Harder to Treat a Burn Scar?

I have a third degree burn on my arm that hasn't really diminished over time like some of my other scars from various cuts, scrapes and surgeries. Does this mean a burn scar is harder to treat than scars caused by other skin trauma?

Doctor Answers 3

Burns vs othe scars

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Any deep burn (3rd degree) or abrasion to the skin can penetrate down to the deeper layers where the body's healing response is to shrink the wound and make scar. If you have more of a "cut" in the skin, whether accidental or surgical, the skin edges try to re-unite and the scar is less noticeable. Also, different areas of your body heal differently.

Third degree burn healing

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A third degree burn will not heal without hypertrophic scarring in the majority of cases.  Usually this requires excision and grafting unless it is a very small area of a few cms wide. 

Treating a Third Degree Burn

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Classifying burns in degrees enable doctors to predict if a surgical treatment is required. A FIRST degree burn is similar in harshness to a bad sun burn - it will heal but you will be red for a while.

A THIRD degree burn is a FULL thickness burn; one in which ALL the skin was damaged into the fat. This means that there is no skin at the bottom of the wound to enable healing and all the healing must take place from the side walls. These burns must be treated with removal of the burn (ESCHAR) and often have to be skin grafted.

a SECOND degree burn is a partial thickness burn. It can vary in severity from just worse than a first to almost as bad as a full thickness burn.

In your case, I suspect you had either a very deep second or a full thickness burn which was not operated upon. Since it was never skin grafted, you have scar tissue there. Scar is a poor skin substitute especially when covering a wide area which is constantly under tension. It tethers, retracts, has poor coloration and cracks and bleeds.

If this bothers you, which it sounds like it does, you should see a Plastic surgeon (check www.PlasticSurgery.org) and see what he / she suggests. The scar will need to be removed and replaced with either local tissue, a distant flap or a skin graft.

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.