There’s no real consensus on whether or not silicone gel ointments are just as effective as silicone sheeting. There’s (at least) one study demonstrating superiority of creams. However, some studies conclude they are equally beneficial where others indicate sheeting to be superior.
Controversy About Silicone Gel Ointments vs. Sheets
There’s some dispute as to whether ointments or sheets are more effective. Fact is that a silicone cream is more convenient and suitable for exposed areas.
Study concluding silicone sheeting is more effective:
Currently, the most accepted treatment for old andnew hypertrophic scars is silicone gel sheeting. Silicone ointment or gel alone, however, is less effective than silicone sheeting.
Topical Treatments for Hypertrophic Scars. Zurada, Kriegel, Davis. J Am Acad Dermatol 2006;55:1024-1031.
Study stating they are equally effective:
Results from clinical trials and clinical experience suggest that silicone gel is equivalent in efficacy to traditional silicone gel sheeting but easier to use.
Mustoe TA. Evolution of silicone therapy and mechanism of action in scar management. Aesth Plast Surg 2008;32:82–92. (source: PubMed)
Study showing that combining both methods works better than a cream alone:
Interestingly, the use of silicone cream alone compared with silicone cream with occlusive dressing showed 22% and 82% scar improvement, respectively, with respect to erythema, tenderness, pruritus, and hardness. These results supported that occlusion may be synergistic in wound healing and suggested that silicone gel alone may not be as effective as silicone sheeting. top treatments hpyertro scars 2.pdf 6. Sawada Y., Sone K.: Treatment of scars and keloids with a cream containing silicone oil. Br J Plast Surg 43. 6683-6688.1990;
These results support that occlusion may be synergistic in wound healing and suggested that silicone gel alone may not be as effective as silicone sheeting.