Efficacy of Silicone Gel Versus Placebo for Postsurgical Scars of the Eyelids: A Randomized, Controlled, Double-Blinded Study

Purpose: While silicone has been shown to be effective on scars on the sternum, foot, and other areas with thicker skin, the effect of silicone on scars in the thin periocular skin has not yet been evaluated in a prospective, randomized, and double-blinded fashion. Methods: This prospective, randomized, double-blinded study enrolled patients undergoing bilateral upper eyelid blepharoplasty or bilateral upper eyelid ptosis repair. Subjects were randomized to apply silicone gel to 1 eyelid incision site and placebo (petrolatum ointment) to the other side twice daily postoperatively. Outcome measures were physician-graded scar erythema, elevation, and pigmentation, as well as patient-reported satisfaction, itching, pain, and firmness. These were assessed postoperatively at 1 week, 1 month, 3 months, and 6 months. Results: Of 192 eyelids from 96 patients, there were no significant (p ≤ 0.05) differences in any outcomes between silicone gel and placebo across any measure or time point. Patient satisfaction and blinded doctor and patient appearance preferences did not show any significant difference between the 2 treatments at any time point. Average follow-up was 11 weeks (range: 1-136 weeks). Discussion: This clinical trial suggests that topical silicone may not offer significant advantages over petrolatum ointment in improving eyelid scar healing. Overall results indicate similar efficacy between treatments. These results underscore the importance of evidence-based medicine in choosing beneficial and cost-effective interventions.