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How the Right Treatment Can Help with Disfiguring Burn Scars

If you have a burn injury, you’re well aware of how painful it can be and how hard it can be to recover. Burns can cause uncomfortable scars, restrict your movement and change your appearance. 

After a burn injury, you’ll want to do everything you can to minimize scarring. We spoke with Lourdes Castanon, MD, a burn care specialist and the director of the burn program at Banner – University Medicine, to learn more about burn scars and how to treat them.

Understanding burn scars 

When your skin gets burned, your body sends white blood cells to the area to contain the open wound and prevent infection. New cells then start migrating and grow to fill in the damaged skin. Over time, your body produces scar tissue, which is made up of different types of collagen fibers. In some situations, the new tissue can be very similar to the original skin. But many factors can lead to scarring that can make this new tissue very different.

Burn scars can form when your body produces too much collagen or when scar tissue shrinks or sticks to nearby muscles and tendons. How severe a burn scar becomes will depend on how deep into the layer of skin the burn is, your health status, genetics and even your nutrition. 

“Your scars can continue to change for up to two years after your wound has healed,” Dr. Castanon said.

With mild, minor burns, you may notice changes in your skin’s texture, elasticity or color. With deeper burns, you can have more scar tissue. It’s important to get treatment for burn wounds since they are likely to scar more if they heal on their own. 

There are three common types of burn scars: 

  • Hypertrophic scars are raised scars that look red or purple. They form inside the area that was burned. They can be itchy and uncomfortable, but they usually get better over time. They are more common in younger people and people with darker skin.
  • Contracture scars are thick scars that can form when hypertrophic scars shrink, or when the burn damages deeper skin layers, muscles and tendons. They can tighten, restrict your movement and be disabling. They may require surgery. 
  • Keloid scars are thick, raised scars that grow beyond the borders of the wound. They may develop months or even years after the burn injury and can be itchy and uncomfortable. 

Steps you can take to minimize burn scars

“Scar management begins at the time of the injury,” Dr. Castanon said. Seek medical care after a burn and keep the wound clean so you’re less likely to get an infection.

Your care team can recommend techniques you can use at home to improve the appearance of burn scars while minimizing pain and problems. These techniques are generally safe, effective, inexpensive and easy. Here are a few to consider:

  • Creams and ointments: Applying products specifically made for burns that contain silicone, vitamin E and hyaluronic acid may help your scars look and feel better. These treatments may soften and flatten scars, reduce redness and itching and improve appearance. 
  • Sunscreen: Exposure to the sun’s UV rays can make your scars darker and more noticeable. It is important to use sunscreen with an SPF of 30 to 50 on all exposed skin, including fully healed scars. 
  • Compression: Wearing compression garments after a burn may help make scarring less severe.
  • Self-massage: Gently rubbing the scar in a circular motion for several minutes each day can help loosen scar tissue and improve flexibility and range of motion in the area. You can use your fingers, a silicone roller or another massage tool. 

It may take some time before you see results from these techniques, so it is important to be patient and consistent. 

“Scars change over time. What you see at first doesn’t have to be permanent, and you may not need expansive or extensive procedures to improve scarring. Sometimes, just keeping the tissue moisturized, wearing sunscreen and massaging the area daily can lead to the best results,” Dr. Castanon said.

Other procedures that treat burn scars 

Along with the steps you can take at home, your doctor may recommend more advanced techniques to help minimize your burn scars. Depending on your scarring and how it’s affecting you, your doctor may suggest any of the following: 

  • Laser therapy uses a focused beam of light to remove or reduce scar tissue. 
  • Corticosteroid injections may reduce inflammation and swelling in scars. 
  • Dermabrasion uses a rotating tool to remove the top layer of scar tissue. 
  • Chemical peels use acid to remove the top layer of scar tissue. 

In some cases, you may need surgery to treat your burn scar. Some common options include: 

  • Excision, where surgeons remove the scar tissue and stitch together the skin in the area. 
  • Z-plasty or W-plasty, where surgeons cut the scar tissue in a Z or W shape and rearrange the flaps of skin to create a more natural-looking scar. 
  • Skin grafting, where surgeons replace scar tissue with skin from another part of your body. 
  • Tissue expansion, where a surgeon implants a balloon under nearby skin and expands it over time to stretch the skin. When there’s enough new skin, it can replace some or all of the burned skin. 

Emotional healing with burn scars

Dealing with burn scars can be emotionally challenging. You may feel a range of emotions, such as anger, sadness, embarrassment or fear. You may feel self-conscious and embarrassed. You may also have mental health conditions such as anxiety, depression or post-traumatic stress disorder (PTSD)

“Burn scars can be a permanent reminder of the event, and this can be debilitating as your scars become part of who you are,” Dr. Castanon said. “With support, counseling and therapy, these scars can also be a reminder of strength, resilience and hope. Some people are proud of their scars since they can be a testament to their strength and survival. Others incorporate them into their lives. They may even choose to get tattoos to highlight or cover them.”

These tips can help you heal emotionally when you have burn scars:

  • Allow yourself to grieve the loss of your old skin and mourn the changes that your burn scars have caused. 
  • Be patient with yourself. It’s OK to feel the emotions you’re feeling. Healing takes time.
  • Be physically and emotionally kind to yourself.
  • Find healthy ways to cope with stress. Exercise, relaxation techniques and spending time in nature may all help. 
  • Join a support group. There, you can share your experiences and connect with others who understand what you are going through. 
  • Talk to someone you trust, such as a friend, family member, therapist or support group member. They can support your healing journey and help you cope with your emotions and feel less alone. 
  • Focus on your strengths and successes. Make a list of your accomplishments and remind yourself of all the things that you are good at. 
  • Set realistic goals. Talk to your care team about what to expect as you heal. Set small, achievable goals to help you feel a sense of accomplishment and to boost your self-confidence. 
  • Seek professional counseling. A therapist can help you understand and process your emotions and teach you ways to cope. Most burn centers have long-term follow-up and resources that are available years after the injury.

The bottom line

Burn scars can be uncomfortable or painful. You may not like the way they look and they can be unwelcome reminders of how you got burned. But by working with your health care team or a Banner Health provider, you can keep burn scars and their impact on your life to a minimum. 

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