Topical Silicone Gel Found to Improve Burn Scars
Topical silicone gel, Dermatix, improves burn scars and lessens itching associated with healing according to a new study in the August issue of the Journal of Plastic and Reconstructive Surgery.
Deep dermal injuries from burns are frequently followed by scarring. The normal course of scar maturation after the wounded skin heals is characterized by an increasing occurrence of redness, thickness, stiffness, pain, and itching, and a disturbance in pigmentation and surface roughness.
Burn scars are often treated with intralesional corticosteroid injections, occlusive dressings, custom-made pressure garments, and silicone sheets.
The silicone sheets, introduced in the early 1980s, have been shown to helpful in improving scar appearance. The drawbacks of their use include compliance issues on scars in visible areas, difficulty of use for scars on or adjacent to joints, and hygienic issues of prolonged use. The sheets can trap moisture creating skin irritation or rashes.
A topical silicone gel named Dermatix (Meda Pharma, Amstelveen, The Netherlands) was introduced to overcome the disadvantages of silicone sheets. It can be applied easily and dries to form a thin, flexible coating that does not restrict movement. Unlike the silicone sheets, cosmetics can be applied over the silicone layer to camouflage the scar.
Martijn van der Wal, M.D., VU University Medical Center, Netherlands, and colleagues conducted a randomized, double-blinded, within-subject comparative, placebo-controlled trial to investigate the effectiveness of topical silicone gel in the treatment of scars resulting from a burn injury.
Forty-six scars on 23 patients were included in the study and followed for 1 year. The mean age of the scars at inclusion was 4 months. The patients were given two blinded and coded products to be applied two times per day on the two included scars with instructions to not interchange the therapies between the two scars. One tube held a placebo cream and the other tube held Dermatix (kindly provided by Meda Pharma BV). Effectiveness on scar quality was evaluated at 1, 3, 6, and 12 months using the Patient and Observer Scar Assessment Scale and the DermaSpectrometer.
Over all visits, the benefit on surface roughness was statistically significant (p = 0.012). The surface of the topical silicone gel–treated scars showed significantly less roughness (p = 0.014) at 3 months after start of the treatment, and the topical silicone gel–treated scars were significantly less itchy (p = 0.018 and p = 0.013, respectively) at 3 and 6 months.
On average, observers rated scars treated with topical silicone gel slightly better than scars treated with the placebo cream, but repeated measures analysis did not show a significant treatment effect (p = 0.154). The patients rated the scars treated with topical silicone gel and the placebo cream almost equally.
Topical silicone gel may significantly improves the surface roughness of burn scars and aid in decreasing itching, but overall appearance of the scar may be helped more by the simple act of scar massage regardless of the cream/gel used.
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Topical Silicone Gel versus Placebo in Promoting the Maturation of Burn Scars: A Randomized Controlled Trial; van der Wal, Martijn B. A.; van Zuijlen, Paul P.; van de Ven, Peter; Middelkoop, Esther; Plastic & Reconstructive Surgery. 126(2):524-531, August 2010; doi: 10.1097/PRS.0b013e3181e09559