Almost all survivors of serious burn injuries deal with some level of scarring. While many of these scars are aesthetic, some — known as burn scar contractures — can also cause functional problems with nearby joints. Early on, those with burn injuries are in a fight for their lives. However, once survivors are out of the woods, quality of life becomes the focus. This includes making efforts to reduce contractures and other scarring.

What are burn scar contractures?

Contractures occur when the healing skin covering a second- or third-degree burn is tighter than the original skin in the area. New skin that grows to heal severe burns has different characteristics than the original skin, and also has a tendency to thicken and tighten as it matures. This tightening can make it difficult for victims to use that part of the body. For example, contractures on the hand may prevent burn survivors from gripping things, holding a pen or pencil, or even feeding themselves.

According to a study published in the Journal of Burn Care & Research, about 39 percent of survivors who suffered major burns have at least one contracture. The study found several significant predictors of whether or not a survivor developed contractures, including the length of hospitalization, the size and depth of the burn, and whether or not they received a skin graft.

While doctors work to prevent as much scarring as possible for all burn survivors, contractures are of utmost concern, and they treat them as a serious complication. Patients need to discuss any tightened area with their doctor as soon as possible in order to retain as much movement as possible in the affected joint.

What problems do burn scar contractures cause?

As we stated above, contractures limit the range of motion in affected joints and can prevent burn survivors from using otherwise healthy joints. Depending on the joint affected by this tightened skin, some people struggle with self-care activities, including feeding, bathing, and bathroom needs. Contractures of the legs or hips can limit mobility.

In some cases, they even disrupt sleep patterns, preventing sufferers from getting comfortable in bed. The chronic pain sometimes associated with skin contractures may also require pain medication, bringing with it a number of additional side effects.

Both limited mobility and sleep issues can make returning to school or work difficult or even impossible.

Can you prevent contractures?

While it is not possible to prevent contractures in all cases, some things have been effective in minimizing their impact. These include:


Splinting a joint can help the skin heal with the most flexibility possible, allowing burn survivors to retain their full range of motion. Doctors often use splints in conjunction with pressure garments in order to minimize scarring and encourage proper healing. 

Physical therapy

A regular physical therapy regimen including range of motion exercises in any affected joint can help keep joints mobile, and prevent skin tightening. This may cause pain, but is key in preventing disabling contractures. 

Recommended exercises

In addition to regular treatments with a physical therapist, it is important to do any homework the PT recommends. This often includes stretches and exercises to keep new skin from thickening and tightening. 

Staying active

When possible, burn survivors should complete as many activities of daily living on their own as possible. This activity stretches the new skin, keeping it flexible and helping the joints retain range of motion.

Depending on how their burns affected their body, it may be difficult for some people to complete some tasks or they may take several minutes for even a simple task. However, caretakers should allow survivors to feed themselves, brush their own teeth, and dress themselves; this is important for both contracture prevention and their emotional well-being.

How can Burn Victims Resource Center help?

The Burn Victims Resource Center helps burn survivors, their families and their caregivers learn more about how their injuries affect their everyday lives. For more information about types of scarring, treatment, body image, or getting used to your “new normal,” check out our blog or give our lawyer referral advocates a call at 844-549-8774 if you need help finding a lawyer.