Scarless vs silicone sheets: gel or sheet for scars?

Quick comparison

The differences that matter most

1. 1

   Apply or wear. Scarless is spread over the scar two to three times a day and dries in a few minutes. A silicone sheet is worn: Cica-Care, according to its Australian product page, is cut to fit, placed adhesive side down without stretching, and worn for longer each day, building up to at least 12 hours and ideally 24.

2. 2

   Maintenance and reuse. A sheet needs looking after; a gel does not. Cica-Care's instructions say to clean the sheet twice a day with mild soap, rinse and dry it, wash the scar before putting it back, and replace it when it wears or cleaning becomes difficult, usually after about 28 days. It is reused on the same person only.

3. 3

   Body area and daily life. Where the scar is may decide which format is easier to keep up. A dried gel is an invisible film that make-up or sunscreen can go over, and needs no fitting. A sheet can cover a broad, flat area in one piece and sits under clothing, but has to be cut, kept in place and, with Cica-Care, kept free of creams underneath. These are practical points, not differences in results.

Cica-Care as an example of a silicone sheet

What it is. Cica-Care is a self-adhesive silicone gel sheet from Smith+Nephew, supplied in a tray with a printed plastic release sheet. In Australia it comes in 6 cm × 12 cm, 3 cm × 12 cm and 12 cm × 15 cm sheets, and it is cut to fit the scar.

Fitting it. Wash and dry the scar, cut the sheet with a small overlap onto the surrounding skin, remove the plastic sheet and apply the adhesive side without stretching. It can be held with a light bandage or tape, but not too tightly. For large scars, several sheets are placed side by side, edge to edge, not overlapping.

Wearing, cleaning and replacing. Wear time is built up over several days to at least 12 hours a day, and ideally 24. The sheet is cleaned twice a day with mild soap, rinsed and dried, and the scar is washed before it goes back on. It is reused on the same person and replaced when it wears or cleaning becomes difficult, usually after about 28 days.

When it is used. Only on fully healed, closed skin, never on open wounds; on a surgical incision, only after the sutures are removed and the site has fully healed. Ointments and creams are not used under the sheet. Its Australian page names new and existing hypertrophic and keloid scars, after surgery, including caesarean section, and after accidents, including burns.

Not a rule for all sheets. These are Cica-Care's own instructions. Other silicone sheets may use different materials, wear times, cleaning steps and replacement intervals; follow the instructions for the sheet you use.

Gel or sheet: practical points by body area

These points are about convenience and daily routine, not about which format gives better results. They describe gels and sheets in general, with Cica-Care's instructions where named.

• Face. A dried gel is an invisible film that make-up or sunscreen can go over, so it may be easier to keep discreet. A sheet sits visibly on the skin and may be harder to conceal during the day.
• Neck. A sheet has to stay in place as the neck moves and against collars; Cica-Care can be held with a light bandage or tape, not too tightly. A gel needs nothing to hold it in place.
• Joints and areas that bend. A sheet has to stay on as the skin stretches and folds, and Cica-Care's instructions say to apply it without stretching. A gel needs no dressing; it is simply reapplied two to three times a day.
• Abdomen and caesarean scars. A long, fairly flat scar can be covered by a sheet, or by several placed side by side, under clothing; Cica-Care names caesarean scars among its uses. A gel is spread along the scar without cutting to fit. The one trial comparing a gel with Cica-Care was on caesarean scars and found no difference in scar scores.
• Long surgical scars. Cica-Care's instructions say to place several sheets side by side, edge to edge, for large scars. A gel is spread along the whole length.
• Small, isolated scars. A sheet is cut to fit with a small overlap onto the surrounding skin; a small amount of gel covers a small scar.
• Curved or irregular areas. A sheet has to be cut and shaped to follow the contour; a gel spreads over whatever shape the skin has.
• Scars under clothing. A sheet can be worn under clothes for the long hours Cica-Care's routine asks for. A gel is left to dry for a few minutes before clothing goes over it.
• Visible areas during the day. Once dry, Scarless can be covered with make-up or sunscreen. Cica-Care's instructions say not to use creams or ointments under the sheet.

Which may suit different priorities?

Each has documented features that may matter to different people:

• A silicone sheet may suit someone who prefers a physical sheet that can be washed and reused, has a fairly flat scar the sheet fits well, can wear it for many hours a day, and is comfortable with the cleaning routine. Cica-Care, for example, comes in three sheet sizes and is cut to fit.
• Scarless may suit someone who prefers a gel to a sheet, wants nothing to wear or keep in place, has a scar on an irregular or visible area, or wants squalane and a vitamin C derivative alongside silicone. Once dry, make-up or sunscreen can go over it.
• If you are not sure which suits your scar, a pharmacist or doctor can advise.
• The two formats are also discussed more generally in silicone gel or silicone sheets: how to choose.