A burn scar forms when skin damage from a burn triggers the body’s repair mechanisms. This process involves the production of collagen, a protein that helps rebuild the affected area. When deeper skin layers are damaged, the resulting scar tissue can appear thick, discolored, or irregular. This article explores various approaches, ranging from medical interventions to home-based practices, that can help improve the appearance and function of burn scars.
Understanding Burn Scars
The type of scar that forms depends on several factors, including the depth and extent of the burn, as well as individual healing responses. Burns that affect only the outer layers of the skin may heal without permanent scarring, but deeper burns typically leave visible marks.
Hypertrophic scars are raised, often pink, red, or purple, and remain within the boundaries of the original burn. They may feel warm and itchy. Keloid scars, similar in appearance, are raised, shiny bumps that extend beyond the original wound margins and can continue to grow over time.
Atrophic scars appear as sunken or depressed areas due to a loss of tissue, though these are less common with burns. Contracture scars are characterized by thickened tissue that tightens the skin, muscles, and tendons, potentially restricting movement, especially around joints.
Professional Treatment Options
Medical and clinical interventions offer several approaches to revise burn scars and improve both their appearance and functionality.
Laser Therapy
Laser therapy uses different types of lasers for specific effects. Pulsed dye lasers (PDL) target blood vessels within the scar, reducing redness and thickness by limiting blood flow and collagen synthesis. Fractional lasers, such as CO2 lasers, create microscopic channels in the skin to stimulate collagen remodeling and improve scar texture.
Surgical Revision
Surgical revision can address severe scarring, particularly contractures that limit movement. Procedures may include skin grafts, where healthy skin is transplanted from another body area, or local flaps, which involve moving nearby healthy skin to cover the wound. Tissue expansion, using a silicone balloon to stretch healthy skin, can also prepare skin to replace scarred tissue. These surgeries aim to release tight scar tissue and make scars less noticeable.
Pressure Garments
Pressure garments are custom-fitted elastic garments that apply continuous, even pressure to healing burn areas. This constant pressure helps to flatten and soften raised scars by reducing blood flow and limiting excessive collagen production. Patients wear these garments for several months, typically 12-18 months, for effective scar management.
Silicone Products
Professional-grade silicone gel sheeting and topical silicone products are available. These products form an occlusive barrier over the scar, which helps regulate moisture levels and normalize collagen production, leading to a flatter, softer, and less noticeable scar. Silicone is considered a primary treatment ingredient recommended by dermatologists and plastic surgeons.
Steroid Injections and Microneedling
Steroid injections, specifically corticosteroids, can be administered directly into hypertrophic or keloid scars. These injections work by breaking down excess collagen fibers and reducing inflammation, which can decrease scar size, redness, itching, and tenderness. Multiple sessions are often required for optimal results. Professional microneedling involves creating tiny punctures in the scar tissue to stimulate the body’s natural healing and collagen production, which can improve scar texture and appearance.
At-Home Scar Management
Consistent at-home care plays a supportive role in managing burn scars and optimizing their healing.
Scar Massage
Scar massage involves gently rubbing the scar with lotion or moisturizer. This helps keep the scar moist, improves flexibility, reduces sensitivity, and decreases itching. Regular massage can also loosen stiff scar tissue as it matures.
Topical Creams
Over-the-counter topical creams and ointments may contain ingredients like vitamin E, onion extract, or cocoa butter. While some individuals report benefits, scientific evidence supporting the effectiveness of these specific ingredients for scar reduction is less consistent compared to medical-grade silicone.
Sun Protection
Sun protection is important for burn scars. New skin is highly susceptible to sun damage, and UV exposure can cause permanent discoloration, darkening, or blotchiness. Applying sunscreen with an SPF of 30 or higher, covering scars with tightly woven clothing, and avoiding peak sun hours are recommended.
Hydration and Nutrition
Adequate water intake supports collagen production, essential for tissue repair and maintaining skin structure. A healthy diet rich in protein, vitamins, and minerals supports the body’s healing processes. Protein is crucial for tissue regeneration, while vitamins like A and C, and minerals such as zinc, contribute to cell turnover, collagen formation, and immune function. Incorporating a variety of fruits, vegetables, lean meats, and nuts can provide the necessary nutrients for optimal scar maturation.
Realistic Expectations and When to Seek Help
While treatments can significantly improve the appearance and function of burn scars, they do not disappear completely. The healing process is dynamic, and scars will change over time, becoming flatter, softer, and paler. Factors influencing scar healing include age, genetics, the severity and depth of the burn, and the location on the body. Burns that take longer than 14 days to heal carry a higher risk of problematic scarring.
Consult a healthcare professional for evaluation, diagnosis, and personalized treatment plans, especially for severe or problematic scars. Seek medical attention if a burn does not heal within a week, or if the scar is large or does not fade. Immediate medical care is necessary for deeper burns or those covering large areas, as these have a higher risk of complications. Signs of infection, such as increased redness, swelling, warmth, or pus, also warrant prompt medical consultation.