Silicone sheets and new gels to treat hypertrophic scars and keloids: A short review.

Silicone dressings have been used to treat hypertrophic scars and keloids since 1983. This treatment modality is considered to be safe and efficacious, leading to a progressive improvement in scar color, size, erythema, pliability, pain, and itching. Its mechanism of action is due to the hydration of the skin corneal layer; and modulating the cell signaling between fibroblasts and keratinocytes, mediated by cytokines. Silicone dressings are considered first line treatments for hypertrophic scars and keloids. Silicone gels were developed later, in order to help treating those scars in areas such as the scalp or joints, where fixing the silicone sheets would be a more difficult task, or on the face, where a silicone dressing would be cosmetically undesirable to most. Similar to silicone sheets, silicone gels have also proved to help treating and preventing hypertrophic scars and keloids. A new silicone gel combined with hypochlorous acid has recently been developed to help in treating scars. Hypochlorous acid acts as a biocide and anti-inflammatory agent, therefore, it has also been used in post procedure, on recent traumatic scars or on nonepithelized skin. This manuscript reviews the use of silicone dressings, silicone gels, and combined gels to treat scars.