Two Weeks Post-Burn: Is My Healing Process Normal?

Burns that have been present for two weeks..?

Hello, doctor.
Two weeks ago, I burned myself on a motorcycle exhaust pipe.
A thin layer of skin turned black, approximately 2cm x 7cm in size.
The next day, blisters formed.
A classmate gave me two types of ointments that he received from his doctor when he had a burn.
First, I applied a clear, gel-like ointment, followed by a pink, paste-like ointment.
I have also avoided getting the wound wet and have been protecting it with gauze when going out.
However, over these two weeks, the blisters have burst, and some of the black skin has peeled off.
The wound has remained soft and not scabbed over, which I think might be due to the ointments being moist.
It seems to be healing now, but it itches, so I scratched the wound lightly through the gauze, which caused it to bleed.
It appears that the remaining black skin is easily coming off and bleeding.
I'm quite worried about the wound as it looks a bit unpleasant, and it hasn't been healing well since it burst.
Doctor, was my previous care appropriate? What should I do now? Note: I bought Silver Sulfadiazine at the pharmacy but haven't used it yet.

nvhai, 20~29 year old female. Ask Date: 2002/03/14

Dr. Chen Yiying reply Dermatology

Since the ointment you described does not specify its ingredients, and the depth of your burn injury is not exactly the same as your classmate's condition, it would have been more appropriate to consult a physician for a suitable medication tailored to your situation.
Your wound should have healed well by now; please allow the scab to fall off naturally as it serves as a natural protective layer.
Please be patient and avoid picking at it.
If the depth of your burn was superficial and did not damage the dermis, it should not leave a scar, although there may be some pigmentation changes.
Once the wound has completely healed, you can use sunscreen and topical agents for pigmentation as needed.

Reply Date: 2002/03/14

More Info

Burn injuries can be quite complex, and understanding the healing process is crucial for effective recovery. Based on your description, it seems you sustained a second-degree burn from a motorcycle exhaust pipe, which is characterized by the presence of blisters, pain, and changes in skin color. The healing process for such burns typically involves several stages, and it’s important to monitor the wound closely.

Understanding Your Healing Process
1. Initial Reaction: After a burn, the body responds with inflammation, which can cause redness, swelling, and pain. The formation of blisters is a protective mechanism, as they help to cushion the underlying skin and prevent infection.

2. Skin Changes: The blackened skin you mentioned is likely necrotic tissue, which can occur in deeper burns. As the healing progresses, this tissue may slough off, revealing new, tender skin underneath. It’s normal for the area to feel soft and not form a hard scab immediately, especially if the wound is kept moist with ointments.

3. Itching and Sensitivity: Itching is a common part of the healing process as new skin forms. However, scratching can lead to further injury and bleeding, as you've experienced. It’s important to avoid scratching the area to prevent complications.

4. Use of Ointments: The use of topical medications like Silver Sulfadiazine can be beneficial for burn wounds as they have antimicrobial properties and promote healing. However, if you’ve been using a different ointment that keeps the wound moist, it might delay the formation of a protective scab. It’s essential to follow the advice of a healthcare professional regarding which ointments to use and when.

Recommendations for Care
1. Wound Management: Since you have been using a protective dressing, continue to do so. Ensure that the dressing is changed regularly to prevent infection. If the wound is moist and not healing properly, consider consulting with a healthcare provider about the best dressing options.

2. Avoiding Infection: Keep an eye out for signs of infection, such as increased redness, swelling, pus, or a foul odor. If you notice any of these symptoms, seek medical attention promptly.

3. Using Silver Sulfadiazine: If you have Silver Sulfadiazine available, it may be beneficial to apply it as directed by a healthcare professional. This medication can help prevent infection and promote healing in burn wounds.

4. Monitoring Healing: It’s important to monitor the wound closely. If the area continues to bleed or does not show signs of healing, it would be wise to consult a healthcare provider. They may need to assess the wound for any underlying issues that could be affecting the healing process.

5. Pain Management: If you are experiencing significant pain, over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage discomfort. However, consult with a healthcare provider for appropriate pain management strategies.

Conclusion
In summary, while some aspects of your healing process seem normal for a second-degree burn, it’s crucial to ensure that you are managing the wound properly to avoid complications. If you have any concerns about the healing process or if the wound appears to worsen, do not hesitate to seek professional medical advice. Proper care and monitoring are key to a successful recovery from burn injuries.

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