Child burn scars can often be made softer, flatter, less itchy, and easier to move, although treatment may not remove them completely. The best approach depends on how deeply the skin was burned, how long it took to heal, the scar’s appearance, and whether it limits movement. Care may include silicone gel or sheets, pressure garments, moisturising and massage after healing, sun protection, rehabilitation, or specialist procedures.
What causes burn scars in children?
A burn scar forms when the skin repairs itself after an injury caused by heat, hot liquids, steam, chemicals, or electricity. The depth of the burn and how long the wound takes to heal influence the type and extent of scarring. Burns that heal quickly may leave little visible scarring, while deeper injuries can cause thicker scars, changes in skin colour, or tight areas of skin that affect movement.
The 2025 clinical practice guideline for pediatric scar prevention and treatment, published in Burns & Trauma, identifies effective wound management and timely healing as central to reducing scar formation. Wounds expected to take longer than about 20 days to heal deserve particular attention because prolonged healing is associated with a greater risk of excessive scarring. Children with deeper burns may therefore benefit from early assessment by a specialist burn team.
What types of burn scars can children develop?
Burn scars can look and feel different depending on the original injury, the child's skin, and the healing process. Common changes include raised or firm skin, redness, differences in pigmentation, itching, and sensitivity. Some scars gradually soften and become less noticeable, while others remain thick or become tight as the child grows.
Several patterns are particularly relevant when planning treatment:
- Hypertrophic scars: These are raised, thick scars that remain within the boundaries of the original burn. They may be red, firm, itchy, or uncomfortable.
- Keloid scars: These grow beyond the original injury's boundaries and may continue enlarging over time.
- Scar contractures: These occur when scar tissue tightens and pulls on the surrounding skin. They can restrict movement, especially when a burn affects the hands, elbows, knees, neck, or other areas around joints.
- Colour changes: Healed skin may appear lighter, darker, pinker, or redder than the surrounding skin. These differences may change over time.
According to the American Academy of Dermatology (AAD), different scar types require different treatments. A dermatologist or burn specialist can assess the scar's thickness, location, symptoms, and effect on daily activities before recommending a suitable approach.
How can burn scars be prevented or reduced?
Scar prevention begins while the burn wound is healing. The main goals are to protect the injured skin, promote healing, manage complications, and identify wounds that need specialist treatment. Although not every scar can be prevented, appropriate early care may reduce the amount of scar tissue that develops.
1. Give a fresh burn the right first aid
For a new burn, the NHS recommends cooling the affected area under cool running water for 20 minutes as soon as possible, ideally within three hours of the injury. Remove nearby clothing or jewellery unless it is stuck to the skin. Do not apply butter, oils, or creams to a fresh burn, and do not burst blisters. After cooling, protect the area according to appropriate first-aid guidance and seek medical assessment when needed.
Large or deep burns, burns affecting the face, genitals or buttocks, and burns caused by chemicals or electricity require urgent medical attention. Parents should also seek prompt advice if they are unsure about a child's burn or how to care for it. Appropriate early assessment can help determine whether specialist wound cleaning, dressings, or other treatment is necessary.
Source: NHS guidance on burns and scalds.
2. Follow the wound-care plan until the skin has healed
Keep dressings in place as instructed and attend recommended follow-up appointments. Do not apply scar creams, silicone sheets, or massage techniques to an open burn unless a treating clinician has specifically advised their use. Wounds that are slow to close, appear infected, or are located over important joints may need additional assessment.
Parents should pay particular attention to deeper burns or wounds that are taking longer than expected to heal. A burn specialist can decide whether further wound treatment, surgery, or closer monitoring is needed. The priority is to achieve safe wound closure while preserving skin function and reducing avoidable complications.
3. Protect newly healed skin
Skin that has recently healed after a burn can remain fragile and sensitive. A plain, fragrance-free moisturiser may help relieve dryness when recommended by the child's burn-care team. If itching occurs, discourage scratching because it can damage the delicate new skin. Massage may be introduced after healing, but the appropriate pressure and timing depend on the condition of the skin and the clinician's advice.
Sun protection is especially important because newly healed skin has less natural protection against sunlight and may burn more easily. Cover the area with clothing where practical and use broad-spectrum sunscreen with a high sun protection factor, such as SPF 50, when appropriate for the child's age and skin condition. Continue protection while the skin remains sensitive, and follow the burn clinic's advice about how long it is needed.
The Chelsea and Westminster Hospital NHS Foundation Trust advises families to protect newly healed skin from sunlight and seek specialist guidance if a scar becomes thicker, firmer, larger, more itchy, or starts affecting movement.
Which treatments can improve child burn scars?
There is no single treatment that suits every child. The most appropriate option depends on whether the scar is raised, tight, uncomfortable, or mainly a cosmetic concern. Treatment may begin once the burn has completely healed, with follow-up to assess changes over time and adjust the plan as the child grows.
Silicone gel and silicone sheets
Medical-grade silicone gel and silicone sheets are commonly used to prevent or manage raised scars. They may help soften a scar and reduce its thickness, redness, itching, or discomfort. Silicone is intended for healed skin, not an open wound. A clinician can recommend when to start, which product to use, and how long it should remain on the skin each day.
Silicone gel may be easier to apply over curved or sensitive areas, while sheets can be useful on flatter surfaces. Sheets can sometimes cause irritation, rashes, or skin breakdown, particularly when the new skin is fragile. Parents should stop and seek advice if the child develops a persistent rash, blistering, or worsening irritation.
Pressure garments and custom supports
Pressure garments are close-fitting garments designed to apply controlled pressure to selected scars. A burn specialist may recommend them for certain raised scars, particularly after deeper burns. Depending on the affected area, treatment may also involve pressure pads, facial masks, or splints.
These devices need professional fitting and regular review. The child may need adjustments as the body grows or the scar changes. Families should follow the prescribed wearing schedule and contact the treatment team if a garment causes pain, skin damage, or persistent irritation. Pressure therapy is not necessary for every burn scar, and its potential benefits should be weighed against discomfort and other risks.
Scar massage, stretching, and rehabilitation
Once the wound has healed sufficiently, guided scar massage may help improve tissue flexibility and relieve dryness or tightness. Exercises, gentle stretching, positioning, and splints may also be recommended to preserve movement, particularly when burns affect the hands, arms, legs, or neck. For young children, rehabilitation can incorporate play and age-appropriate activities to encourage regular movement.
A physiotherapist or occupational therapist experienced in burn rehabilitation can demonstrate suitable techniques. Parents should not force a joint to stretch or massage fragile skin aggressively. When a scar crosses a joint or begins limiting ordinary activities, early assessment is important because scar tightness can interfere with movement as the child grows.
Laser treatment and specialist procedures
Laser treatment may help improve the thickness, colour, texture, or flexibility of selected scars. The type of laser and timing depend on the scar's characteristics and the child's needs. More than one session may be required, and treatment should be planned by a clinician experienced in pediatric scar care.
For particularly thick or symptomatic scars, a specialist may also consider injections into the scar. Surgery may be appropriate when a scar causes significant contracture, repeatedly breaks down, restricts function, or creates problems that other treatments have not adequately addressed. Surgical treatment can involve releasing tight tissue or reconstructing the affected area. Rehabilitation is often an important part of recovery after a procedure.
The 2025 clinical practice guideline for pediatric scar prevention and treatment describes silicone-based products, pressure therapy, laser treatment, rehabilitation, and surgery among the options selected according to scar type and functional impact. Because children are still growing, treatment decisions require careful follow-up rather than relying on cosmetic improvement alone.
When should a child see a burn or scar specialist?
Arrange an assessment if a scar is becoming thicker, harder, larger, or increasingly uncomfortable, or if it affects the child's ability to move normally. Wounds that are slow to heal, scars over joints, and scars affecting the face, hands, or neck may also need specialist review.
Other reasons to seek advice include persistent itching or pain, repeated skin breakdown, or changes that interfere with sleep, play, school activities, or everyday care. A specialist can determine whether the child needs further treatment, rehabilitation, or a change in the current scar-care routine.
The child's age matters when planning longer-term treatment. As the body grows, a scar that initially causes little difficulty may become tighter or restrict movement. Regular reviews allow the care team to monitor skin changes, check that pressure garments or splints still fit, and adapt treatment when necessary.
What can parents expect as a child grows?
Burn scars can change for months or longer after an injury. Redness, pigmentation, thickness, and sensitivity may gradually improve, but the timing varies. Some scars become softer and less visible, while others remain raised or require treatment. Even when a scar cannot be removed completely, care may improve comfort, flexibility, appearance, and function.
Supportive care is also important. Children may feel self-conscious about a visible scar, particularly when returning to school or taking part in activities with other children. Listen to their concerns, answer questions in an age-appropriate way, and seek psychological support if the injury or its appearance is causing ongoing distress. The aim of scar care is to support the child's physical recovery, confidence, and participation in daily life.