How does silicone gel work? Its effect is limited to the epidermis, the top layer of the skin. If you have ever used it, it seems a little hocus pocus. You put this strip of slightly filmy stuff on top of your scar. Somehow this makes scars better. That silicone gel is effective is not controversial. We have used it for years, particularly in burns. It works.
So how? What they think (they being some of the experts who spoke at my recent plastic surgical meeting who are doing research on this) is the stratum corneum (the top layer of your epidermis) is a barrier to water loss.
We know wounds heal better in a moist environment. The mucosal skin in your mouth doesn’t tend to scar. (We see this on lip scars all the time). Their theory is the stratum corneum serves as a barrier to water loss, which causes a down regulation of inflammatory cytokines. They think it takes about 3 months for your stratum corneum to be thick enough again to be water protective.
Occlusive materials (like the silicone gel sheeting) help restore homeostasis by helping the stratum corneum keep in the skin’s moisture.
They did a rat study where they looked at suture lines in two groups: one was treated with paper tape, one was not taped. They found the nontaped scar to be thickened. They then did a rabbit ear model and analyzed it with the scar elevation index. and they found when they treated with liquid silicone gel, they had the best result.