Doc, is this burn healing well ?- 2nd degree superficial burn

Doc, I am sending you a picture of my son who had a burn on his chest twelve days back. I just want to be sure that things are fine and that we are on the right course. Do you think that this will result in a bad scar?

Jane, mumbai.

 

Thank you for the query, it appears that the burns are healing well. second degree burns are of two types- superficial and deep. The superficial one often heals well as seen above in this sweet child. The deep 2nd degree burn is the problem- because they may not heal and need additional procedures like skin grafting to heal the burn.

2nd degree superficial burns heal well usually don't form scars. However over some sites such as the chest wall and the shoulders the skin tension is high and possibility of scars are also high. If on follow up it seems that that scars may result then one must start scar treatment subsequently.

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Scars and keloids

Scars are of different types. Some may be flat while others may be indent below the level of the normal skin.
Sometimes they start to grow in size and spread over the normal skin. They may cause pain, itching and even get infected because as they grow they cover the hair bases and sweat and sebaceous gland pores. Blocked pores tend to get infected. They may fail to settle and continue to grow in size for more that a year, at which time they start to be referred to as keloids scars rather than hypertrophic scars, as hypertrophic scars often settle down over time. Keloids  scars are most common on areas where the skin is normally under stretch or tension as over the shoulders and  anterior chest wall. They can also occur on other areas. While the exact causative factors are unknown, a positive family history, a tendency to form keloids, tissue loss and healing that occurs without the lost tissue being replaced, burns and  injuries on prone sites as mentioned above are some of the common causes. All the patients shown above developed keloids spontaneously from small lesions that started to itch and grow in size.
Scar treatment can be a complex affair as each scar must be treated on its own merits: each one must be individually analyzed to see which modality of treatment will help to resolve the scar.

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