternative scar therapies is what has preserved its position as the internationally recommended first-line form of scar management, favored by census among healthcare professionals.” ³

Are there any side effects or risks? Safety considerations

Silicone scar tape is generally safe and is associated with minimal side effects, some of which may include itching, rash, breakdown of skin under the tape, foul smell, redness, swelling, or increased pain. Patients living in hot climates may also be at a greater risk of experiencing skin irritation.

Importantly, removing the silicone tape and washing the area with mild soap at least once a day can reduce the risk of these side effects while also preventing the development of skin infections. However, the care needed to wash and reapply these sheets can be cumbersome and subsequently lead to reduced patient compliance. Many patients may also be reluctant to apply the silicone tape on certain regions of their body, such as their face.

References

1. “Scars” [Online]. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/scars.

2. “Scars: Diagnosis and Treatment” [Online]. Available from: https://www.aad.org/public/diseases/a-z/scars-treatment.

3. Bleasdale, B., Finnegan, S., Murray, K., et al. (2015). The Use of Silicone Adhesives for Scar Reduction. Advances in Wound Care 4(7); 422-430. doi:10.1089/wound.2015.0625.
4. Pruksapong, C., Burusapat, C., & Honkarnjanakul, N. (2020). Efficacy of Silicone Gel versus Silicone Gel Sheet in Hypertrophic Scar Prevention of Deep Hand Burn Patients with Skin Graft: A Prospective Randomized Controlled Trial and Systematic Review. Plastic and Reconstructive Surgery – Global Open 8(10). doi:10.1097/GOX.0000000000003190.
5. Basson, R., & Bayat, A. (2022). Skin scarring: Latest update on objective assessment and optimal management. Frontiers in Medicine Dermatology. doi:10.3389/fmed.2022.942756.

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