Early vs Old Burn Scars: How Do Their Treatments Differ?

Hello. This is Jinmun Kang, a dermatologist at the Skin Concern Counseling Center.

Burns are one of the types of injuries that cause severe damage to the skin. In particular, if early burn scars are not properly treated, hypertrophic scars, commonly known as 'tteoksal' (rice cake-like scars), can develop. If the burned area is large, these tteoksal can go beyond being a mere cosmetic issue and lead to severe complications such as joint contracture or impaired movement. Therefore, early treatment to prevent the formation of tteoksal is considered most important.

Preventing tteoksal from forming allows scars to remain minor later on. If severe tteoksal develop, they can lead to severe joint contracture, which can be a major problem. Since burns are also injuries that cause skin damage, the most important factor in aiding wound healing is maintaining skin moisture. Maintaining good humidity plays a key role in minimizing scars.

Depending on the area, size, and severity of the burn, it can be a serious condition requiring emergency treatment. In such cases, professional emergency treatment must be received. In particular, treatment to prevent infection and electrolyte deficiency is essential.

After emergency treatment has been successfully administered, the following methods can help minimize scarring:

• Consistently apply scar ointment
• Use silicone sheets
• Diligently apply moisturizer to maintain skin moisture

The most serious problem among burn scars is tteoksal. In severe cases, tteoksal can become more than 1-2 cm thick. Once they become this thick, treatment becomes very difficult, so it is most important to treat them preventatively to keep them from worsening.

The effectiveness of burn scar treatment can vary depending on several factors. Naturally, the more severe the scar, the less effective the treatment tends to be.

Differences in regenerative capacity by body part

The biggest factor influencing treatment effectiveness is the burn area. Generally, the face has very good regenerative capacity, so treatment tends to be effective. On the other hand, the fingertips and toes are areas with the poorest blood circulation, and skin regenerative capacity is also reduced, which can lower treatment effectiveness. This is because lasers are used to stimulate regeneration, but ultimately, the skin's own regenerative capacity is important.

Characteristics of joint areas

Joint areas are constantly moving, so treatment effectiveness may be somewhat lower than in areas that remain still.

Does age affect treatment?

Some people worry that regenerative capacity decreases with age, leading to ineffective treatment. However, in our experience, regenerative capacity often does not significantly decrease even in people in their 70s and 80s, so age rarely poses a major problem for scar treatment.