Expert: Jim B - 12/8/2008

Question
QUESTION: Hi Jim-

My 4-year-old daughter sustained burns on her face from cooking oil 4 weeks ago.  Burns ranged from 1st degree to deep 2nd (w/ some eschar).  We were treated at our local burn unit and continue to be monitored weekly.  She has new pink skin all over her face (which we keep moisturized)and eschar is gone.  

When will we know when/if scarring will occur?  If I look very, very closely at the edges of the new pink skin, they do seem slightly indented from her regular skin.  It is slight, but is it the beginning of something more?  Will these textural differences be permanent?

Thanks very much!

ANSWER: Hi Lindsay,

It is likely that there will be no scars (from your descrption). The new healing skin is still thinner than the uneffected surrounding skin and should heal to the same thickness as the original skin. Give things some time. But so far it sounds like a good result so far.

Jim

---------- FOLLOW-UP ----------

QUESTION: Hi again,

First, thank you for being such a valuable resource.  We are fortunate to be receiving great care at our pediatric burn unit, but are not able to ask questions in between visits.  Of course, that's when I always think of the questions!

My question is about scarring, which the doc informed us could happen at anytime during the next six months or so.  He said everyone heals differently and it's impossible to predict whether or not scarring will occur.  (Darn.  Not what I wanted to hear.  I thought we were home free with the new smooth pink skin)  But, I'm wondering, does scarring start gradually (i.e., will we begin to see signs early)?  Or could a hypertrophic scar just appear overnight four months from now?

There is one spot on her face that has a very slight raised line (less than 1 cm) that just appeared one afternoon.  Is that how hypertrophic scarring begins?  I guess I'm wondering what kinds of things I should be looking for.

Doc has us doing massage on all the new pink skin (w/ Eucerin) twice daily.  Not sure how helpful that is, but it seems to be the only thing we can do, so I'm doing it!

Answer
Hi Again,

I would suspect from the description that there will be little scars. And that any that do show up will be most likely remain as very minor. The massage treatment should be very good treatment option and reduces scaring. The 1 cm spot may be a which could be a scar. You are correct that it could be an area of hypertrophic area. It can also be a small area of a irritaton that may need some treatmeent. Send me a picture of the area.

Jim