Last reviewed: July 3, 2026 · Compression Socks Canada Team
Burn recovery does not end when the wound closes. The months that follow are when the body's scarring response unfolds, and that response can leave behind raised, red, itchy, and sometimes restrictive scars. Pressure garment therapy is one of the oldest and most established interventions used during this phase. It is a long, patient process, and it works best when patients, caregivers, and the rehabilitation team are aligned. This article walks through how pressure garments are used after burn injuries, what to expect, and how compression interacts with the broader rehabilitation picture. It is general educational content and not a substitute for medical advice from the burn unit or rehabilitation team managing your care.
What happens to skin after a burn
Deeper burns — partial-thickness burns that do not heal quickly, and full-thickness burns — disrupt the normal organisation of skin layers. As the body repairs the area, fibroblasts produce collagen rapidly to close the wound. If that collagen organises in an excessive, disorganised way, the scar becomes hypertrophic — raised, red, firm, and often itchy. In some patients, scars become keloid, extending beyond the original wound boundary. Scars over joints can also contract, restricting motion. The Merck Manual outlines the scarring response and rehabilitation considerations.
Scars mature over many months. Within the first year to eighteen months, an active scar can soften, flatten, fade, and become more pliable. Intervention during this window has the greatest effect.
How pressure garments work
Pressure garments apply sustained mechanical pressure to maturing scar tissue. The exact mechanism is still being studied, but observed effects include:
- Reduced blood flow into the developing scar, which may modulate collagen synthesis.
- Encouragement of more organised collagen alignment along the line of pressure.
- Reduction in scar thickness, redness, and itching over time.
- Better preservation of joint range of motion when scars overlie joints.
The pressure delivered is typically in the 15-25 mmHg range for many burn scar applications, but the precise specification belongs with the rehabilitation team. The effect depends on consistent wear — most protocols call for 23 hours a day, removing the garment only for skin care, bathing, and brief intervals.
What pressure garments look like
Pressure garments are typically custom-made to fit the individual body part involved. Common configurations include:
- Face masks for facial burns.
- Chin straps for jawline and neck involvement.
- Vest and torso garments for chest and back burns.
- Sleeves and gloves for upper-limb involvement. Browse the arm sleeves collection for the broader category, although burn-specific garments are typically custom-fitted.
- Pants, leggings, and below-knee sleeves for lower-limb burns. Browse the leg sleeve collection and the compression garments collection.
- Custom flat-knit garments for irregularly shaped scar areas.
Most burn rehabilitation pressure garments are custom rather than off-the-shelf because the area, contour, and seam placement matter for both effectiveness and comfort.
The timeline
A typical pressure garment journey unfolds over many months:
Wound healing phase
Pressure garments are usually introduced once the wound has closed (epithelialised) and the skin can tolerate fabric without breakdown. Some teams use interim garments earlier as the wound nears closure.
Active scar phase
From wound closure through roughly six to twelve months, the scar is active — red, firm, and remodelling. Pressure garments are worn 23 hours a day during this phase in most protocols. Multiple replacement garments are typically issued because fabric loses recovery over time.
Maturation phase
As the scar matures — often by twelve to eighteen months, sometimes longer — wear time may gradually reduce. Some patients transition to nighttime-only wear, others continue daytime wear for specific functional reasons such as joint motion.
Long term
Once the scar has matured, pressure garments are usually no longer needed, although some patients continue to benefit from occasional use for specific symptoms.
Adjuncts that support pressure garment therapy
Pressure garments are part of a larger toolkit:
- Silicone inserts. Sheets or gels placed between the skin and the garment can further improve scar appearance and pliability.
- Massage. Once skin tolerates it, scar massage helps mobilise collagen and reduce itching.
- Range-of-motion exercises. Particularly important when scars overlie joints; pressure garments do not replace the work of moving the joint regularly.
- Sun protection. Active scars are very sensitive to UV; pigmentation changes can be permanent.
- Moisturisation. Maintains skin barrier under daily fabric.
- Psychological support. Burn recovery is a long process. Mental health support is part of standard burn care.
The American Burn Association and similar professional bodies publish patient resources on scar management that complement clinical care.
Daily life with a pressure garment
Patients and caregivers usually need to adapt daily routines:
- Two garments are typically rotated so one is being washed and dried while the other is worn.
- Most pressure garments are machine washable on gentle settings and air dry best.
- Donning is faster with practice but can be challenging in the first few weeks; therapists provide guidance.
- Skin should be inspected at every removal for new redness, blisters, or pressure marks.
- Garments are replaced periodically as elastic recovery declines.
When to call the rehabilitation team
- New blistering, breakdown, or open areas under the garment.
- Persistent pressure marks that do not fade.
- Worsening itching or pain.
- Loss of joint motion.
- Signs of infection: increased redness, warmth, drainage, or fever.
Pressure garment programs work best when patients communicate early and often. Small adjustments — a different seam placement, a slightly altered pattern, a tweak to wear time — can make a significant difference in comfort and adherence.
The cost and access picture in Canada
Coverage for pressure garments after burn injury varies by province and by individual insurance. Burn rehabilitation programs at major centres typically have established processes for ordering custom garments, and social work or occupational therapy teams can help navigate funding. For arm and leg sleeves that may be used as adjuncts during specific phases, the broader compression-garment categories — compression sleeves and compression garments — give a sense of what off-the-shelf options exist within the larger compression category.
Putting it together
Pressure garments are one of the longest-running interventions in burn rehabilitation, and they remain a foundational part of scar management. The work is slow, the protocols are long, and patient adherence is what makes the difference. Worn consistently and combined with silicone, range-of-motion work, moisturisation, sun protection, and the rest of the rehabilitation plan, custom pressure garments support a softer, less restrictive, more functional scar over the course of the maturation window. It is an example of compression doing exactly what it does best — sustained, gentle mechanics that gradually reshape biological tissue.
Frequently asked questions
How long do I have to wear a pressure garment?
Many protocols call for 23 hours a day during the active scar phase, often for several months to over a year. The exact timing depends on individual healing and your rehabilitation team's recommendation.
Are pressure garments off-the-shelf or custom?
Most burn rehabilitation pressure garments are custom-made. Off-the-shelf compression sleeves and stockings can play adjunctive roles in specific situations.
Will my scar fully flatten?
Outcomes vary. Many patients see significant improvement in scar thickness, redness, and pliability. The scar does not disappear, but it often matures into a less symptomatic, less restrictive form.
Can I shower while wearing my garment?
The garment is typically removed for bathing. Skin care is done while the garment is off, then the garment is replaced.
What if the garment is uncomfortable?
Talk to your rehabilitation team. Adjustments to fit, seam placement, fabric, or wear protocol can usually improve comfort.
Related reading
- The role of compression socks in managing lymphedema
- Different types of compression socks: understanding the grades
- Managing edema with compression socks
This article is general educational content. Pressure garment therapy after a burn injury should always be coordinated with the burn unit and rehabilitation team managing your recovery.