If your child has had a burn injury, you may have many questions about their treatment and recovery. This page will help to answer the most commonly asked questions. Sometimes, it is difficult to find the most up-to-date information. It is always best to ask your child’s Burn Team for the most current evidence-based information on your child’s injury and treatment plan.
Will my child have scars?
It is difficult to answer this question immediately after you child has been burned. This depends on many factors such as how deep the burn is, how long the burn takes to heal, genetics in your family and whether or not your child develops any infections. Typically, if a burn takes less than two weeks to heal without any complications, there is a low risk of scars developing. Deeper burns that take more than two to three weeks to heal have a much higher chance of leaving permanent scars.
My child has been burned. What other organs were burned?
Almost all burn injuries involve injuring just the skin. If your child has a burn on the abdomen, this does not mean their stomach or kidneys are burned. If your child has a burn on their face or scalp, it does not mean the brain or skull bones have been burned/injured too. These burn injuries damage the layers of the skin. If you have concerns about other injuries, please ask your child’s Burn Team to ensure you have the correct information.
How long will it take for my child to heal?
This depends on whether or not your child needs surgery (skin grafting) to treat their burn(s). If your child does not need surgery, they may have to come to the hospital once a week for about three weeks to have dressing changes done. Your child will be sedated during the dressing changes. After the burn is healed, frequent follow ups may not be needed.
If your child needs surgery, recovery from the burn takes longer. The overall healing process will take approximately four to six weeks. Your child will usually have a dressing change once per week for approximately two weeks after their injury. They will be sedated during the dressing changes. Once the decision is made that your child needs surgery, they will have their burns removed and temporary skin placed on the burn site in the operating room. After one week, your child will go back to the operating room to have a skin graft (a thin sheet of skin taken from a place close to the burned area) secured in place over the burn site. They will need to return the following week to have the surgery dressings removed and make sure the skin graft has “stuck” in place. Usually, this is the last time your child will require sedation to change their dressings.
Does my child really need sedation? Isn’t it dangerous to have so many anaesthetics?
Sedation for a burn dressing change has the benefits of keeping a child still, as well as minimizing their pain. Performing the procedure without any sedation can be difficult for the health-care provider doing the dressing change and potentially traumatizing to the child if they are uncooperative. To minimize pain and ensure the dressing changes are successful, the Burn Team recommends that your chid receive sedation for burn dressing changes.
Anaesthetics are never without risk and, as such, are given under a monitored setting with the direct presence of an anaesthesia provider. Studies show that giving anaesthetics repeatedly for short periods of time in otherwise healthy children is safe.
My child seems uncomfortable. What pain medications can I give them?
The Burn Team will provide your child a prescription for a narcotic pain medication for their burn. Usually, morphine or hydromorphone are prescribed. These medications are used for moderate to severe pain. They are very safe medications to give when used properly. Many families are scared to give these medications as they think their child will “pass out” or “get addicted” to them. When used to treat a specific condition, they are very effective; and children with burn injuries need these stronger pain medications to make sure they sleep well, eat well and recover as best as they can. You will also be given information on how to minimize the side effects of narcotic pain medication and how to use other pain medications, such as acetaminophen and ibuprofen. These medications are used for minor to moderate pain. All these medications can be given together if needed. Please follow the instructions on the bottle and make sure you do not give the medications more often than prescribed.
Are there any restrictions to my child’s eating if they’ve been burned?
Burn wound healing is best when your child is eating a well-balanced meal. Consuming high protein foods is best. It is suggested you limit high-sugar drinks/foods that will fill your child up with “empty calories” such as juices and candy. Instead, provide your child with nutritious, high-protein foods and drink such as meats, fishes, soy, nuts, yogurts, cheeses and plain/chocolate milk. If your child requires extra nutritional supplements due to a larger burn, a dietitian will see you and your child to make recommendations for extra calories.
What can be done to get rid of my child’s scars?
There is nothing that can be done to remove scars permanently. Scars are the body’s response to a deep injury, and they change a lot over time. Burn scars start out thick, raised, firm, red and itchy in the first six to nine months. Then, most scars start to settle, becoming flatter, less red/itchy, softer and less thick. This is a very long process.
The burn injury and healing process can be very upsetting for patients and their families. The Burn Team can support you and your child through this process and help manage your child’s scars using different techniques. The first thing you will be taught is how to provide firm massage to scars to help break down the scar tissue. An occupational therapist can help provide the best treatments for scars including silicone gels/sheets, and pressure garments/splints. The Burn Team can also offer pulsed dye and carbon dioxide laser treatment, which may be options for your child. The team will let you know if your child would benefit from these treatments.
Families are encouraged to accept the new differences in their child’s skin. Children recover and cope the best when they feel their parents and caregivers accept their scars. Using positive words to describe your child’s scars can help your child feel better about their appearance. The Burn Team is also there to help support you and your child through the healing journey, as they understand how devastating these burn injuries are and how they impact everyone.
Is a burn scar the same as a keloid scar?
Burns scars develop as a result of injury deep in the layers of the skin. These scars become thick and firm over time, and the medical term is called a “hypertrophic scar”. Hypertrophic scars “grow” over time. Some parents/caregivers think the skin looks “swollen” or “bubbling” and the scar requires urgent care, but there is no emergency. It is expected that the scars get thicker and more raised over time. Almost every hypertrophic scar will settle eventually. This is very different from a keloid scar. A keloid scar is much thicker and firmer than a hypertrophic scar. It also grows beyond the edges of the initial injury. Sometimes, if someone in your family has a history of developing keloid scars, your child may also develop keloid scars from their injury. Keloid scars are much more difficult to treat than a hypertrophic scar, but they are much less common.
When will my child’s skin colour return to normal?
When your child’s skin has been burned, the cells that make the skin colour (pigment) are also injured. It takes a very long time for the colour to return. It can take up to 12-18 months for the pink colour to fade away. In some cases, the colour never returns to a “normal” shade. Even though your child may not develop scars in the area, the skin colour may never return. There are no creams or treatments to make the colour return faster. One thing that helps with restoring your child’s normal pigment is avoiding direct sun exposure for approximately one year. The pigment in your child’s skin helps protect their skin from getting sunburned. If your child’s burn gets exposed to the sun before the pigment returns, it could cause further permanent changes in colour to their skin.
Does avoiding direct sunlight mean my child can’t go outside?
No. This means that your child should avoid direct sun exposure to the burn site. They can still play outside or be in a car when the sun is out. You do not have to shut your curtains or blinds at home on a sunny day. When your child is outside, make sure the area that was burned is covered with clothing and your child is wearing sunscreen with an SPF of 30 or 50. They can also wear a protective sleeve over a healed arm or leg rather than pants or a long-sleeve shirt. If your child’s face has a burn, ensure they reapply sunscreen frequently and they wear a sunhat.