Massaging healed burned skin

What is different about my skin?

The burn injury may have damaged structures in the skin. When these are damaged or missing completely they will affect how your skin functions.

The following structures in your skin that may have little to no function are:

 

• Sweat glands
• Hair follicles
• Sebaceous glands
• Nerves
• Melanin – skin colour

 

Sweat Glands

Sweat normally works by evaporative cooling. If your sweat glands are affected then you may not be able to sweat from where you had your burn injury and so you will have trouble cooling your body when it is hot.

Hair Follicles

Hair grows from hair follicles in your skin. Hair has a few functions including helping with sweat distribution and cooling, and with ‘goose bumps’ when it is cold to help keep you warm. Hair can be part of your skin’s ability to feel sensations. Hair also can be a visual feature that may be important to the person such as on the head and face. If your hair follicles are damaged or missing it may affect your skin sensation and heat and cold regulation as well as your appearance.

Sebaceous Glands

Sebaceous glands produce oils to naturally moisturise the skin which helps keep the skin supple and elastic, stops it drying out and assists in cold weather temperature control. If your sebaceous glands are damaged or missing your skin will get dry and tend to breakdown and make new wounds easily.

Nerves

The nerves in your skin give your body information about touch, pain, temperature changes and pressure. If these are damaged or missing in the skin it will affect how you feel all of those things. It may be that you have little or no sensation in those areas or it may be that you become more sensitive in those areas as damaged nerve endings may become more sensitive or give you different kinds of sensations such as itch, tingling and stinging.

Melanin

Melanin is the pigment in the skin that determines the colour of the skin. Generally darker coloured skin has more melanin and it helps protect the skin from sunburn. When the skin is damaged there is often loss of melanin and the skin is paler than unburnt skin and will get more sunburn than previously.

Skin Breakdown

Scarred skin is not as tough and robust and does not have the same qualities as unscarred skin.  Your new skin may be fragile and easily blister and breakdown with what seems like a littel knock or rub. This can be common in boney areas like elbows, knees and knuckles on your hands. This may require you to be more cautious with some activities and possibly wear extra padding over some areas if the area is prone to damage. You may need to keep a supply of small dressing products to treat any knocks, abrasions and blisters.

What can I do to manage these changes in my skin?

It is important to moisturise your skin at least daily with a simple water-based moisturiser. Daily washing or showering to cleanse the skin and remove excess creams to prevent any build-up of creams.

If you have any small skin breakdowns you need to get advice on how to care for them from your treating team. You may have to apply small areas of dressings for these.

Daily sun protection is very important and you should use protective clothing, wide brim hats, and minimum SPF 30+ sunscreen for at least 18 months after your burn has healed and then continue good sun protection as normal.

It is best if you apply your moisturiser and sunscreen at separate times.

Massage can be very helpful not only for softening your scars but helping to make your skin less sensitive to touch, pain and itch and can be done when you are applying moisturising creams.

When to seek further assistance:

 

• If you have new wounds or skin breakdown
• If any wounds are not improving

If any of the above occurs or for further assistance contact your treating therapist or your burn team.