Keloid Scars After 45: What Silicone Gel Can (and Can't) Do, and When to See a Doctor
Quick summary
A keloid is a raised scar that grows beyond the edge of the original wound, unlike a normal scar that stays within it. For a keloid, silicone gel is a first-line, non-invasive option that may help soften, flatten and fade the scar over several months of daily use. It works best on newer scars and as a preventive step, and the evidence is stronger for hypertrophic scars than for large, established keloids. Silicone cannot remove a keloid, and a keloid that is growing, painful or spreading needs a doctor, not a cosmetic gel. This guide explains the difference, what silicone realistically does, and when to see your GP or dermatologist.
What is a keloid scar, and how is it different from a normal scar?
A keloid is a raised, firm scar that keeps growing past the boundary of the original wound. A normal scar or a hypertrophic scar stays inside the lines of the injury. That single difference, growing beyond the wound edge, is what makes a keloid a keloid.
Keloids form when the skin makes too much collagen while healing. They can appear after surgery, a skin cancer excision, an ear piercing, a burn, or even a small injury like an insect bite. They are more common in people with darker skin tones and often run in families.
For women over 45, this matters for a practical reason. You may be having more procedures at this stage of life (skin cancer removals, biopsies, joint or abdominal surgery), and each healing wound is a chance for a raised scar to form. Knowing what you are dealing with early gives you the best shot at managing it.
Keloid vs hypertrophic scar: how to tell the difference
These two raised scars get confused constantly, and the difference changes what you should expect from treatment.
| Feature | Hypertrophic scar | Keloid scar |
|---|---|---|
| Growth | Stays within the wound border | Grows beyond the wound border |
| Over time | Often settles and flattens on its own | Tends to persist and can keep growing |
| Recurrence | Lower | High, especially after being cut out |
| First-line care | Silicone, sometimes with pressure | Silicone plus medical treatment (often steroid injections) |
If you are not sure which one you have, that is a good reason to see a GP or dermatologist. A true, spreading keloid is a medical scar, and the plan for it usually involves more than a topical product. Our guide to hypertrophic scars after 45 covers the other side of this pair in more detail.
Does silicone gel work on keloid scars?
Silicone is described in international scar-management guidelines as the first-line, non-invasive option for both preventing and treating raised scars, including keloids. It has a long track record and is low-risk, which is why doctors so often suggest it as a starting point.
Here is the honest part. The strongest evidence for silicone is in hypertrophic scars and in preventing raised scars on fresh, healed wounds. For large, established keloids, the high-quality trial evidence is thinner. A Cochrane review of silicone gel sheeting for keloid scars found only a small number of studies with few participants, and concluded the evidence was too limited to be certain of the benefit. That does not mean silicone does not help. It means expectations should be realistic and, for a genuine keloid, silicone is best used as part of a medical plan rather than instead of one.
Silicone is thought to work by covering and hydrating the scar. This creates a stable, moist environment that appears to calm the signals driving excess collagen, which is what may help a raised scar soften and flatten over time. The Genova Silicone Scar Gel is designed around that same principle.
A quick-drying silicone gel designed to support the appearance of raised and older scars with once or twice daily use.
What silicone gel can and cannot do for a keloid
Being clear about this protects you from wasting money and from disappointment.
Silicone gel may help:
- Soften and flatten a raised scar gradually over months
- Reduce the look of redness and ease itch or discomfort in some scars
- Support the prevention of a raised scar on a fresh wound once it has fully closed
- Support the appearance of the scar as part of a broader plan
Silicone gel cannot:
- Remove or cure a keloid
- Shrink a large, long-standing keloid on its own
- Replace medical treatment for a keloid that is growing, painful or spreading
- Work overnight, results take patience
Realistic expectations: Silicone is a slow, gentle approach. Most guidance suggests using it consistently for at least 8 to 12 weeks, and often 3 to 6 months, before judging the result. It is designed to support the appearance of a scar; it does not erase it, and individual results vary.
How do you use silicone gel on a keloid scar?
If your doctor has confirmed silicone is appropriate for your scar, the method is simple but consistency is everything.
- Wait until the wound is fully closed. Silicone goes on healed skin, never on an open or weeping wound.
- Clean and dry the area. Wash gently with a mild cleanser, rinse, and pat completely dry.
- Apply a thin layer. A little goes a long way. Spread a thin film over the scar and let it dry, usually a minute or two.
- Use it daily. Once or twice a day, every day. Missed days are the most common reason people see no change.
- Protect it from the sun. Cover the scar or use SPF, as sun exposure can darken healing scars.
- Give it months, not days. Reassess at 8 to 12 weeks, and keep going if it is helping.
Quick-drying and clear once set, so it fits into a morning or evening routine and can sit under sunscreen.
What are the medical treatments for keloid scars?
For a true keloid, especially one that is large or growing, doctors have options that a cosmetic gel does not replace. Understanding them helps you have a better conversation with your GP.
- Steroid (corticosteroid) injections. Often the first medical treatment, given directly into the scar to flatten and soften it. Usually a course over several visits.
- Silicone therapy. Used alongside other treatments, as a supportive, low-risk layer.
- Cryotherapy. Freezing the scar, sometimes combined with injections.
- Laser treatment. Can help with colour and, in some cases, flatness.
- Surgical removal. Possible, but keloids have a high rate of coming back after being cut out, so surgery is usually paired with another treatment to lower that risk.
Which of these suits you depends on the scar and your skin. That decision belongs with a doctor.
Who silicone gel is for, and who it is not for
It may suit you if:
- You have a newer raised scar and want a low-risk first step
- Your doctor has suggested silicone for your scar
- You want to support the prevention of a raised scar on a recently healed wound
- You can commit to daily use for a few months
It is probably not enough on its own if:
- Your keloid is large, old, painful, or actively spreading
- The scar is changing quickly or you are worried about it
- You want fast or complete removal
- The wound is not yet fully healed
If you are in the second group, see a GP or dermatologist first. Silicone can still play a supporting role, but it should not be the whole plan.
Frequently asked questions about keloid scars
Can silicone gel get rid of a keloid?
No. Silicone gel is not a keloid removal treatment. It may help soften, flatten and fade the appearance of a raised scar over months, but it cannot remove an established keloid. For that, see a doctor, who may suggest steroid injections or other options.
How long does silicone gel take to work on a scar?
Give it time. Most guidance suggests using silicone consistently for at least 8 to 12 weeks, and often 3 to 6 months, before judging the result. Daily use matters more than anything else, and results vary between people.
Is silicone gel or silicone sheeting better for keloids?
Both use medical-grade silicone and work in a similar way. Sheets can be worn for long stretches, while gel dries clear and is easier to use on visible areas, joints and awkward spots like the face. Many people choose gel for convenience and comfort.
How do you flatten a keloid scar naturally at home?
There is no proven natural cure for a keloid. The most evidence-supported at-home step is consistent daily silicone use on a fully healed scar, along with sun protection. Home remedies like toothpaste, lemon juice or apple cider vinegar are not supported and can irritate the skin.
Do keloids come back after treatment?
Keloids are known for coming back, especially after being surgically removed. That is why doctors usually combine treatments, and why silicone is often used as ongoing, supportive care rather than a one-off fix.
Should I see a doctor about my keloid scar?
Yes, if the scar is growing, painful, itchy, spreading beyond the original wound, or simply worrying you. A GP or dermatologist can confirm whether it is a keloid and set the right plan. Silicone can be part of that plan, not a substitute for it.
Simple & quick drying for raised scars
For a fully healed raised scar, Genova Silicone Scar Gel offers a simple, quick-drying way to add silicone to your daily scar-care routine. For a growing or confirmed keloid, speak with your doctor and ask whether silicone is suitable alongside your treatment plan.
Genova Silicone Scar Gel
Quick-drying silicone gel to support the appearance of raised and older scars.
8-week money-back trial. Proudly Australian made.
Related reading
- Hypertrophic Scars After 45: Why Your Skin Heals Differently Now
- Can Silicone Gel Help an Old Scar? The Science of Silicone and Mature Scar Tissue
- Red Scars: Why Some Scars Stay Red for Months
This article is general information, not medical advice. Genova products are cosmetics designed to support the appearance of the skin; they are not therapeutic goods. Individual results vary. For persistent or severe concerns, consult your GP or dermatologist.
Sources
- O'Brien L, Jones DJ. Silicone gel sheeting for preventing and treating hypertrophic and keloid scars. Cochrane Database of Systematic Reviews, 2013.
- Jiang Q, et al. Silicone gel sheeting for treating keloid scars. Cochrane Database of Systematic Reviews, 2022.
- Meaume S, et al. Management of scars: updated practical guidelines and use of silicones. European Journal of Dermatology, 2014.
- Berman B, Maderal A, Raphael B. Keloids and Hypertrophic Scars: Pathophysiology, Classification, and Treatment. Dermatologic Surgery, 2017.
