Is Silicone a Useful Topical Treatment in Atopic Dermatitis?

Silicone topical formulations may have a role in the treatment of atopic dermatitis (AD), found data from a literature review conducted by investigators at the University of Miami Leonard M. Miller School of Medicine. This review was published in Dermatologic Therapy.

Silicone has been used to treat multiple dermatologic disorders, including burns, striae, keloids, and scars. Topical silicone comes in the form of creams, gels, and sheets.

A study cited in the review that investigated silicone in the setting of AD found that affected skin covered with a silicone sheet had approximately a 50% lower rate of water evaporation, thereby restoring hydration to the dry AD skin. This effect was superior to impermeable plastic, suggesting that silicone has hydration properties. Another study referenced by the researchers found that silicone gel significantly decreased itch in healing scars, likely due to its hydration properties. As pruritus is 1 of the major symptoms of dermatitis, silicone applications would likely both improve hydration and the associated symptoms of itch.

Silicone can also serve as a microbial barrier. A study found that silicone itself did not have antibacterial properties, but was impermeable to Escherichia coli, Staphylococcus aureus, Pseudomonas, Klebsiella, Candida, and Streptococcus. Skin with AD lesions is more susceptible to secondary infections, which, if infected, can exacerbate symptoms of dermatitis.

Despite the ability of silicone to provide a barrier to water evaporation and microbial invasion, a study demonstrated that oxygen diffusion was maintained when silicone gel was applied at a thickness of 0.151 cm. This finding indicated to researchers that the oxygen diffusion needed to facilitate wound healing would not be impeded by silicone gel.

A silicone topical solution may be useful as a combinatorial therapy with other solutions, such as corticosteroids, investigators noted. Silicone has been shown to facilitate transdermal drug delivery, thereby enhancing absorption of concomitant medications.

Combination wet wrap therapy and silicone can reduce the discomfort felt by patients with open lesions, oozing, crusting, and dryness that can result in peeling when clothing is removed. Furthermore, upon first application, silicone has a cooling effect which may temporarily improve some symptoms of inflammation.

Review authors concluded, “The use of silicone has been found to be effective in addressing lesions of the skin and it is thought that these properties can be applied for the treatment of AD. The introduction of a silicone proprietary base in combination with a topical steroid is a novel form of the treatment.” They hypothesized that “the efficacy of silicone lies within the properties of silicone, such as hydration, occlusion, sufficient oxygen permeation, anti-microbial benefits, enhanced drug delivery, and gentle physical features. With this knowledge, the use of the traditional wet wrap therapy can be improved by adding a silicone cream.”

Disclosure: An author declared affiliations with industry. Please refer to the original article for a full list of disclosures.