Two commonly mentioned disadvantages are care requirements and price, including for a silk pillowcase.

Silk usually needs gentler care: wash carefully at a low temperature with a mild detergent, do not wring it out, avoid the tumble dryer, and be cautious with harsh stain removers. That takes extra time and attention. In addition, real silk is often significantly more expensive than cotton or polyester satin, especially at higher momme weights and larger sizes.

Other possible downsides include that silk can be more sensitive to wear from friction and to damage from heat or sunlight, some people need time to get used to the slippery feel, and irritation can occur if someone reacts to certain finishes or detergents (though that is not specific to silk itself). The choice is often comfort versus cost and upkeep.