Burn Injuries

Appearance, body image, and identity

This section covers:

  • Looking different
  • Changing appearances and covering up burns
  • Accepting scars and celebrating uniqueness
  • Body image and how you feel about the way you look
  • Personal identity and sense of self

Appearance was spoken about by many of the people we interviewed. A few told us that they had sometimes struggled with their appearance after having had a burn and that it could be difficult to accept how they looked. Some people said that, with time, they were more comfortable with their appearance and now had a more positive body image.

Holly, whose son was burnt as a baby, worries about how he will feel about his appearance as he grows up.

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Holly, whose son was burnt as a baby, worries about how he will feel about his appearance as he grows up.

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I am concerned about when we have to have the conversation with him about what happened. That’s something that I can’t say I sort of look forward to doing. I mean, even the psychologist said to me, and a number of people have said to me ‘Oh, boys love a scar’ but that’s … that’s not necessarily the case and you don’t know how MY boy, how MY [son] going to react to it. Which, I guess, is a bit, I don’t know, it’s a little bit … I know everyone’s trying to be nice saying that but it’s a bit stereotypical and it doesn’t reflect necessarily the society we’re living in nowadays where you say ‘Oh, yeah, you should see the other guy’ sort of thing and, you know, ‘I got it in a fight’ or whatever and, you know, the story behind it. Um, I know people are trying to be nice but yes, most people have said that to me including members of the NHS, um, in a jokey way perhaps but it does make me think ‘Yeah, how will he deal with it?’ It might be that he literally couldn’t care less, or it might be that actually he is very looks-orientated and very sort of self-conscious of its. So, it will be interesting, but it’s also something that I think about, of how he’ll cope with it. Because I know there’s always going to be things that you’re … that anyone who has something that they’re self-conscious of, so it’s whether that is his thing or whether he just thinks ‘Oh well.’ It remains to be seen, doesn’t it?

Life experiences, as well as appearance, can be important to people’s sense of self (who they feel they are). Some people saw themselves as a ‘burn survivor’, whereas others did not want to make the burn part of their identity.

Looking different

Looking and feeling different to others can be a difficult part of living with a burn. In the early days and weeks, the burn might look very “raw”, “gory” or “crusty”, and involve bulky bandages. Many people described how different burn scars can be in terms of where they are on the body, the colours, shapes, sizes, and textures. Some people had also lost parts of their body as a result of their injuries.

Saffron said that it was a “big concern” of hers that she “looked different from all of my peers and my family”. This could sometimes lead her to worry about what other people would think of her and if she would “stand out walking along the street”. Because of her scarring, India was “aware that she does not look like everyone else”.

Saffron said that getting changed in front of others as a child during sports was her “biggest challenge”.

Saffron said that getting changed in front of others as a child during sports was her “biggest challenge”.

Age at interview: 24
Sex: Female
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I think that was the biggest challenge was when we were in that age where I couldn’t really escape the sense of-, I had to get changed in front of other people and they would look because they didn’t really understand.

I guess I want to use the word ‘normal’ or definitely distorted, you get a view that it’s this horrible texture, and I guess that, you know, you then think to yourself, that’s when you start thinking “Well, how will other people view me?” or “Am I really going to fit in?” or that I’m just going to stand out, you know, walking along the street. And I guess I still feel that to a level.

Some had found having a burn or scars as a teenager and young person especially difficult. Natasha, who was burnt as a child, said she became much more self-conscious from the age of 16 onwards. Many thought appearance was particularly important at this life stage, and worried about other peoples’ reactions to burns and impacts on friendships, socialising, and dating and relationships.

Although a burn can affect someone’s confidence about their appearance at any age, a few people we talked to felt they had been less affected because of when they were burnt. Hadyn, who was burnt as an adult, thought “the fact that I was at that stage in life where I was married and I had a family, I think it [the impact on my appearance] wasn’t as big a deal as it would have been if it would have happened to me 20 years beforehand”. India, who was burnt as a child, thought that others like her might be more comfortable with their appearance because they’ve grown up with burn scarring for most of their life.

Sarah thought that having children and her body already having changed through pregnancy and birth meant that the appearance of a burn was less impactful than it might have been before.

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Sarah thought that having children and her body already having changed through pregnancy and birth meant that the appearance of a burn was less impactful than it might have been before.

Age at interview: 34
Sex: Female
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I’d just had three children really quickly, one after the other, um … so I guess I’d already kind of entered a phase of a life where it [her appearance] didn’t matter as much as it would have done, you know, 10/15 years ago, when I was younger. …but it doesn’t bother me too much. I don’t… you know, it’s certainly not something that I dwell on.

Changing appearances and covering up burns

Some treatments aim to reconstruct body features or reduce the appearance of scars. Justyn had reconstructive surgery to recreate his earlobe. Raffaella had micro-needling in her skin graft area which “helped a lot with the texture” but less so with the colour of her scars.

Some people minimise the visibility of their burn injuries using make-up (such as special full-coverage skin camouflage products), clothing or accessories. Raiche’s hair didn’t grow for a long time after she was burnt, and she wore hats, bandanas and wigs.

Permanent ‘make-up’ tattoos, sometimes called micropigmentation or medical tattoos, are when someone gets a tattoo to look like an original body feature, such as an eyebrow or the outline of a lip. Justyn had a tattoo to look like an areola (the dark part of the nipple).

As well as wearing sunglasses to cover his burn in the early stages of recovery, Haydn found that projecting confidence actually made him feel more confident in social situations.

As well as wearing sunglasses to cover his burn in the early stages of recovery, Haydn found that projecting confidence actually made him feel more confident in social situations.

Age at interview: 46
Sex: Male
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I think that it would just meant that I’d have been a little bit more, or a little bit less relaxed. I would have had to have put some energy into countering, into trying to come across as more, relaxed and more positive and yeah, I think, as I mentioned earlier, that was how I coped, by trying to stay relaxed and positive and trying to put that across. I think it took a bit of effort to do that. So, if I was wearing the sunglasses maybe I didn’t need to put quite so much effort into doing that.

So I think that’s maybe a lesson that I learnt, or something that I learnt and maybe I used it with this as well in terms of “Right, ok, again, I’ve got something on my face that I don’t want to be there, let’s up the confidence level that I’m sort of…” portraying is the wrong word but, you know what I’m saying, sort of putting across.

Yeah for some reason it always stuck in my mind that that’s what I did at that time, so, yeah, it’s obviously, the fact that I still remember it now, it’s always been in my mind and, like you say, chucked in that mental toolkit of “Ok, if there’s something about my appearance that I don’t like just up the confidence level and that should counter it”.

For some, strategies of covering up or distracting from their burn injuries helped them feel less self-conscious and avoid comments or questions from others. Tom “hid” the burns on his face and hands as best as he could when he went to his university graduation ceremony. Frazer would sometimes cover his burn by wearing a watch to “take attention away from it”.

Others said they were not interested in trying to change or cover up the appearance of their burn scars. Helen X recalled once using lipstick to define a bottom lip which was missing after her burns, but concluded, “No, I don’t need this”. Tara, who was burnt as a young child, said she had never really been interesting in trying to “reduce” and “cover” her scars, because she didn’t have an idea of how she looked “before” to compare with: “I don’t think about it that often because it’s just me”.

Accepting scars and celebrating uniqueness

Some of the people we spoke to viewed their burn as something that made them unique from everyone else. Rhian said her burn is now just a part of her that “makes me beautiful and stand out from others”. Parents of children with burns would sometimes speak about their child’s burn as a way to explain diversity and celebrate differences.

Jessica hopes that speaking to her daughter about scars will help her to realise that they are normal and everyone has them.

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Jessica hopes that speaking to her daughter about scars will help her to realise that they are normal and everyone has them.

Age at interview: 44
Sex: Female
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I mean, at the moment we, you know, obviously because we are still putting creams and things on them, we talk about them being scars and we try and normalise it. You know, we talk about the scars that everyone else in the family has from like falling over or my son broke his wrist one and he has a scar from the operation and I have a scar on my knee when I was younger and we talk about scars in general to try and make her understand that it’s just normal, everyone has scars in some way, on them, and that’s how I hope that she’ll be able to view that as she’s older.

Not something really different. Everybody has a scar, so that if people do ask her about it, she can say “I had an accident when I was young and that’s a scar”. Just like my son shows his scar from when he broke his arm.

In time, some people were able to accept their scars as “a part of them” and valued their uniqueness. Saffron said that she was able to accept her scars through recognising what her body has achieved and overcome. Charlotte eventually felt “proud” of her scars, for showing she had “got through something, and I survived something, and I am now doing well”. She added that she was able to accept her scars “through experience and through age, and just realising differences are what make people special”.

Saffron was able to accept her scars through recognising the challenges her body had overcome.

Saffron was able to accept her scars through recognising the challenges her body had overcome.

Age at interview: 24
Sex: Female
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Self-acceptance is key because it’s not changing and I think the more you resent it, the least you’ll be able to accept yourself in life and who you are. Whereas, if you can accept it as a part of you, then I just think that you can move forward more in life.

I guess it’s not just self-acceptance, it’s having a bit of resilience to realise how far you’ve already come to have that scar. So, to have the scar you’ve already been through the hospital treatment and the pain, and you’ve overcome that, and you’ve physically recovered, so really the acceptance is accepting that this is where you are now and doing that will enable you to move forward as well. So, I guess, self-acceptance, yeah, is a really key thing here.

Rhian said that her scars make her unique.

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Rhian said that her scars make her unique.

Age at interview: 28
Sex: Female
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I’m now like “Oh, it’s just part of me now and it is part of me and it’s one thing that makes me beautiful and it makes me stand out from others” and even though sometimes I think it’s the most ugliest thing in the world, but then it’s not, like, there is a lot worse things, like I could be well, you know, there’s a lot of worse diseases out there and, at the end of the day, can I walk? Yes! Can I breathe? Yes. Am I able to carry on doing what I wanted? Yes. Life’s fantastic then. It’s like “Don’t worry about it”.

Because I think if it’s just a different pattern on your skin, well then why can’t you make it feel nice? Why can’t you grow to like it? Like, why can’t you accept it and make it part of you? Like mine’s an odd shape.

Raiche said she has become “attached” to her scars and doesn’t even notice some of them anymore.

Raiche said she has become “attached” to her scars and doesn’t even notice some of them anymore.

Age at interview: 28
Sex: Female
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But the funny thing is about scars is when you have them for such a long time you kind of get used to the way they look and how they are in your body and then, when it changes, you’re like “Oh, ok, that’s different!”. And then, it’s really weird because it’s only scar compared to like, the rest of the scars combined on your body and it’s such a small thing but I was like “Oh, it’s a big scar, oh my God!” I was like “I miss the last one, it was just a straight line!”. But yeah, I guess it’s like a weird psychological thing where you just get attached to your scar. Yeah, I don’t even notice this one anymore.

After Justyn looked into micropigmentation (a tattoo procedure to make burn scars look more like the colour of the rest of a person’s unburnt skin), he decided it wasn’t for him. Instead, it was “a turning point” in seeing his scars as “beautiful” for telling a story about who he is and has been through.

Body image and how you feel about the way you look

Body image is how you feel about your body and the way you look. After sustaining an injury which changes your appearance, it can be normal to struggle with body image and adjust to living with an altered appearance. Some people experienced negative body image after a burn injury, though many eventually adopted a more neutral or positive body image.

Natasha tries to forget that her burn is there and tells herself “there’s nothing I can do about it”.

Natasha tries to forget that her burn is there and tells herself “there’s nothing I can do about it”.

Age at interview: 19
Sex: Female
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I sort of just tell myself to ignore it. So, if for instance, I’m in the mirror and I’m getting ready and you can see a little bit of my burn on my shoulder or something like that, I just sort of tell myself “There’s nothing I can do about that, so just ignore it, pretend it’s not there.” And then, if I do that, I tend to actually just forget it’s there. And, as long as I’m not looking in a mirror it’s not there to me. So, it’s just sort of, yeah, it’s just about that and then I deal with other body image issues as well. So, it’s almost like it’s definitely the least important of all the problems that I have but it is still, it just sort of adds it on. So, if I’m having a really bad day and I’m upset about that one and that one and then that’s as well and it just, sometimes it just does get a bit much, but that’s very rarely does that happen and it’s usually when I’m in a bad mood or, you know, I’ve had a bad day or something like that. But it’s never long term, you know, and it doesn’t always come back, it’s just if I’m looking at it really, but yeah, yeah. But then, I sort of remember then, like I say, then I’ll chat to my boyfriend and then he’ll make me feel happy again, so you know, and it’s fine and then actually I tell myself “Actually, why am I getting silly about this? This is, it’s really not, it’s great, it’s just part of me.” It’s almost like I just tell myself “There’s nothing I can do about it, it’s here to stay.”

Tom told us that, during his recovery from his burn, he worried about his future “in terms of how I’d look”. He told us that the appearance of his burn is “not ideal, but I can live with it”; if he is having a bad day where he feels like he doesn’t look good, he will exercise as it “makes him feel better about things”. Helen Y felt self-conscious about the appearance of her breast after she was burnt and had surgery to make her breasts more symmetrical.

Some people said that they did not feel either positive or negative about their bodies, and instead used the term “body neutral”. Quite a few people believed that their appearance was one of the least important aspects of them.

India believes that it is enough to feel neutral about your body.

India believes that it is enough to feel neutral about your body.

Age at interview: 21
Sex: Female
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I think we’re sold this idea that we need to love our bodies, like we should love everything and, to be honest, I do really love my body, but I think, I’m not going to, like, force everyone to get to that point. Just accepting it can be enough and I think time helps with that. And, you know, you might not feel like that right now, you might not feel like you’re at that point, but I promise you that point is there, it is on the horizon, it just takes time and a bit of self-kindness as well.

I feel like I’m able to be on the body positive end at this point, but I spent a lot of years just being body neutral and, to be honest, I was very happy. It didn’t hold me back from what I was wearing and what I wanted to do. I know that, you know, as I said, I actually think it’s a privilege that I had my scarring very young. I don’t really know how I look without my scars, so I think it’s been easier for me to reach that point of body positivity but, you know, don’t put yourself through the ringer because you don’t absolutely love yourself. Like, most people don’t love themselves and love the way they look. Body neutrality is enough, I just don’t want people to see their scars as like this enemy that they hate, you know. It’s just a part of you, it’s like anything else. It’s just your skin, it’s skin deep so, there’s so much more to you than that.

Adopting a positive body image was not an overnight process and, for some people, it took years to reach this point. Claire told us that in reaching a place of positive body image and acceptance, “you just get used to what your body looks like and the scars”. Raiche said that she began to “look at my body as a whole, not just in sections, and just appreciate everything”. Rhian said that “in one way I really do like it because it’s my bit of uniqueness”.

Raiche said it was a journey to accepting how she looks, but now she has learnt to love herself.

Raiche said it was a journey to accepting how she looks, but now she has learnt to love herself.

Age at interview: 28
Sex: Female
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It’s not something that happens overnight, like accepting how you feel and the way you look, and especially when you’ve got media and celebrities looking a type of way and everyone thinking that’s the norm and that’s how you should look and anything different isn’t right and it’s just weird or you’re ugly or evil according to these horror movies where you only see burned people. Yeah, it’s definitely a journey. I think now, in the space that I am, I think I look fricking amazing!

I go out with no make-up on whatsoever and I literally do not care what people say, but I’m just in love with the way my skin looks, like the different colours, the different tones, the textures, the shapes. I’ve got the rarest diamonds in the world on my shoulder and other bits of skin graft that creates different textures and like, just skin in general, it is just so amazing what it can do and how it looks like and how it changes like different weathers. In the sun you go a bit more gold, and you go a little bit pale in the winter but depending on preference you might love a bit of sun or more.

I don’t know, I’ve just learnt, I guess, where I’ve learnt to be loved and fall in love, I’ve kind of learnt to love myself and I guess I’ve always appreciated the way I look because I always took care of my teeth and my skin and my eyelashes, but it’s literally just taking a step back and just really appreciating yourself by looking at a photo, like whether you’re in your favourite outfit or if there’s certain colours or if your make-up looks amazing or if you’ve got no make-up, just appreciating like the features that you have. Yeah, maybe I don’t look like the supermodels on the runway but one day someone that looks like me will be rocking their stuff on that runway, if it’s me, or of its someone else.

Personal identity and sense of self

Living with a burn injury often led to people feeling like their identity had been changed in some way. This often involved their appearance being different, but also their experiences of the burn and recovery. For some, being a “burn survivor” was part of who they were, and they felt positively about their burns shaping part of their identity. Other people felt like their burn did not define who they were in any way, and that their burn was just something that they had experienced but now wanted to move on from.

Frazer said the most important thing to him was not let the burn “become who you are”.

Frazer said the most important thing to him was not let the burn “become who you are”.

Age at interview: 22
Sex: Male
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The most important thing to never let that become who you are. I was always just the guy who rode bikes, it's not the guy who blew himself up, you know?

I take control of it. It's really not, I’m not letting it define me. That's the important thing.  I’ve put such an importance with not letting it define who I am, so that definitely helps to just keep it at bay.

And that's why I always say that I always bring it back to the bike because that's how I want people, to look at a bike, “Oh, Frazer likes bikes!” on people so, you know, somebody might burn themselves on a pan and think “Oh, Frazer has a burn”. You know, I don't want to be remembered. I want to be remembered as the guy that like bikes. That's sort of I think I play such an important identity and, you know, and that's it, yeah. Making sure people remind me but think of me as the guy who likes bikes.

Sinead said that having a burn injury is only a small part of her daughter’s story.

Sinead said that having a burn injury is only a small part of her daughter’s story.

Age at interview: 43
Sex: Female
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Yeah, I just think it’s only a small part of her story, or her journey, not even, you know, the story has an ending – this doesn’t have an ending yet. So, yeah, it’s a very small part of who she is. It’s a massive thing that’s happened to her, but actually on the grand scheme of it she’s like that, she’s Elizabeth, she’s eight, she’s a sister, a friend, a daughter and she wants to be a Formula 1 driver, she wants to roller-skate around the world, you know, there’s a million other things that are, you know, far more interesting than she had a big burn injury.

Sometimes people struggled to decide whether they wished to identify as a “burn survivor” or not. Some people would compare their burns with other people and felt that theirs were not severe or large enough to warrant the title “burn survivor”. Simon, who’s son sustained a burn the size of a 50 pence piece, said “he is a burnt child, but he’s not what I previously would have considered a child with a burn”.

Raffaella said her identity doesn’t revolve around being a “burn survivor”.

Raffaella said her identity doesn’t revolve around being a “burn survivor”.

Age at interview: 42
Sex: Female
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Sometimes I do like, I find it, when I say, ‘burn survivor’, it’s too much of a big word to say about myself, because  I’m really not that burned, like compared to, I mean, yeah, of course I was going to survive, like it was 20% of my body, wasn’t like 60/90. But you did still survive, you know, in a literal term, you did survive a burn, like, doesn’t mean that you’re still alive, you survived it even emotionally, psychologically.

India said that her burn injury was a small but important part of her.

India said that her burn injury was a small but important part of her.

Age at interview: 21
Sex: Female
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I think everyone’s going to have a different experience and that’s completely understandable. I think for me, because my burn injury happened when I was so young, it doesn’t feel as much, it doesn’t have as much magnitude I think as it might for someone who has it when they’re older. So, for me, it’s like me having burns is almost like aside from, ok, all the surgery, hospital treatment I had to have, me having burns is like me having brown hair, or like me having, you know … being white, or whatever it might be. It’s an important part of me but it’s, me having burns is a little bit like, I don’t know, yeah, it’s a small part, me having burns is like a small part of me. It’s an important part of me but it’s not everything and I always want people to view me for my achievements, who I am, my values, above my scarring. To me, it’s kind of like an afterthought, it’s just a physical trait. Yeah, there’s a lot of stuff I’ve had to deal with, with it but when I think of myself or ask me to tell them about me, I would probably talk about that I want to go into law, or the fact that, you know, I love music or I love to spend time with my friends, over the fact that I’m a burns survivor. It’s kind of like the last thing I think about. But I think that is a privilege to be able to do that because I don’t have surgery anymore and I was very young when it happened. Not everyone, you know, is able to do that because they’re still have surgery and their burn injury is very, very present in their life. So, this might just be a random prediction, but it may be that people who put their burn injuries lower on the list, maybe ones who had it younger or they’ve lived with their burn injury longer.

But personally, I kind of want, so I guess separating myself a certain amount from my burn injury and live my life outside of that and not let it become everything I sort of do. And I’m always going to be passionate about the issues that face it and get involved with stuff as much as I can, but I want to feel like I have a world and life outside of it, I think, and that’s probably why I keep it more private, if that makes sense.

Rhian said that although she thought of her burn as “a part of me”, she didn’t want to let it “take [over] your life”. She explained how it was a “traumatic experience” in the past, but now she needed to “move forward and see what happens” with her new scar. Marilyn also viewed her burn as a “closed chapter”. You can read more here about how people we spoke to described coping with the psychological impact of burn injuries.

 

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