The role of the epidermis and the mechanism of action of occlusive dressings in scarring

Wound Repair Regen. 2011 Sep;19 Suppl 1(0 1):s16-21. doi: 10.1111/j.1524-475X.2011.00709.x.


The problem of cutaneous scarring has conventionally been approached as a pathology of the dermis. Multiple lines of evidence from the clinic, in vitro experiments, and in vivo animal and human studies, however, increasingly suggest that the epidermis plays a major role in the control of underlying dermal scar. Building on the demonstrated efficacy of silicone gel occlusion, in this paper we review the evidence for epidermal regulation of scar, and propose the novel hypothesis that dermal fibrosis is exquisitely linked to the inflammatory state of the epidermis, which in turn is linked to hydration state as a function of epidermal barrier function. In the spectrum of factors contributing to dermal scar, the epidermis and its downstream effectors offer promising new targets for the development of antiscar therapies.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Biocompatible Materials
  • Cicatrix / pathology
  • Cicatrix / physiopathology*
  • Cicatrix / therapy*
  • Dermis / pathology
  • Dermis / physiopathology
  • Epidermis / immunology
  • Epidermis / physiopathology*
  • Humans
  • Occlusive Dressings*
  • Silicone Gels
  • Water-Electrolyte Balance
  • Wound Healing / physiology


  • Biocompatible Materials
  • Silicone Gels