Scar Management for Children: What Are the Options?

Scars can form after injuries, cuts, or surgery and can be particularly noticeable at times. There are several ways to help scars heal and look better, but some options work better than others.

Silicone Gel Sheets: The Best Choice

- Silicone gel sheets are soft, flexible pads made from medical-grade silicone.

- They are placed directly over the scar once the skin is fully healed (no open wounds or scabs).

- Silicone gel sheets help keep the skin hydrated and can reduce redness, thickness, and itching of scars.

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   - They should be worn for 12 to 24 hours each day, for at least 2 to 3 months.[1]

   
   

   - Clean the scar and the sheet daily with mild soap and water. Pat dry before reapplying.

   - Silicone gel sheets are safe, easy to use, and have the strongest evidence for helping scars heal well in children.[2][3][4][5][6][7][8][1][9][10][11][12]

   
   

2. See the Silicone Gel Sheets we recommend at Big Trees MD: HERE

   
   

   Other Topical Options

   - Silicone gels (applied as a thin layer) work similarly to sheets and may be easier to use on the face.[5][6][10][11] See an option we recommend HERE.

   
   

   - Moisturizers with balanced hydration and occlusion (such as Alhydran or DermaCress) may help, but the evidence is not as strong as for silicone products.[13]

   
   

   - Microporous paper tape can help reduce scar thickness if used early after surgery or injury.[7]

   
   

   - Topical tretinoin cream (a vitamin A derivative) may help prevent thick scars, but should only be used if recommended by a healthcare provider.[9]

   
   

   - Other products like onion extract, vitamin E, green tea, and aloe vera have been studied, but there is little strong evidence that they work well for scars.[2][14][12]

   
   

   Sun Protection Is Important

   
   

   - Sun exposure can make scars darker and more noticeable, especially on fair skin.

   - Use a broad-spectrum sunscreen with SPF 30 or higher, wear hats or clothing that covers the forehead, and avoid direct sunlight during peak hours (10 a.m. to 4 p.m.).[7][8]

   - Reapply sunscreen every 2 hours and after swimming or sweating. HERE is one we recommend (Mineral Sunscreen).

   
   
   
   

   When to See a Doctor

   - If the scar becomes very red, swollen, painful, or starts to ooze, contact a physician or non-physician healthcare provider.

   - If there is an allergic reaction to any product, stop using it and seek advice.

   
   
   
   

   Summary

   
   
   
   

3. - Silicone gel sheets are the best-proven option for helping scars heal and look better in fair-skinned children.

   - Other options exist, but they do not work as well or have less evidence supporting them.

   - Sun protection and gentle care are also important for scar healing.

   
   

4. See the Silicone Gel Sheets we recommend at Big Trees MD: HERE

   
   

5. With consistent care, most scars will improve over time. Scars may not disappear completely, but these steps can help them heal as smoothly as possible.[2][13][3][4][5][6][7][8][1][9][10][11][12]

   
   
   
   

   References

   1. A Review of the Biologic Effects, Clinical Efficacy, and Safety of Silicone Elastomer Sheeting for Hypertrophic and Keloid Scar Treatment and Management. Berman B, Perez OA, Konda S, et al. Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [Et Al.]. 2007;33(11):1291-302; discussion 1302-3. doi:10.1111/j.1524-4725.2007.33280.x.

   2. Topical Scar Treatment Products for Wounds: A Systematic Review. Tran B, Wu JJ, Ratner D, Han G. Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [Et Al.]. 2020;46(12):1564-1571. doi:10.1097/DSS.0000000000002712.

   3. Silicone Gel Sheeting for Treating Hypertrophic Scars. Jiang Q, Chen J, Tian F, Liu Z. The Cochrane Database of Systematic Reviews. 2021;9:CD013357. doi:10.1002/14651858.CD013357.pub2.

   4. Silicone Gel Sheeting for Preventing and Treating Hypertrophic and Keloid Scars. O'Brien L, Jones DJ. The Cochrane Database of Systematic Reviews. 2013;(9):CD003826. doi:10.1002/14651858.CD003826.pub3.

   5. Silicone Sheets and New Gels to Treat Hypertrophic Scars and Keloids: A Short Review. de Oliveira GV, Gold MH. Dermatologic Therapy. 2020;33(4):e13705. doi:10.1111/dth.13705.

   6. Efficacy of Topical Silicone Gel in Scar Management: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Wang F, Li X, Wang X, Jiang X. International Wound Journal. 2020;17(3):765-773. doi:10.1111/iwj.13337.

   7. Advances in Scar Management: Prevention and Management of Hypertrophic Scars and Keloids. Del Toro D, Dedhia R, Tollefson TT. Current Opinion in Otolaryngology & Head and Neck Surgery. 2016;24(4):322-9. doi:10.1097/MOO.0000000000000268.

   8. Evidence-Based Scar Management: How to Improve Results With Technique and Technology. Khansa I, Harrison B, Janis JE. Plastic and Reconstructive Surgery. 2016;138(3 Suppl):165S-178S. doi:10.1097/PRS.0000000000002647.

   9. Comparative Effect of Topical Silicone Gel and Topical Tretinoin Cream for the Prevention of Hypertrophic Scar and Keloid Formation and the Improvement of Scars. Kwon SY, Park SD, Park K. Journal of the European Academy of Dermatology and Venereology : JEADV. 2014;28(8):1025-33. doi:10.1111/jdv.12242.

   10. The Use of Fluid Silicone Gels in the Prevention and Treatment of Hypertrophic Scars: A Systematic Review and Meta-Analysis. De Decker I, Hoeksema H, Verbelen J, et al. Burns : Journal of the International Society for Burn Injuries. 2022;48(3):491-509. doi:10.1016/j.burns.2022.03.004.

   11. Evolution of Silicone Therapy and Mechanism of Action in Scar Management. Mustoe TA. Aesthetic Plastic Surgery. 2008;32(1):82-92. doi:10.1007/s00266-007-9030-9.

   12. Skin Scarring: Latest Update on Objective Assessment and Optimal Management. Basson R, Bayat A. Frontiers in Medicine. 2022;9:942756. doi:10.3389/fmed.2022.942756.

   13. Occlusion and Hydration of Scars: Moisturizers Versus Silicone Gels. De Decker I, Hoeksema H, Vanlerberghe E, et al. Burns : Journal of the International Society for Burn Injuries. 2023;49(2):365-379. doi:10.1016/j.burns.2022.04.025.

   14. The Effectiveness of Topical Anti-Scarring Agents and a Novel Combined Process on Cutaneous Scar Management. Fang QQ, Chen CY, Zhang MX, et al. Current Pharmaceutical Design. 2017;23(15):2268-2275. doi:10.2174/1381612822666161025144434.