When Using Silicone Sheeting for Scarring, Does One Apply Sunblock to the Scar First?

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Apply the sunblock first, let it absorb, the use the silicone.  This should be good. Thank you for your question and good luck with everything.

It can be difficult to figure out what to do for a thick red surgical scar with all the conflicting advice out there, plus the many "scar creams" on the market that have little double-blind, placebo-controlled evidence (the best quality evidence). It's important when being bombarded with scar cream commercials to remember that scars improve on their own over time, regardless of treatment, if they are not "true keloid" scars, which are tumorous tissue that grows in lumps beyond the original injury site--NOT hypertrophic scars which are normal scar tissue that is thickened but stays put where the original injury was.

Many people, including some surgeons and doctors, call everything thick a keloid. It's important to differentiate. Keloids need intervention by a doctor. Hypertrophic, thick scars may flatten by themselves over time (but will likely spread no matter what) but they can also be helped with injection of a cortisone, or by the application of silicone gel sheets. No matter what, keeping them out of the sun is important. This can be accomplished with sunscreen if there is no gel sheet. If there is, best to cover the gel sheet with something opaque like a bandaid or clothing.

The sun block should be applied first if the silicone sheet is not opaque. There may be some interferance with silicone sheet sticking to the skin in which case an opaque tape can be applied on top.

Silicone gels or sheeting are recommended for the first 2 months in the life of a healing scar. Silicone is the only topical product that has shown a clear advantage in scientific studies to improve the ultimate appearance of a healing scar.

Likewise, sunscreen is recommended to help prevent darkening (hyperpigmentation) of the scar. These products can be messy when applied separately. I recommend a combination product, such as Biocorneum Plus, which has the silicone plus an spf 30 sunscreen. This product can be found online or in physician's offices.