Burns injuries range from mild, first-degree burns that leave no scars to serious, third-degree burns that cause permanent scarring and significant disability. Fires, chemicals, extreme heat and electricity can all cause deep second-degree and third-degree burns. Efforts to prevent scarring start the day of a significant burn, although some scarring inevitably occurs and requires follow-up treatment, possibly for many years.
Compression Bandages and Garments
Pressure wraps helps prevent thick scarring by applying pressure to the new skin that grows after a burn. Ace bandages wrapped around burned areas or custom-made compression garments may be used. Pre-made compression garments may fit firmly over an extremity such as the arms, hands, feet or legs, or may be specifically made to fit the chest, neck, abdomen or face. Compression garments are worn for up to two years, 23 hours a day for best results, the Johns Hopkins Burns Center says. Applied as soon as a wound closes, compression garments produce thinner, more pliable scars in 50 percent of burn scars, Burnsurgery.org reports.
Medications
Medications used to treat scarring include corticosteroids injected directly into the scar, antihistamines and interferons--the latter which reduce scar formation by blocking growth factor TGF-beta, according to Burnsurgery.org. Interferons are given intravenously or injected directly into burn scars. Calcium channel blockers and collagen inhibitors such as topical putrescine may also decrease scaring.
Skin Grafts
Scar tissue may be removed and replaced with grafted skin from the unburned areas of a person's body (called autografts), or from donor skin from a deceased person (called allografts), or from an animal such as a pig, called xenografts. Artificial skin grafts may also be used. Skin grafting helps prevent scarring in large burns and may be placed temporarily or permanently, the Encyclopedia of Surgery says. Allografts and xenografts last only a week or so before being rejected and provide only a temporary skin covering. Partial thickness grafts involving only the top layers of skin or full thickness, including both the epidermal and dermal layers, are used to prevent and treat scarred skin.
Physical Therapy
Physical therapy helps keeps scar tissue from causing contractures. These prevent movement and damage joints and muscles by pulling them into unnatural positions. Range of motion and use of splinting help prevent contractures. Stretching and scar massage keeps scar tissue supple, the University of California Burn Center says.
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