What are scar management techniques?
Scar management techniques are different methods you can use to help your child's burn scar to heal. These techniques include:
massage (gentle rubbing)
pressure garments
splints
inserts
stretching
Your therapist will explain to you the scar management techniques you need to learn. The ones that are best for your child will depend on:
This page will give some details about each of the scar management techniques. It also tells you about how to protect the scar when your child is playing outside.
Massage (gentle rubbing)
Rubbing cream into the scar helps keep it soft and moist so that it does not dry out. Massage also provides pressure on the scar. This helps take away the itchy feeling and makes the skin feel more normal.
Usually your therapist will show you how to gently stretch the skin at the same time as the massage.
How to massage
Use thick cream, such as Nivea or Vaseline. Choose a cream without perfumes.
Slowly rub the cream in circles with your fingertips.
Try to cover all areas of the scar.
Be sure to press hard enough so that the scar turns white under your fingertips.
Be careful not to massage over any open sores.
Massage has to be done every day. At first, you will be massaging 3 to 4 times per day. You can massage more often if the scar becomes dry or itchy.
Other kinds of creams and oils
You can use any creams or oils as long as they keep the scar moist. If the scar dries out it will become very itchy and uncomfortable. The action of massaging is what keeps the scar soft. It is more important than what kind of cream you use.
Do not use perfumed lotions. The skin may react to them and become itchy, and a sore red rash may appear. Choose one cream or oil and keep using it. If you keep changing products and your child gets a rash, you will not know what caused it.
Pressure garments
Pressure garments are special clothes made out of an elastic material. They fit tightly over the scar. This helps keep it flatter and less itchy. Your child wears pressure garments underneath their regular clothes. There are several different brands, such as Jobst, Tubigrip, and Elastogrip. Please note that if your child has to wear a pressure garment, you should not use oil-based moisturizers since they can break down the garment.
Pressure garments are not for every burn
Your therapist or surgeon will let you know if your child needs to wear pressure garments, and will explain why.
Wearing the pressure garment 24 hours a day
Your child will need to keep the pressure garments on 24 hours a day. Take them off only when your child bathes, and during massage and stretching. We will give you 2 sets: 1 for day and 1 for night.
Your child should keep wearing the garment until the scars are smooth and close to normal skin colour. This can take 1 to 3 years. Also, you will need to replace the garments 3 to 4 times a year as your child grows and wears them out. Your occupational therapist will keep an eye on how well the garment fits as your child grows.
The garments allow the skin to breathe, but they can be warm in summer. A fan at night and playing in the shade outdoors may help.
Washing your child's pressure garment
Wash the garment by hand every day.
Use warm water and a mild soap, such as Ivory.
Lay the garment flat to dry. Do not put it in the dryer, since this will break down the elastic in the garment.
Splints
A splint is a hard plastic brace. Its job is to stretched out your child's scar.
Splints are not for every burn
Your therapist will let you know if your child needs a splint. Your child may need to wear one if the burn scar covers joints. Joints are the areas of the body that move such as the ankles, knees, elbows, shoulders, hips and neck.
Sometimes when scars heal, the skin gets tight. This makes it hard to move these joints. A splint will help keep the scar stretched out. It is usually used along with massage and stretches.
Wearing the splint
Your therapist will give you instructions about when your child should wear the splint.
Write down the instructions here:
Washing the splint
Make sure you wash the splint every day with soap and cold water. Hot water can melt the splint.
Inserts
An insert is a special piece of foam or gel. Your therapist may give you an insert to help keep a scar smooth and soft.
Wearing an insert
Your therapist will give you instructions about when your child should wear the insert.
Write down the instructions here:
Washing your child's insert
Our staff may give you further cleaning instructions, depending on what kind of insert you have.
Stretching
Burn scars and skin grafts tend to shrink and become tight. This can limit your child's range of movement. This is especially true if the burned area crosses over joints. It is very important to stretch out this tight skin several times a day. Your therapist will show you specific stretches to do with your child.
Open sores and rashes
While they are healing, areas of the skin can open or blister because the skin is very fragile. This is normal. If you find an open area bigger than the size of a small coin (such as a dime or a quarter), be sure to keep it clean.
Here is how:
Wash the area with soap and water during your usual bath routine.
Put Vaseline or Polysporin and gauze on the sore. This will keep it clean and dry.
If your child is wearing a pressure garment, take care as you put the garment over the gauze. You want to avoid wrinkling the dressing.
What do you do if your child gets a skin rash?
Your child may get a red sore rash because their skin is sensitive to one or more of the following:
If you notice a rash, call your therapist.
Outdoor activities
Swimming
Your child may swim in any pools or lakes as long as all areas of the burn scar are healed. There should be no big open areas on the skin.
Chlorine tends to dry out burn scars. So be sure to rinse off all pool water and put extra cream on the scar when your child comes out of the pool. If your child wears pressure garments and has an old set, they can wear those to swim in. If they only have one set, it is better to take them off for swimming so that they will not get ruined.
No direct sunlight for at least a year
Your child should avoid having sunlight shine directly on the scar for the first summer after the burn. Use waterproof sun block lotion on all other skin that is exposed to the sun. Make sure the label says SPF 30 or higher. Also, make sure it says it has UVA and UVB protection.
Cover the burned area with a piece of clothing. New skin burns easily. If the new skin gets tanned, it will not fade and there will always be a dark area. The sun can also cause little itchy red dots to appear on your child's skin. If your child wears pressure garments, have them wear cool clothing over top.
During the second and following summers, you can use sunscreen on all closed burn scar areas.
Key Points
Scar management techniques will help you child’s burn scar heal.
Your child’s scar should be kept moist and soft with creams.
Your therapists at your child’s burn clinic can tell you which techniques are right for your child.
Your child’s burn scar should be protected from heat, cold, and direct sunlight