What Causes It?
Thermal burns - Injuries from flames, hot liquids, steam, or contact with hot objects.
Chemical burns - Damage from corrosive substances like acids, alkalis, or strong chemicals.
Electrical burns - Injuries from electrical current passing through the body.
Radiation burns - Damage from excessive exposure to radiation, including sunburn and radiation therapy.
Friction burns - Skin damage from rubbing against rough surfaces.
Second-degree burns (partial-thickness) - Affect both the epidermis and part of the dermis, often resulting in some scarring.
Third-degree burns (full-thickness) - Destroy the entire dermis and damage underlying tissues, always resulting in significant scarring.
Fourth-degree burns - Extend into fat, muscle, and even bone, causing the most severe scarring.
Delayed wound healing - Prolonged time to heal increases scarring risk and severity.
Infection during healing - Complicates the wound healing process and worsens scarring.
Insufficient or improper medical care - Inadequate initial treatment can lead to more severe scarring.
Genetic predisposition - Some individuals are genetically prone to forming more noticeable scars.
Age factors - Children and young adults often develop more pronounced hypertrophic or keloid scars.
Skin tension - Burns across joints or areas with high skin tension tend to develop worse scars.
Skin type - Darker skin types (Fitzpatrick types IV-VI) are more prone to hypertrophic and keloid scarring.
Signs & Symptoms
Physical characteristics:
Discoloration - Ranges from pink/red in newer scars to white, brown, or purple in mature scars.
Texture changes - Smooth, rough, raised, indented, or uneven surface compared to surrounding skin.
Thickness variations - Hypertrophic (raised) or atrophic (depressed) compared to normal skin.
Shininess or glossiness - Different light reflection than normal skin.
Hair loss - Absence of hair follicles in scarred areas.
Absent sweat glands - Reduced or absent sweating in scarred regions.
Functional limitations:
Contractures - Tightening and shortening of scar tissue that restricts movement, especially over joints.
Range of motion limitations - Difficulty moving affected body parts normally.
Muscle weakness - From disuse or direct muscle damage.
Growth restriction - In children, scars may limit normal growth of affected areas.
Sensory changes:
Hypersensitivity - Increased sensitivity or pain with touch or pressure.
Hyposensitivity - Decreased sensation or numbness in scarred areas.
Persistent itching - Often severe and difficult to relieve.
Pain - Ranging from mild discomfort to severe pain, especially in active scars.
Temperature sensitivity - Difficulty regulating temperature in scarred areas.
Psychological impacts:
Body image concerns - Distress about appearance, especially with visible scars.
Social anxiety - Fear of others' reactions to visible scars.
Post-traumatic stress - Flashbacks or anxiety related to the traumatic burn event.
Adaptive challenges - Difficulty adjusting to changes in appearance and function.