Take The Scar Away!! Scar Management After Burns.
Burn injury can be excruciatingly painful for burn survivors, both physically and mentally. However, for people experienced burn injuries, sometimes
The worst nightmare actually comes from hypertrophic scaring (or keloids) after burns.
⭐ Hypertrophic Scar
Hypertrophic scaring happens when your body produce excessive amount of collagen fibers in wound healing, which causes the scar to be raised above the surrounding skin.
Hypertrophic scar generally develop after thermal or traumatic injury that involves the deep layers of the dermis.
⭐ Keloid Scar
Keloid scars are a more serious form of excessive scarring, because they can grow beyond the boundaries of the original wound.
It is seen 15 times more frequently in people of African descent than in people of European descent.
Unlike regular scars, keloids do not regress over time.
⭐ How to Make Burn Scars Look Nicer?
⭐ ⭐ ⭐ Besides surgical intervention, “compression” is the most essential & effective treatment in scar management !
✨ Custom-made pressure garments or other compressive sleeves/gloves provide optimal compression to the scar area, it helps to flatten and soften the scar more effectively. They should be worn 23 out of 24 hours a day!
✨ Silicon Gel Sheets have shown its efficacy in scar management in clinical studies, even have some cosmetic effect for scaring, it is recommended to wear it underneath pressure garments or orthotics.
✨ Putty Elastomer is another great option to help flattening hypertrophic scars. It can contour to the scarring area and should be used under pressure garments.
✨ Deep Friction Massage can also help to soften and desensitize the scar.
⭐ Other Common Problems with Burn Scars
1. Contracture
Contracture is definitely the worst problem in burn scars!
Especially when scar tissue covers the moving joints (neck, elbow, fingers, knee, and ankle…etc), it can greatly limit the range of motion, then lead to joint stiffness and severe function loss.
✨ Treatments to Prevent Contracture: 
* Orthotics – “Positioning” is crucial to prevent ligament, tendon and skin shrinkage after burn injuries. Thermoplastic orthotics can be molded on the injured joints, to maintain them in an optimal (functional) position.
* Stretching – To prevent tendon tightness and joint stiffness, stretching should be started in acute stage. Also make sure to keep stretching all affected joints 4-6 times a day even months after the burn injury.
2. Itchiness
As skin heals from a burn injury, it may get itchy. Burns can damage the oil glands that usually keep skin from getting too dry. The lack of oil glands leads to dry itchy scars. Studies have shown that the larger the burn, the more likely that itching will be a problem.
✨ Ways to help relieving itchiness: 
* Moisturizers – Use unscented or fragrance-free moisturizers can help to reduce the itchiness, because itching increases with dry skin.
* Pressure Garments – The compression from pressure garments helps to alleviate the itchiness.
* Skin Massage – Firm and deep massage with lotion also helps to reduce itching.
3. Sunlight Sensitivity
You should avoid exposing your healing scars to sunlight, it may easily cause sunburns over the scarred area. Always apply a sunscreen with at least SPF 15 or minimize the exposure of your skin with clothing.
4. Blisters / Skin Tears
Once your primary burns have healed, your healed skin is vulnerable and fragile. You may easily find skin breakdowns or wounds after daily activities, so it is important to check your skin often. These wounds generally become less frequent over time as your scars mature and become more resistant to injuries.
⭐ Final Thoughts
Rehabilitation after burn injuries can often be a long and frustrating journey. If burn scars are managed well, it can largely alleviate the burden on burn survivors and his or her family members in the rehab journey.
Again, compression is the most crucial & effective treatment in scar management. Always consults with your healthcare professionals before using pressure garments and other scar treatment products!
✨ References:
Anzarus A., Olson J., Singy P., Rose B. & Tredget E. (2009). The effectiveness of pressure garment therapy for the prevention of abnormal scarring after burn injury: a meta-analysis. Journal of Plastic, Reconstructive & Aesthetic Surgery, 62.77-84.
Gretchen J. Carrougher & Walter J. Meyer III. (2016). Itchy Skin After Burn Injury . Model Systems Knowledge Translation Center.
Sandra H., Karen K. & Radha H. (2011). Wound Care and Scar Management after Burn Injury. University of Washington Model Systems Knowledge Translation Center.
Andrew believes rehab-related knowledge should be easy to learn and follow at home, because "knowledge is power only when we can share it" !
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