Scar formation, a common consequence of wound healing, may result in hypertrophic scars confined to the original wound or keloids extending beyond. Influenced by wound depth, body location, skin pigmentation, and age, scars present cosmetic and physical challenges like pain and itching. Effective post-surgical scar management significantly impacts patient quality of life. Silicone-based products (gels or sheets) have become frontline scar treatments, especially after surgery. Recommended post-wound closure, they're applied over scars 12-24 hours daily for 3-6 months. Silicone treatments primarily work through occlusion and hydration, reducing excessive scarring by limiting water loss and keratinocyte stimulation. Occlusive silicone is more effective than non-occlusive methods, with evidence suggesting a role in fibroblast activity and cytokine production modulation. Hydration and occlusion are key in silicone's therapeutic action, with promising results when combined with compression. For silicone-resistant scars, second-line therapies like intralesional corticosteroids, 5-fluorouracil, bleomycin, or verapamil may be considered. Surgical scar revision, resurfacing, radiotherapy, or intralesional cryotherapy are options after non-invasive treatments fail. Silicone-based treatments consistently improve scar appearance, reducing redness and flattening raised scars. Silicone's occlusion promotes hydration, vital for scar maturation and reduced collagen production, mitigating hypertrophic and keloid scarring. Further research is needed to determine optimal scar management strategies. Scar care should be standard in postoperative care, especially for patients at higher risk of hypertrophic and keloid scarring.