Burn scars are one of the most difficult forms of skin scarring. They develop as a result of the body’s natural healing process after a thermal injury. Depending on the severity of the burn, the scar tissue can vary greatly in:

• Texture
• Color
• Thickness
• Flexibility from the surrounding skin.

Removing them completely can be challenging

The skin is a multi-layered organ. In the event of a burn, the deeper layers (the dermis and below) heal and regenerate collagen. But it is structurally different from the original tissue.

This replacement collagen is usually thicker and less structured. It does not have the fine structures that create the normal skin’s:

• Texture
• Elasticity
• Pigmentation.

This results in a skin tissue that is visibly and functionally different from the surrounding skin.

The healing process cannot always exactly replicate the original tissue architecture. So complete elimination of a burn scar, in the sense of reconstructing skin to its original pre-burn state, is not medically or aesthetically achievable in every case.

What treatment can realistically achieve

Complete scar elimination may not be possible. But it is possible to improve it. The treatment for burn scars will vary based on some factors:

• Age of scar
• Type of scar (hypertrophic, keloid, or atrophic)
• Location on the body
• Individual skin type
• Healing rates.

Earlier intervention yields better results. Also, a combination of treatment modalities may improve the scar better than any individual type of treatment alone.

There are several treatment options for burn scars, including:

• Laser-based treatments
• Radiofrequency technology
• Microneedling
• Steroid injections
• Surgical revision.

The treatment aims to restructure the scar tissue. That is, to make it softer, smoother, less discolored, and more flexible and functional.

Scar and tissue remodeling is very promising

These are the advanced professional treatments for burn scars.

Scar remodeling is the process whereby the dense, disorganized collagen within scar tissue is slowly replaced by collagen that is more similar to normal skin architecture.

Advanced tissue remodeling technology involves stimulating the natural process that the skin uses to regenerate. This encourages a series of controlled responses in the dermis that will over time:

• Rebuild collagen
• Increase vascularisation
• Restore a more normal surface appearance over time.

However, the amount of improvement from remodeling varies by person and by scar type. But for many patients, the results are worthwhile.

What to expect from a professional assessment

Treatment of a burn scar should start with a comprehensive evaluation by a trained clinician. They will assess the characteristics of the scar and outline a treatment plan that is suitable to the type and stage of scar maturation.

Treatment of scars is different depending on whether scar tissue is:

• Still changing
• Active
• Matured.

Scar tissue changes with time, usually taking between 12 and 24 months to mature after the initial injury. A scar management specialist will evaluate your scar by:

• Thickness
• Vascularity
• Pigmentation
• Flexibility
• Your skin type.

This helps to determine a treatment plan.

The bottom line

Although burn scars cannot always be totally removed, they can almost always be greatly reduced with the appropriate medical care. Patients have the best chance of obtaining significant and long-lasting effects when sophisticated remodeling technologies are combined with a treatment plan customized to the unique features of the scar.