Burn Scars

The Cadogan Clinic offers a number of cutting-edge techniques to improve the look and feel of burn scar tissue.

Burn Scars

What are burns?

Burns remain one of the most common injuries, and the majority of these are relatively minor.

This majority of burns are self-managed at home, or at the GP Practice and in the emergency room. Whilst the functional outcome of these may be excellent, they can also result in an itchy sensation, a feeling of tightness, pain, and a material difference in cosmetic appearance. This difference in appearance may be due to colour (darker, lighter or mixed), differences in contour (raised or at times even sunken) and skin texture, and moisturisation.

At the Cadogan Clinic we specialise in treatments and cutting edge techniques to improve these issues.

What type of burns can be treated?

There are three main types of burns, classified by their depth. The extent of the depth determines treatment and outcome.

Superficial Burns - the most common and typically relate to scalding incidents. They are characterised by redness and blisters. The epidermis or outer layer of skin is destroyed. They are painful but heal from the deeper viable layers within 10 days. Treatment is simply to avoid infection to allow natural healing. Patients are left with no scars, only minor skin colour changes.
Deep Dermal Burns – deeper burns that extend further into the skin. Healing starts from the deeper sweat and sebaceous glands, and will take as long as 3 weeks. Scarring can be severe (hypertrophic or keloid)
Full thickness burns – the deepest burns. These are painless as the nerve endings are lost, but there are no live cells to allow healing from below. There is no blistering. They either heal very slowly from the edge with major scars or are properly treated with skin grafts or flaps.

We treat all types of burns at the Cadogan Clinic.

What treatments are offered by the Cadogan Clinic?

At the Cadogan Clinic our treatments are designed to support with the healing and scarring process.

This often takes some weeks or months after the burn incident itself, and the preliminary phases of burn control (depth minimisation by cooling and infection control to prevent further complication) are complete.

There are many ways to speed and improve healing burns scars. These include:

Injections (steroids, fluorouracil, botulinum toxin)
Needle-less injections are possible with our state-of-the-art Enerjet™ kit (high-pressure air devices)
Lasers (eg. ICON)
Medications
Pressure garments
In certain cases, reconstructive surgery

Treatment Options

Enerjet is a state-of-the-art high-pressure air jet device that allows the expert surgeon to introduce various medications at the right depth within the skin layers. It precisely controls the volume, depth and nature of the substance injected achieving a painless, precise, even distribution. By varying the medications it can be used to improve sunken, as well as raised scars, as well as itch and pain within the scar, and improve the overall appearance of skin that has needed skin grafting. Enerjet can be used to plump up this kind of result providing increased dermal thickness, and pliability to skin.

Lasers are now well established into the treatment of burn scarring. The ablative fractioned laser can be used to drill tiny holes spaced within unaffected skin/scar which will address itchiness and at times pain. In conjunction with expert physical therapy, this can be used to stretch the burn scar, providing increased movement and flexibility.

The fractioned laser allows treatment over the skin as the beam is split (fractioned) into tiny beams with intervening spaces, which reduces the risk of injury, reduces downtime over multiple treatments. In another ground-breaking first, Lasemar lasers also allows microscopic fiberoptics to go under the skin, (subcutaneously) which can be very useful in dealing with recalcitrant, deep scars, keloids, and other issues. Other lasers like Carbon-dioxide fractioned laser also creates microscopic holes in the skin that may help with skin tightness, pruritus, discomfort, tightness, and at times restricted movement.

Laser-assisted drug delivery can also be used with specific medications to increase the flexibility of the scar. This cutting-edge technique is well published and only practised at leading centres internationally.

Scar tightness discomfort and itch can also be managed with a combination of topical creams, oral medication, and at times laser. Radiofrequency devices (Indiba) may also help to improve the texture of the skin over a course of treatment.

Types of Scar

Hypertrophic or Keloid Burns Scars

At times the burn process consumes all the structures in the skin, and the scar may be contracted, may develop hypertrophic or keloid scars. These present a complex challenge. At the clinic, a team of experts are at hand to assist with cosmetic complications of such scars and their subsequent management. At times, scars become hypertrophic, red raised and itchy, whilst keloid scars will also extend to involve pristine skin. In these cases, internationally recognised treatment protocols, including medication with steroids, fluorouracil, are required to reduce and mature such scars. Less commonly, the scar becomes sunken and tethered. Colour changes are also common in these injuries. This may be because of exposure to sunlight, because of intrinsic scar discolouration, previous necessary treatments (including with injections) and formation of tiny blood vessels in the skin. Further, in burns that have been previously treated with expanded skin grafts, a troublesome honeycomb appearance may arise.

Discolouration in scars

In addition, or independently, burns scars can also suffer from changes in colour. A suite of preventative and treatment options are available including advice regarding sun protection, skin lightening creams and protection, on to laser and light therapies, which may address darker pigmented vascularised skin.

Aftercare

It is important to have realistic expectations in the management of these conditions, therefore it is essential to prioritise concerns in agreement with your consultant, maybe longer-term treatment. An intensive post-therapeutic regime is important and may include pressure garments, topical creams, special moisturisers, sun protection factor, and at times also oral medication.

Frequently Asked Questions

Is IPL treatment suitable for burns?

IPL therapy can be used as a standalone non surgical treatment to treat burns and burns scars, or as a single element of a broader package of treatments.

When treating burns it is vital to make sure treatment follows a certain order and is delivered by experts (or team of experts) to ensure the best results and safety. You may be a better candidate for surgery.

Either way, it is vital to speak to one of our specialist burns and laser consultants to assess what the appropriate treatment is for you.