Efficacy and Safety of Silicone Gel Plus Laser Therapy for Scar: A Systematic Review and Meta-analysis

Although silicone gel combined with laser therapy is commonly used for scar management, its comparative efficacy and safety versus monotherapy remain uncertain.

This meta-analysis (CRD420251008217) searched PubMed, Embase, the Cochrane Library, and Chinese databases from database inception to February 6, 2025, for randomized controlled trials (RCTs) comparing silicone gel plus laser therapy with either modality alone in patients with scars. Risk of bias was assessed using the Cochrane risk of bias 2.0 tool. Outcomes encompassed the Vancouver Scar Scale (VSS), absolute scar height, pain/pruritus scores, satisfaction, and safety. A random-effects model was used for outcomes with high heterogeneity (I ² > 50%); otherwise, a fixed-effects model was applied. Efficacy of silicone gel combined with different laser types was compared using Bayesian network meta-analysis.

Forty-five RCTs (3806 participants) were included; 40 RCTs were eligible for quantitative analysis. Forty-four studies were at high risk of bias. Compared with monotherapy, silicone gel plus laser therapy significantly reduced VSS scores at 6 months (standardized mean difference = -1.33; 95% confidence interval, -1.85 to -0.81) and improved patient satisfaction (odds ratio=4.21; 95% confidence interval, 1.91-9.24). These findings remained consistent across subgroups. Silicone gel plus laser therapy had fewer treatment-emergent adverse events than monotherapy. In ranking probabilities, silicone gel plus nonablative laser ranked first in improving VSS scores at 6 months and VSS score reduction from baseline to 6 months posttreatment.

Silicone gel plus laser therapy demonstrated improved efficacy and safety over monotherapy, with consistent benefits across multiple subgroups.