How to care for your child’s skin after they have healed from a burn injury

The following information will help you to continue to care for your child’s skin. Your child’s burn will now be fully healed.

Your child’s skin will possibly be a different colour to their normal skin for a few months after they have healed. It may be pinker or have no other colour.

It may become more noticeable when your child is hot, angry or cold as the blood supply to the skin changes with your child’s activity or temperature. This colour change will settle over a few months and we would hope it would look the same as the rest of your child’s skin and barely noticeable after 4 to 6 months.

If your child is being followed up by the Occupational Therapist for scar management, you can ask them about your child’s scarring and what to expect.

How do I clean my child’s skin?

Your child’s skin should be thoroughly, but gently, washed at least once each day, using a non-perfumed soap (such as Infa-care) and water followed by gently drying the area. This helps to prevent the build-up of cream, which can block the pores on the skin and cause a spotty rash (similar to teenage acne).

If you do find your child develops a spotty rash then usually the soaping needs to be more thorough. If this still does not help, then try changing the moisturiser you are using, as it may not suit your child’s skin. You can contact the burns service for advice if necessary.

How do I moisturise my child’s skin?

After a burns injury, the oil production in the skin can take a while to return to normal (at least a couple of months). The skin needs to be moisturised at least 3 to 4 times a day, using a suitable non-perfumed moisturising cream.

You will have been given a cream by the burns team and can get this on repeat prescription from your GP or buy it from your chemist or supermarket such as QV cream, Aveeno, or E45. This will help your child’s skin to remain moist and not become dry, it can also help to relieve any itching your child may experience.

You can keep the cream in the fridge, as this may help to relieve the itch sensation.

What is the scar massage technique?

Massaging the healed skin with moisturising cream is a good way to keep the skin supple, relieve itching and desensitise (make less uncomfortable) the healed area. It will also help to reduce the risk of your child developing a burn scar which can appear raised, red, itchy, lumpy in appearance.

The Burns Team will show you how to ‘massage’ the skin using a pressing technique, for 20 seconds all over where the injury was before you are discharged from the dressings clinic. This pressing and moisturising will help to reduce the development of scarring.

Care of the healed skin in the sun

Sun exposure of the healed area is best to be avoided during the first 2 years after injury. The healed areas will be very sensitive to damage from the sun and may blister even if exposed to even mild sunshine.

In the sun, protect the healed areas with clothing (such as a hat, long sleeved T-shirt, or UV sun suit). Be aware that the sun can still burn through a thin fabric, so use use factor 50 sun cream or sunblock. Remember to apply plenty of the cream to any exposed skin at least an hour before going outside and re-apply it frequently and generously.

Your child should avoid the sun between 11am and 3pm. We recommend this routine from early spring through to autumn, not just summer. You still need to take precautions even on bright but cloudy days.

A good rule of thumb, is if the sun is bright enough to cast a shadow, then your child’s skin needs protecting.

Itchy skin

Many children experience quite a lot of itching both whilst their burn is healing and for a while afterwards.

Please try and distract or stop your child from scratching their skin. Make sure to keep their fingernails short and dress them in cool cotton clothing. Itching can be mostly managed by correct washing and moisturising as mentioned earlier.

For some children, despite this, itching is still a problem. If your child is still suffering, then antihistamine medicines can be effective. You may have already been given medicines to help your child’s itch, continue to give these until you are confident your child is no longer experiencing any itch at all. Then slowly over several days and weeks, reduce the frequency of the medicines, if your child becomes itchy again then go back to giving the medicine regularly and try again in a couple of weeks.

If you are unsure please contact the Burns Unit to discuss what is most suitable for your child’s needs. You may be asked to attend the unit if this becomes a regular problem and your child is damaging their healed skin.

If you have been given a medicine called Gabapentin do not stop giving this without seeking advice from the burns team at your clinic follow up appointment. Stopping gabapentin needs to be done slowly and carefully or your child will feel unwell.

Scarring

It is unlikely that your child will develop scarring from the burn or scald injury if healing has occurred within 3 weeks of the injury happening. However, if over the next 6 months you notice that any of the healed areas become red, raised or hard (hypertrophic) then please contact the Burns Unit for advice.

If your child’s burn took longer than 3 weeks to heal or your child has had a skin graft, the Occupational Therapist will be able to provide advice regarding your child’s scar management and what you can expect. You will continue to be followed up by the Burns team for up to at least 6 to 12 months and in some cases longer than this (until they are now being seen on adult services).