A burn scar represents the body’s deep tissue repair process after damage from thermal, chemical, or electrical injury. It forms when the skin’s deeper layer, the dermis, is compromised, leading to the creation of new collagen fibers to bridge the wound. The ultimate appearance of this scar tissue is highly variable, depending on the initial burn depth and the individual’s unique biological healing response. Understanding what a burn scar looks like involves recognizing its specific type and observing its visual evolution over time.
Primary Types of Burn Scars
The most noticeable burn scars often fall into two categories of raised tissue. The hypertrophic scar is characterized by its raised, thick, and firm texture, often appearing red or pink. It develops due to an excessive production of collagen but remains strictly confined within the boundaries of the original burn wound. They may cause discomfort or itching.
Hypertrophic scars typically develop within weeks of the injury and can stabilize over several months, sometimes showing a tendency to flatten and fade slightly over time. They are frequently seen in areas of the body where the skin is under tension, such as over the chest, shoulders, or joints. The visual presentation is one of a thickened, elevated ridge that precisely mirrors the size and shape of the initial injury.
A keloid scar presents a more aggressive and visually different type of growth pattern. This scar also involves an overproduction of collagen, but its defining visual feature is that it extends beyond the original wound margins, spreading onto surrounding healthy skin. Keloids often appear as raised, dome-shaped, and lumpy or ridged masses that can feel rubbery and firm.
The coloration of keloid scars can range from pink or deep red to a darker tone than the surrounding skin, sometimes appearing shiny. Unlike hypertrophic scars, keloids do not typically regress spontaneously and can continue to enlarge over months or even years.
After the healing process is complete, a mature scar is generally flat, soft, and pliable. Its color typically becomes pale white, a condition known as hypopigmentation, as the skin’s pigment-producing cells were destroyed in the deep burn.
Visual Characteristics During Scar Maturation
The appearance of a burn scar changes dramatically over time. In the initial phase following the wound closure, the scar is often characterized by pronounced redness and swelling due to inflammation. This initial bright color is a result of increased blood flow and the formation of new blood vessels.
As the body enters the proliferative phase, the scar begins to look raised and firm as collagen production increases to strengthen the damaged area. The color during this stage remains vibrant, often a deep pink or red, reflecting the high metabolic activity beneath the surface. The skin may also appear taut or shiny during this period of rapid tissue buildup.
The long-term remodeling phase involves significant visual changes as the scar matures. The color gradually transitions from bright red or pink to a duller, less pronounced shade. This color fading occurs as the excess blood vessels that were initially created begin to diminish. This phase can take 12 to 18 months, or even longer, depending on the burn’s depth.
The texture and height of the scar tissue change as the collagen fibers realign and reorganize. The final color of a fully mature scar can be either lighter than the surrounding skin (hypopigmented) or sometimes darker (hyperpigmented), reflecting the permanent changes to the skin’s pigment cells.
Contracture Scars and Functional Appearance
The contracture scar is defined by its appearance of tightness and restriction. These scars develop when the healing tissue shortens and thickens, literally pulling the edges of the skin together. The visual outcome is skin that looks constricted, puckered, and severely pulled inward.
Contracture scars are most apparent and problematic when they cross a joint, such as the elbow, knee, or neck. When located over a joint, the skin appears to be stretched thin and tethered, causing a visible distortion of the natural anatomical lines. This tightness visually signals an underlying restriction of movement, as the shortened scar tissue prevents the full extension of the limb or joint.
In some severe cases, the contracture can form a constricting band around an entire limb or the torso. This appearance of a tight, circumferential ring indicates that the scar is not merely raised but is actively shortening the skin surface.