Intimacy: Life After Burns

Peer Review Status: Internally Peer Reviewed
Creation Date: March 2001
Last Revision Date: March 2001

A wife of a burn survivor said, "I just want to be a wife again."

A burn survivor who prided herself on her looks said, "I can’t believe that anyone would ever find me desirable again."

Another burn survivor wonders whether he will ever be able to do the things he used to do.

If this sounds like your life, understand that these concerns are normal. It takes patience, understanding, and lots of work on the part of everyone–burn victims and loved ones–to adjust to these life-changing events.

Sometimes you may need to take a reality check on yourself.

Sometimes you must allow your partner’s needs and wishes to take precedence.

Relationship and intimacy issues
When you’re first admitted to the hospital, your focus and that of your family is on your survival and physical condition.

Once you begin to heal other concerns begin to surface:

• How normal can life be?
• How will I handle relationships with others?
• How will others see me?

One of the realities of burns is that your perception of your body has changed — often challenging your self-esteem.

Because sexuality is something patients and health care providers hesitate to discuss, this pamphlet was designed to help you and your partner address your expectations and feelings related to sexuality. Sexuality is an integral part of being human and is inseparable from body image and self-esteem.

What is a normal sex life?
A normal sex life is one you and your partner decide is comfortable and gives you both pleasure. It can be gentle and healing. It can be holding a hand, a caress, or gentle and loving words.

Key ingredients to staying sexually healthy

• Gather as much information as you can about the effects of burns on sexuality. It is realistic to expect grafts to take eight to 12 weeks to heal. Sexual intercourse after that time is fine. After intercourse, check your skin grafts for signs of irritation.
• Keep an open mind about ways to feel sexual pleasure. A gentle massage or cuddling are ways to enjoy physical touch.
• Because your usual routine has been disrupted, don’t limit yourself in the ways you express caring and feeling alive.
• Establish good communications with your partner about sex–what works, and why. Talking can be the best sexual aid; the worst enemy of sexual health is silence.

Effects of burns on sexuality — and possible solutions

Loss of skin sensitivity

"I can’t feel when she touches me."

"I can’t feel his body when I touch him because my hands are so scarred."

Decreased energy level

"I’m just so tired all of the time."

While perfumed and scented body oils must be avoided, scented candles, soft lighting, mineral oil as lotion, and soft and/or satiny bedding and clothing contribute to a romantic atmosphere.

Decreased mobility and pain

"I’m stiff and it’s hard to move. How am I supposed to have sex?

Slow down and take small steps. Have fun with each other. Use some humor and give yourself time. If at first you don’t succeed, try, try again.

If you experience pain from your burns during sex, try taking pain medication about one-half hour to one hour before the anticipated sexual relations. If decreased mobility is a problem, take time to stretch before or as a part of lovemaking.

You and your partner may find your usual sexual positions are affected by pain and decreased mobility. It is OK to say, "Let’s try it this way." Be creative and find alternate positions that are pleasurable to both of you.

Communication between you and your partner is an essential part of your lovemaking. Do not expect your partner to read your mind. You may have a certain way or place you like to be touched. Share what feels good to you.

Redefining yourself and your relationship

"If I can’t look at myself, how can I expect anyone else to?"

"When I look at myself, all I see are scars."

Your partner needs to know that as you heal–and this may take months–things will get better. Your partner may tend to take personally any reluctance on your part to be intimate but this is part of the normal healing and adjustment process.

It is hard to feel romantic when you question your identity and purpose, or spend much of your day as a caregiver.

It is important to remember than any unresolved relationship issues prior to being burned will likely resurface during stressful periods and may require outside counseling.

Tips to help you improve your self-esteem:

• Don’t use your past level of achievements as a gauge for what is acceptable today. This is comparing apples and oranges right now.
• Establish a goal for the day. It doesn’t have to be big, but it has to be there. Establish small goals and celebrate successes as you meet the goals.
• Realize that the healing and adjustment takes time. Just like other tings in your life, you have to work at it.

Overcoming depression and anxiety

"I cry at the drop of a hat."

"It’s more effort than it’s worth."

While burns change your life, they don’t cause depression and anxiety. Those are caused by the forced changes in your life and your reaction to those changes.

Staying active is a good way to fight stress. Ask your health care provider about what exercises are best for you.

Identify your strengths. Recognize what you can do. Don’t focus on what you can’t do. If feelings of depression and anxiety persist, discuss them with your health care provider. You may benefit from medication or counseling.

Resources

• The Phoenix Society of Burn Survivors
• National Burn Victim Foundation
• Your local mental health center
• Your local burn treatment center

See related Patient Textbooks about Surgery.

See related Patient Topics Burn Center, Burns, Injuries and Wounds, Men's Health, Procedures and Therapies, Rehabilitation, Scars, Sexual Health, Sexual Health--General, Skin, Hair and Nails, Surgery, Wellness and Lifestyle or Women's Health.

See related Provider Textbooks about Surgery.

See related Provider Topics Burns, Injuries and Wounds, Men's Health, Procedures and Therapies, Scars, Sexual Health, Skin, Hair and Nails, Surgery, Wellness and Lifestyle or Women's Health.

All contents copyright © 1992-2004 the Author(s) and The University of Iowa. All rights reserved.

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