What should you know about burn scar pigmentation?

A burn can disturb pigment-producing cells and the skin’s normal structure. Newer scars may look pink, red, brown or darker, while areas with deeper cell injury can heal lighter. Colour can vary within the same scar and may be more noticeable after sun exposure or irritation. Pigment alone does not show how deep the original burn was.

Do not scratch, peel or apply strong lightening agents without professional advice. After the surface has closed, use the sun protection recommended for your skin and keep the area moisturised if it is dry. A dermatologist can distinguish pigment from active inflammation and discuss fractional laser treatment, scar revision surgery or, for larger areas with significant tissue loss, a skin graft. Skin tone and the scar’s texture influence the safest plan.

Have the area assessed if colour changes are spreading, accompanied by increasing itch or pain, or appear with thickening. Prompt review is needed for warmth, tenderness, swelling, discharge, fever, bleeding or breakdown of the skin. Seek advice before treating a scar that is still open, crusted or inflamed.

Ask whether the colour is post-burn pigmentation, redness or another skin problem; whether treatment could make the contrast more noticeable; and what preparation and sun protection are required. Ask how progress will be judged when colour changes slowly.