Scar care is one of the questions the Institute of Dermatologists gets asked about most often on social media, usually some version of the same thing: why won't this scar flatten out, and what can be done about it once it's already there?

Raised, thickened scars, known as hypertrophic or keloid scars, form when the skin over produces collagen while healing. The treatment with the strongest track record for softening, flattening and fading them is silicone therapy, a medical-grade silicone sheet or gel worn over the scar consistently for several months, which outperforms most scar creams and oils.

What Makes a Scar Become Raised or Thickened?

Every wound that breaks through the deeper layer of skin (the dermis) leaves a scar. Most flatten and fade on their own within a year or two. Some don't, because the skin's repair process overshoots and lays down too much collagen at the wound site.

There are two versions of this:

Hypertrophic scars are raised, red or pink, and often itchy or tight, but they stay within the borders of the original wound or incision. They're common after surgery, burns, piercings and inflamed acne.

Keloid scars go further. They spread beyond the edges of the original injury and can continue growing for months or years. They're more likely in people with a family history of keloids, tend to affect certain skin tones more, and are notoriously harder to treat.

Both are more likely to develop on areas of higher skin tension: the chest, shoulders, jawline and ears in particular, as well as the lower abdomen after a caesarean section.

How Does Silicone Therapy Treat a Scar?

Silicone sheets and gels work by covering the scar in an occlusive layer that holds moisture in the skin underneath. That sustained hydration is thought to calm the overactive collagen production behind hypertrophic and keloid scarring, which is why consistent use gradually softens, flattens and reduces the redness of a scar.

Professor Nicola Ralph, Co-founder of the Institute of Dermatologists, has long pushed back on the idea that a wound heals better left open to the air. Moisture speeds healing and lowers the risk of a visible scar forming in the first place, and that same principle carries through into scar treatment: keeping the area hydrated and protected does more than exposing it ever will.

Because silicone therapy works through hydration and occlusion rather than active ingredients penetrating the skin, it's considered very low risk and suitable for long-term use, which matters given how long treatment needs to continue.

When Should You Start, and How Long Does It Take?

Silicone therapy should start once the wound has fully closed over, meaning no open skin, scabbing or stitches still in place. Starting too early, on skin that hasn't finished healing, can irritate the area.

Once the skin has closed, consistency is what makes the difference. Manufacturer guidance across the Scarban range recommends wearing a sheet for at least 12 hours a day, for a minimum of six weeks, or for as long as the scar's appearance continues to improve. More stubborn, larger or established scars often need longer.

It's worth setting expectations early: this is a slow, cumulative treatment, not a quick fix. Patients who stick with it consistently for the full course see meaningfully better results than those who use it on and off.

Hypertrophic vs Keloid Scars: Does Treatment Differ?

This is where it's important to be honest about what silicone therapy can and can't do.

For hypertrophic scars, silicone sheeting or gel is the recommended first step, and many respond well with consistent use alone.

Keloids are more resistant. Silicone therapy can still help as part of managing a keloid, but on its own it's less likely to fully resolve a keloid scar, particularly a larger or long-standing one. Keloids often need to be managed alongside other approaches, such as corticosteroid injections, and a consultation with a dermatologist is a sensible first step if a scar is spreading beyond the original wound or continuing to grow.

A few practical cautions worth flagging: stop use and let the skin settle if a sheet or gel causes irritation, redness or a rash, and don't apply silicone therapy over broken skin or a wound that hasn't fully closed. New scar tissue is also more prone to visible pigmentation change in strong sunlight, so protecting the area from UV exposure while it's healing and remodelling matters just as much as the silicone itself.

Choosing the Right Silicone Treatment for Your Scar

Not every scar suits the same format. The right choice usually comes down to where the scar is and how large or curved the area is.

For scars on visible or flexible areas, such as the face, neck, hands or over a joint: BAPSCARCARE Gel is often the better fit. It's a transparent, quick-drying medical-grade silicone gel that forms an invisible film without massage or residue, so it can be worn under makeup and doesn't require a sheet to stay in place on awkward areas.

For smaller hypertrophic or keloid scars, especially over areas that move, such as elbows or joints, or on sensitive skin: Scarban Light Silicone Sheets are a thin, flexible, self-adhesive option that's washable and reusable, with at least 93% UV protection built in.

For larger or curved scars, such as post-surgical scars on the abdomen, chest or after orthopaedic surgery: Scarban Elastic Silicone Sheets are the most intensive option in the range, an extra-thick, elastic sheet that conforms closely to the body and covers a wider or more irregular area, also with built-in UV protection.

For a caesarean scar specifically: Scarban C-Section Scar Sheets are pre-shaped to the lower abdomen rather than a generic sheet cut down to size. More on this below.

All four are medical-grade silicone therapies, the same category of treatment referenced in international clinical guidelines for hypertrophic and keloid scar management, rather than a cosmetic scar cream.

Is Silicone Sheeting Safe to Use on a C-Section Scar?

Yes, and a caesarean scar is one of the most common places this type of treatment is recommended. The lower abdomen is an area of higher skin tension, movement and clothing friction, all of which make a C-section scar more prone to becoming raised, itchy or thickened as it heals.

Scarban C-Section Scar Sheets are shaped specifically for this: a self-adhesive, elastic, 100% medical-grade silicone sheet pre-contoured to fit the lower abdomen, rather than a rectangular sheet trimmed down to size. It's a registered medical device, suitable for all skin types, and works on both new and established C-section scars.

As with the rest of the range, it should only go on once the wound has fully closed and any stitches have been removed, worn on clean, dry skin for a minimum of 12 hours a day. It carries UPF 50 sun protection built in, and it's worth avoiding greasy creams underneath beforehand, since these can stop it adhering properly.

Frequently Asked Questions

How long does it take to see results from silicone scar therapy?

Manufacturer guidance points to consistent daily use, at least 12 hours a day, for a minimum of six weeks before meaningful flattening or fading is visible, with more established or larger scars often needing longer. Silicone therapy works gradually, not overnight.

Can silicone sheets or gel be used on old scars, or only new ones?

Both. Silicone therapy is most commonly started as soon as a wound has closed, but existing hypertrophic and keloid scars, even long-standing ones, can also improve with consistent use, though older scars may take longer to respond.

Is silicone gel or a silicone sheet better for a facial scar?

Gel is generally the better choice for the face and other visible areas, since it dries invisibly and can be worn under makeup, whereas sheets are easier to see and are better suited to less visible or larger areas of the body.

What's the best scar treatment for a C-section scar?

A silicone sheet shaped for the area, such as Scarban C-Section Scar Sheets, tends to work better than a generic sheet cut to size, since it's contoured to the curve of the lower abdomen and stays in place more reliably under clothing.

Will silicone therapy get rid of a keloid scar completely?

Not reliably on its own. Silicone therapy can improve a keloid's texture, itch and redness, but keloids are more resistant to treatment than hypertrophic scars and often need to be managed alongside other options under a dermatologist's guidance.

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This guidance reflects international clinical recommendations on scar management, independent evidence reviews of silicone gel sheeting for hypertrophic and keloid scars, and manufacturer usage instructions for the Scarban range.