How scars mature
After closure, collagen is laid down and progressively remodelled over roughly 12 months. Where that process is prolonged or disordered, the result is a hypertrophic or keloid scar: raised, firm, often itchy or painful, and slower to fade.
Two modifiable factors dominate: hydration of the stratum corneum, which moderates fibroblast signalling, and mechanical tension across the wound, which stimulates further collagen deposition.
Silicone therapy and tension control
Silicone gel sheets and gels occlude the scar and maintain hydration, and are recommended in international scar-management guidance as a first-line non-invasive option for both prevention and treatment. Therapy needs to be worn consistently — typically many hours a day over months — to be effective.
Tension control matters just as much. In cleft lip repair, taping systems apply sustained approximation across the repair to reduce tension on the closure while the scar matures, and the same principle applies to any closure under load.
Starting therapy
Therapy usually begins once the wound is fully closed and dry, and continues for two to three months at minimum, longer for scars that remain active. Patient education is the main determinant of adherence, so product comfort and simplicity are clinically relevant.
Common questions
Does silicone scar therapy work?
Silicone gel and sheeting are recommended in international scar management guidance as a first-line non-invasive therapy. They work by occluding and hydrating the scar, and require consistent daily use over months.
When should scar therapy start?
Generally once the wound is fully closed and dry, with therapy continued for at least two to three months and longer for scars that remain red, raised or symptomatic.