Burn scars

Accidentally touching something hot, like grabbing a pan right out of the oven, or getting scalded with boiling water can burn your skin. Chemicals, the sun, radiation, and electricity can also cause skin burns.

Burns cause skin cells to die. Damaged skin produces a protein called collagen to repair itself. As the skin heals, thickened, discolored areas called scars form. Some scars are temporary and fade over time. Others are permanent.

Scars can be small or large. Burn scars that cover a wide surface of your face or body can affect your appearance.

Burn and scar types

The amount of heat and how long it stays in contact with your skin determine whether you get a scar and how big it is. Burns are classified by how much of your skin they affect:

First-degree burnSecond-degree burn (partial-thickness)Third-degree burn (full-thickness)
damages epidermis (outer layer of skin)
damages dermis (layer underneath epidermis)
may damage bones and tendons
reddens skin
blisters skin
causes pain
turns skin white or black
damages nerve endings

First-degree burns often heal on their own without scarring. Second- and third-degree burns usually leave behind scars.

Burns can cause one of these types of scars:

  • Hypertrophic scars are red or purple, and raised. They may feel warm to the touch and itchy.
  • Contracture scars tighten the skin, muscles, and tendons, and make it harder for you to move.
  • Keloid scars form shiny, hairless bumps.

When to see a doctor

You can treat small first-degree burns on your own. For a second-degree burn, ask your doctor if you should make an appointment. Look for signs of infection, like redness, swelling, or pus. For third-degree burns, go to the hospital as soon as possible.

Even if the burn is small or first-degree, check with a doctor if it doesn’t heal within a week. Also, call if the scar is large or it doesn’t fade.

Treatment of burn scars

Treatment will depend on the degree and size of the burn. Don’t try any home treatment without first talking to your doctor.

For second-degree burns:

  • Apply a thin layer of antibiotic ointment to your burn to help it heal.
  • Cover your burn with sterile, nonstick gauze to protect the area, prevent infection, and help the skin recover.

For third-degree burns:

  • Wear tight, supportive clothing called compression garments over your burn to help your skin heal. You may have to wear compression garments all day, every day for several months.
  • You may need a skin graft. This surgery takes healthy skin from another area of your body or from a donor to cover your damaged skin.
  • You can also have surgery to release areas of your body that have been tightened by contractures, and help you move again.
  • A physical therapist can teach you exercises to help you regain motion in areas that have been tightened by contractures.

Learn more: Skin graft »

Burn recovery

How quickly your burn will heal depends on how severe it is:

  • First-degree burns should heal on their own within a week without causing scars.
  • Second-degree burns should heal in about two weeks. They sometimes leave a scar, but it may fade with time.
  • Third-degree burns can take months or years to heal. They leave behind scars. You may need a skin graft to minimize these scars.

Burn complications

Minor burns should heal without causing any lasting problems. Deeper and more severe burns can cause scars, as well as the following complications:

Infection

Like any wounds, burns create an opening that can allow bacteria and other germs to sneak in. Some infections are minor and treatable. If bacteria get into your bloodstream, they can cause an infection called sepsis, which is life-threatening.

Dehydration

Burns make your body lose fluid. If you lose too much fluid, your blood volume can get so low that you don’t have enough blood to supply your entire body.

Low body temperature

Your skin helps regulate your body temperature. When it’s damaged from a burn, you can lose heat too quickly. This can lead to hypothermia, a dangerous drop in body temperature.

Contractures

When scar tissue forms over a burn, it can tighten your skin so much that you can’t move your bones or joints.

Muscle and tissue damage

If the burn goes through the layers of your skin, it can damage the structures underneath.

Emotional problems

Large scars can be disfiguring, especially if they’re on your face or other visible areas. This may lead to emotional problems.

Outlook

Your outlook depends on how severe the burn is and how it’s treated. Minor burns should heal with little to no scarring. Deeper burns can be treated with skin grafts and pressure clothing to minimize scars.

Preventing burn scars from forming

Treating second-degree burns the right way can help prevent scars. If you’re burned:

  • Rinse the burn area in cool or lukewarm water. Let the skin air dry.
  • Use a sterile tongue depressor to apply antibiotic ointment to the burn. This will help prevent an infection.
  • Cover the burn with a nonstick bandage and then place gauze around it.
  • Stretch the burned area for a few minutes each day to prevent a contracture.
  • If you have a blister, wait for it to pop on its own. Then cut away the dead skin, or see your doctor to remove the skin.
  • Protect the burned area from the sun with clothing or sunscreen. This area will be very sensitive for several months.
  • Check in with your doctor regularly to make sure your burn is healing properly.

The best treatment for a scar is prevention. You won’t always be able to prevent scarring, but by following your doctor’s directions, you should be able to improve your chances for less or no scarring.