Deep Second-Degree Burns: Healing and Scar Management for Kids

Second-degree burn wound

Hello doctor, my child has a second-degree burn on the thigh from a motorcycle exhaust pipe.
After more than two weeks of daily dressing changes, we have now started applying scar treatment.
After a week of application, I noticed that the wound sometimes appears red and sometimes pink.
Could this be due to soaking during baths? (Previously, we only wiped the area while bathing.) Additionally, I recently noticed a small raised area in the wound, and I'm unsure what it could be.

Danxin Haizi de Ma, 20~29 year old female. Ask Date: 2017/08/08

Dr. Wu Yuxin reply Dermatology

When a wound has just healed, it often appears red, and it may become even redder when exposed to heat.
There may be a small raised area in the wound that is not visible, which could potentially be a scar; it needs to be examined to determine what it is.

Reply Date: 2017/08/08

More Info

Hello! I'm glad you reached out regarding your child's second-degree burn. Deep second-degree burns can be quite serious and require careful management to ensure proper healing and minimize scarring.
First, let's clarify what a deep second-degree burn entails. This type of burn affects both the outer layer of skin (epidermis) and the underlying layer (dermis). It can cause pain, swelling, and redness, and may also result in blisters. Healing can take several weeks, and the area may appear red or pink as it heals. The presence of a small raised area in the wound could indicate several things, such as granulation tissue, which is a normal part of the healing process, or it could be a sign of hypertrophic scarring, which is when the scar tissue becomes raised and thickened.

Regarding the color changes you mentioned—redness and pinkness—these can be normal as the skin heals. The redness often indicates increased blood flow to the area, which is part of the healing process. However, if the area becomes increasingly red, warm, or shows signs of discharge, it could indicate an infection, and you should consult your healthcare provider immediately.

As for the bathing method, soaking the burn in water can sometimes lead to increased irritation, especially if the water is too hot or if soap is used that may irritate the skin. If your child’s burn is still healing, it might be better to stick to gentle washing with a soft cloth and lukewarm water, avoiding soaking the area until it has fully healed.
When it comes to scar management, it’s essential to follow your doctor’s recommendations. After the initial healing phase, silicone gel sheets or silicone gel can be effective in reducing the appearance of scars. These products help to hydrate the scar tissue and can flatten raised scars over time. Additionally, massaging the scar with a moisturizer can also help improve its appearance.

It's crucial to keep the area moisturized and protected from the sun, as UV exposure can darken scars and make them more noticeable. If your child is going to be in the sun, applying a broad-spectrum sunscreen with a high SPF is advisable.

Lastly, if you notice that the raised area continues to grow or does not improve, or if you have any concerns about the healing process, it’s best to consult with a dermatologist or a pediatrician who specializes in wound care. They can provide tailored advice and treatment options to ensure the best possible outcome for your child's healing and scar management.

In summary, while some redness and changes in the wound can be normal during the healing process, it’s essential to monitor for signs of infection and to follow proper care guidelines. With appropriate management, your child can heal well, and the appearance of the scar can be minimized. Please don’t hesitate to reach out to your healthcare provider for any concerns or questions you may have during this process.

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