The purpose of this study was to analyze the efficacy of silicone gel sheeting in the treatment of fresh and long-standing hypertrophic and keloid scars. All subjects applied the gel sheeting in the same fashion and wore it for twelve to twenty-four hours per day for at least two months. After at least six months' follow-up, twenty of thirty-six (56 percent) chronic scars were improved. Eleven of fourteen fresh hypertrophic scars (79 percent) did not recur after surgery during a similar follow-up period. Side effects were minimal. Silicone gel sheeting is safe and effective treatment for hypertrophic and keloid scars. The mechanism of action is not completely understood.