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Introduction: The use of silicone in scar treatment is well established. Despite numerous studies confirming the efficacy the optimal application is still under investigation. For best results continuous application is essential, yet silicone sheets are highly visible, prominent and often impractical in everyday use. To overcome these difficulties other formulations like creams or gels have been developed. We have investigated the use of a silicone spray for the treatment of scars. Materials and Methods: 20 patients with surgical scars took part in a randomized double blinded study with intrapatient control. Scars were treated half and half with drug vs. control or site matched with identical scars. The control was an identical spray without silicone. Patients applied the spray two times a day for three months, starting on the day of suture removal. A photo documentation, modified VSS, patient satisfaction and possible side effects were investigated at 4, 8 and 12 weeks and a follow up visit at 6 months. Results: During the use of the silicone spray the scar quality and patient satisfaction on a non linear 5 point scale was significantly higher in the study drug. Modified VSS scores were 7 vs. 3 (p=0.001) Patient satisfaction was 4 vs. 2 (p