Burns can cause a wide range of injuries to the skin. One common characteristic of more severe burns is that the affected area turns white or a lighter color than the surrounding skin. There are a few reasons why burns often appear white or paler than normal.
Loss of Blood Flow
One of the main reasons a burn may turn white or pale is due to a loss of blood flow to the damaged area. When the skin is severely burned, the heat typically destroys small blood vessels and capillaries near the surface. This vascular damage prevents normal blood circulation, leaving the skin without its regular supply of blood.
Since blood gives skin its more reddish or pinkish hue, a lack of blood flow causes the skin to lose its natural coloration. As a result, the skin takes on a much paler whitish color instead. This is especially noticeable next to unburned skin with normal blood flow.
How does loss of blood flow make burns appear white?
– Heat from the burn destroys small blood vessels near skin’s surface
– With blood vessels damaged, blood can’t reach the burnt area
– Less blood reaching the skin removes the reddish skin coloration
– Lack of blood causes the affected area to appear white/pale
So in summary, the destroyed blood vessels disrupt normal circulation, leaving the burnt skin pale and bloodless, and therefore white in color.
Coagulation of Proteins
Another mechanism that can lead to white-colored burns is coagulation of proteins in the skin. Burns generate significant heat, which can denature and coagulate proteins like collagen and albumin found abundantly in skin tissue.
When these proteins coagulate, it changes their structural properties. Denatured proteins become solid and opaque rather than clear or semi-translucent. This alteration makes the affected area appear whiter.
Furthermore, coagulated proteins can disrupt light reflection, preventing normal pink undertones from showing through the skin. Again, this leads to a white coloration rather than the skin’s normal tone.
How does protein coagulation make burns look white?
– Heat from burn denatures skin proteins like collagen
– Denatured proteins coagulate and become opaque
– Coagulated proteins block normal light reflection in skin
– Makes burnt area look more white than pink or reddish
So in summary, the high heat from a burn can permanently change skin proteins, making them coagulate and turn white, thereby causing white-colored burnt skin.
Formation of a Scar Eschar
Most severe burns will eventually blister, and the fluid-filled blisters may break. This leaves behind a dry, crusty layer called an eschar. Eschar is dead tissue that acts as a protective cover over the underlying burn and developing scar.
Since eschar is dried-out, desiccated skin, it lacks any normal coloration and appears white. As the eschar flakes off, it may reveal even lighter scar tissue underneath, which also lacks pigmentation. So the presence of eschar and scar tissue is another reason why burnt skin often appears stark white.
How does eschar formation cause white-looking burns?
– Severely burnt skin blisters and the blister roofs break
– This leaves behind a dry, crusty layer called eschar
– Eschar is desiccated, dead skin that lacks normal color
– Appears white since it has no blood flow or pigmentation
– Underlying scar tissue also lacks pigment and looks very white
In summary, the eschar and scar left by severe burns are white due to a total loss of skin pigmentation in these dead and damaged tissues.
Lack of Melanin Production
Melanin is the pigment primarily responsible for skin coloration. It is produced by cells called melanocytes. The melanin pigment helps protect deeper layers from sun damage by absorbing ultraviolet (UV) radiation.
However, melanocytes are very sensitive to damage from excessive heat. Severe burns commonly destroy a large number of melanocytes in the affected area. When these melanin-producing cells die off, they can no longer synthesize the pigment.
This leaves the regenerated epidermis without its normal melanin content. With a depletion of melanin, the skin loses its pigmented appearance and takes on a pale, white coloration instead.
How does loss of melanin cause white-colored burnt skin?
– Melanocytes produce the melanin pigment that colors skin
– Burn heat damages and kills many melanocytes
– With melanocytes destroyed, no melanin can be produced
– Lack of melanin removes the skin’s normal pigmented appearance
– Skin appears pale and white without melanin to provide coloration
In summary, destruction of melanin-producing melanocytes is another mechanism causing burns to appear white, as there is no melanin left to give the damaged skin its normal color.
Thickening of the Epidermis
As burns heal, the outermost layer of skin (the epidermis) will thicken and regenerate. However, this new epidermis often lacks normal appendages like hair follicles and glands.
Additionally, the thickened epidermis accumulates more closely-packed layers of cells near the surface. With more cell layers and less vascularity, there is greater diffusion and reflection of light passing through the skin.
This altered optical property makes the healed skin appear lighter and whiter. The lack of skin structures to absorb light prevents normal pigmentation and causes further paling of the burnt area.
How does a thickened epidermis cause whitened burns?
– Healing skin forms a thicker epidermis at burn sites
– More cell layers and fewer glands/follicles in thickened skin
– Increased light diffusion and reflection with more epidermal layers
– Gives healed skin a lighter, paler color rather than normal pigmentation
– Makes the regenerated skin appear white instead of a pink or red hue
So in summary, the accumulation of additional layers of paler cells in the restored epidermis gives healed burns a lighter, whiter appearance compared to normal skin.
Delayed Healing of Deep Burns
Very severe burns that damage deeper skin layers often take significantly longer to heal. Full-thickness burns destroying the entire epidermis and dermis can leave wounds open for weeks before closing.
Open, unhealed burns lack any pigmentation and appear white because the underlying tissue has no protective covering. Normally, blood vessels deeper under the skin provide some redness. But in these wounds, even the blood vessels may be damaged or coagulated.
So very deep burns often remain entirely white until the dermis can regenerate and the epidermis covers over the defect. This delayed healing contributes to the white coloration.
How does delayed healing of deep burns lead to white appearances?
– Most severe burns damage the full thickness of skin
– These deep wounds take much longer to fully heal
– Lack of epidermal coverage leaves the burns open
– Exposed underlying tissue lacks all pigmentation
– Even blood vessels may be coagulated, preventing redness
– Slow healing process leaves burns white until dermis regenerates
In summary, very deep burns often appear white for an extended time due to slow wound closure, lack of blood flow, and no pigmentation in the uncovered burn wounds.
Scarring and Fibrosis
Full-thickness burns typically destroy skin architecture down through the deep dermis. As these severe burns heal, excessive fibrotic scarring is common. Dense, fibrous scar tissue replaces the damaged collagen matrix and elastin networks.
Fibrotic scarring contains high levels of inflexible collagen. The raised, thickened scar tissue does not contain melanocytes or other pigment-producing cells. As a result, scars from serious burns appear white instead of the surrounding normal skin coloration.
How does scarring lead to white-colored burnt skin?
– The most severe burns damage deep into the dermis
– Healing involves fibrotic scarring and collagen accumulation
– Scar tissue lacks melanocytes and other pigment cells
– Makes scars appear white compared to normal skin
– Dense, inflexible collagen gives the scar a pale white color
In summary, the heavy collagen scarring that replaces destroyed dermal tissue does not contain pigments, and this is why scars from the worst burns are often white.
Coverage of Darker Skin
While paler skin becomes white after burns, darker pigmented skin may turn a lighter shade of the original color, rather than fully white. However, in severe cases, the burns may still overwhelm the underlying melanin and appear white or a very pale version of the skin color.
This occurs due to the previously discussed mechanisms like melanocyte destruction, lack of blood flow, and buildup of scar tissue. The white color reflects the degree of damage rather than the original skin tone. But covering of darker melanized skin can partly contribute to the lighter burnt appearance.
How does coverage of darker skin contribute to white-seeming burns?
– Those with darker skin have more melanin pigmentation
– But severe burns damage melanocytes regardless of skin color
– Lack of melanin production makes the burn paler than normal skin
– May seem white compared to original tone, or very light shade of color
– Degree of color change reflects severity and depth of burn
In summary, while the burn may not appear fully white on those with darker skin, the pale color relative to normal skin still reflects serious damage from the burn. The loss of melanin uncovers the white dermis below.
Summary of Why Burns Turn White
There are a number of contributing factors that cause burns to exhibit a white coloration:
– Vascular damage prevents blood flow to the area
– Coagulation of proteins like collagen make the skin opaque
– Formation of scar tissue and eschar that lacks pigment
– Destruction of melanocytes prevents melanin synthesis
– Thickened epidermis increases light diffusion and reflection
– Slow healing leaves deep wounds uncovered long-term
– Scarring contains dense, unpigmented collagen
While burns may destroy some melanin in darker skin and turn a lighter shade of the original color, the degree of paling reflects the severity of the burn regardless of skin tone.
So in summary, white-colored burns result from a loss of multiple physiological contributors to normal skin pigmentation and reflect extensive tissue damage from the burn. Prompt treatment is essential for reducing the long-term effects.
Treatments for Hypopigmented Burn Scars
Since loss of pigmentation is usually permanent after burns, the white-colored scars may remain for life without intervention. However, there are treatments that can help restore some coloration to burn scars. Common options include:
| Treatment | Description |
|---|---|
| Dermabrasion | Removes top layers of scarred skin using a rotating brush or burr. This allows normal skin pigmentation to regrow from deeper layers. |
| Laser therapy | Uses laser energy to resurface the skin, removing scarred layers to improve appearance. |
| Surgical grafting | Healthy skin from another part of the body can be grafted over the scar to provide normal pigmentation. |
| Fat transfer | Injects small droplets of fat cells from elsewhere in the body under the scarred skin. The added fat provides improved color. |
| Tattooing | Inks in skin tones can be tattooed over the scar to camouflage the white coloration. |
These techniques can help restore some natural coloration. But it often takes multiple treatments to achieve noticeable improvement, and the costs may add up over time.
What are the main treatments to restore pigmentation to white burn scars?
– Dermabrasion to remove scar and regrow pigmented skin
– Laser therapy to resurface and remodel the damaged area
– Surgical grafting of healthy skin with normal melanin levels
– Fat transfer to inject pigmented fat cells under the scar
– Tattooing colored ink into the scar for camouflage
In summary, while challenging to treat, there are cosmetic procedures that can improve the appearance of hypopigmented scars by adding coloration back to the skin in different ways.
Preventing Burns that Cause Scar Hypopigmentation
The adage “prevention is the best medicine” certainly holds true when it comes to avoiding burn injuries that can lead to permanent scarring and loss of skin pigmentation. Some tips for preventing severe burns include:
At Home
– Keep appliances in good working order and don’t overload electrical outlets
– Set water heater temperature no higher than 120°F
– Avoid picking up anything hot with unprotected hands
– Keep children away from hot stoves, fireplaces, grills, etc.
– Store flammable materials properly and discard hazardous chemicals
Outdoors
– Apply sunscreen of SPF 30 or higher when outside
– Wear protective clothing and avoid sun during peak hours
– Exercise caution around campfires, bonfires, fireworks, etc.
– Avoid walking on hot sand, pavement, or rocks barefoot
Workplace
– Use machinery guards and personal protective equipment
– Follow all safety protocols for handling hazardous materials
– Use proper technique when working with high heat equipment
– Keep flammables isolated from ignition sources
Proper prevention helps avoid the painful injuries and permanent scarring that can lead to loss of skin pigmentation after burns. So being cautious and using common sense goes a long way toward prevention.
Conclusion
In summary, burns often appear white or paler than the surrounding skin due to destruction of pigmentation-producing cells and vessels, coagulation of proteins, loss of skin architecture, and scar formation after serious burns. Although challenging to treat, procedures like dermabrasion, laser therapy, grafting, fat transfer, and tattooing can help improve the appearance of hypopigmented scars. However, preventing the initial burn injury through safety precautions is key to avoiding permanent discoloration and scarring. Proper first aid and medical treatment are also imperative for reducing long-term damage when burns do occur. With proper care, many burns can heal without leaving behind stark white scars.