Over The Counter Burn Scar Treatment

There are two commonly used classification to describe burns. The traditional classification describes first, second, and third degree burns. A more recent classification makes a distinction between superficial thickness, and partial thickness burns.

• First degree burns are characterized by redness (erythema), a white plaque and minor pain at the site of the injury. These burns involve only the outermost layer of the skin (epidermis). An example of a first degree burn are most sunburns.



• Second-degree burns manifest as redness (erythema) with superficial blistering of the skin, and can involve more or less pain depending on the level of nerve involvement. Second-degree burns involve the superficial (papillary) dermis and may also involve the deep (reticular) dermis layer. Deep dermal burns usually take more than three weeks to heal and should be seen by a surgeon familiar with burn care, because in some people very bad hypertrophic scarring can occur. Burns that require more than three weeks to heal are often excised and skin grafted for best result.



• Third-degree burns commonly are black and occur when the epidermis is lost with damage to the subcutaneous tissue. Burn victims will exhibit charring and extreme damage of the epidermis, and sometimes hard dead tissue (eschar) will be present. Third-degree burns result in scarring and victims will also exhibit the loss of hair shafts and keratin. These burns may also require skin grafting.

As with all scars effective burn scar treatment starts with taking proper care of the wound. Since this lens focuses on burn scars I would like to refer to the links at the bottom of this page for more on this particular subject. I would like to mention the benefits of medical honey dressings for burn wounds.

"Honey is reported to be soothing when applied to wounds (17, 40, 50)] and to reduced pain from burns (17, 48), in some cases giving rapid diminution of local pain (42)."

"Several authors have commented on the rapidity of healing seen with honey dressings. Burlando (48) refers to healing being surprisingly rapid, especially for first and second degree burns. Blomfield (41) is of the opinion that honey promotes healing of ulcers and burns better than any other local application used before."

"There is much anecdotal evidence to support its use, and randomized controlled clinical trials that have shown that honey is more effective than silver sulfadiazine and a polyurethane film dressing (OpSite®) for the treatment of burns. "

"Better relief of pain, less exudation, less irritation of the wound, and a lower incidence of hypertrophic scar and post-burn contractures were noted with the honey treatment. The honey treatment also gave acceleration of epithelialization at 6 - 9 days, a chemical debridement (removal of dead, damaged, or infected tissue) effect and removal of offensive smell."

"Five studies were conducted in patients with partial thickness or superficial burns involving less than 40% of the body surface. Comparators were polyurethane film, amniotic membrane, potato peel and silver sulphadiazine . For some or all outcomes honey was superior to all these treatments. Time for healing was significantly shorter for honey than all these treatments.

Treatment with honey produced significantly more healing at seven days. At seven days 58% of patients were healed with honey, and 19% with other treatments." source: Bandolier

The longer it takes for a burn to heal the higher the chance the scar will become hypertrophic (red and raised). Approximately 26% of all burns develops into a hypertrophic scar.

"If the burn wound healed between 14 and 21 days then one third of the anatomic sites became hypertrophic; if the burn wound healed after 21 days then 78% of the burn sites developed hypertrophic scars."

In the 1970s the common treatment for burn scars was pressure garment therapy. From the 1980's silicone gel sheets therapy became mainstream among hospitals, cosmetic surgeons, and burn centers.

Silicone gel was first reported in 1982 by Perkins et al to be effective therapy in preventing burn scar contractures and hypertrophy. In contrast to compression garments used for burn scars, the mechanism of action for silicone gel was thought to be unrelated to pressure.

A burn scar contracture is a tightening of the skin as a result of a second or third degree burn. As the scar tissue thickens and tightens it might, as a result, prevent movement of muscles and joints.

Polyurethane dressings have shown significantly improved comfort, less redness, and less potential for scarring. They also showed less hardness, and prominence in mature scars.

Polyurethane dressings were found to provide functional and structural improvement in scar tissue that was slightly superior to that obtained from compression alone.

• Gently massage the scar tissue. Stop when it gets painful, redder, or otherwise indicates it is detrimental
• Keep the scar out of the sun or use a sunscreen with a SPF of at least 15
• Moisturize the scar by using Vaseline or a moisturizing ointment of your liking