A prospective, controlled clinical trial was designed to assess the efficacy of a new treatment of
hypertrophic scars.
Silicone gel sheeting was applied to 14
hypertrophic scars in 10 adults for 8 weeks. The treated
scars and untreated, mirror-image or adjacent control
scars were photographed, biopsy specimens were taken, and they were measured elastometrically before and
after treatment. Photography and elastometry were repeated 4 weeks
after treatment was discontinued. All the
scars that had been treated for at least 12 hours a day were improved clinically after 4 weeks. There was further clinical improvement during the second 4 weeks of treatment. Elastometrically, the treated
scars were improved significantly at 4, 8, and 12 weeks, compared with both their own treatment value and the control
scars (p less than 0.05). Control
scars were unchanged elastometrically. Clinical improvement persisted for at least 4 weeks
after treatment was discontinued. The
silicone gel sheeting was well tolerated, except for occasional transient rashes or superficial maceration--both of which resolved promptly when treatment was withdrawn. There was no histologic evidence of
inflammation or
foreign body reaction suggesting that
silicone had entered the treated tissues. We conclude that this simple method of treating
hypertrophic scar is efficacious, even in relatively chronic cases. The mechanism of action of
silicone gel, which is apparently not related to compression, remains to be determined.