Intimacy and Sexuality after a Burn Injury

Written by Health Sciences Centre of Winnipeg, Manitoba Firefighters Burn Unit on August 30, 2019

Intimacy + Sexuality
Body Image
Romantic Relationships

Recovering from your burn injury has taken a lot of work and energy. As you heal, you may have concerns beyond your survival and physical recovery, such as feelings about your body and relationships with others. It is normal for someone with a burn injury to have concerns about intimacy and sexuality after a burn injury.

Feeling good about your body and having positive feelings towards sexuality are important, and you have a right to have your concerns dealt with. We realize that this is a sensitive issue, perhaps making it difficult to discuss with staff. Try to remember that sexuality is a normal part of life and that we are here to help you move towards a full recovery.

Feeling good about yourself is the first step.

Feeling good about yourself and your body is the first step towards a healthy body image. Little things like proper grooming can help you feel positive about yourself. Exercise and staying active can increase energy levels and increase your self-esteem.

Set one small goal for yourself each day, for example, showering independently. Reward yourself when these goals are achieved. Recovering from a burn injury is hard work, and you should feel proud of each accomplishment. Don’t focus on what you can’t do, instead focus on your strengths and what you CAN do.

Getting back to "normal."

Resuming intimate relationships comes at a different time for everyone – some do so soon after they leave the hospital and some not for years after their burn injury. A normal sex life is one you and your partner decide is comfortable and gives you both pleasure.

Feeling good about your sexuality after a burn injury is important whether you are in a sexual relationship or not. If you are, you are probably trying to figure out who you are in your relationship. If you are not, hopefully you will come to accept that the burn is part of who you are and what you bring to a new relationship.

Effects of Burns on Sexuality and Some Possible Solutions

Altered Skin Sensation

Skin is very important to our sexuality. A burn injury affects the skin and can change how we experience giving and receiving touch. You and your partner must discover and respect what feels good for each of you, and one way of doing this is by slowly exploring each other’s bodies to learn what causes pain and what gives pleasure. There should be no rush for sexual intercourse; the goal is learning what feels good for both of you.

Rubbing the skin with moisturizing lotion/oil improves the condition and sensitivity of the skin and helps bring closeness and acceptance. Having skin rubbed even in a non-romantic way, such as getting a massage, can promote acceptance and positive feelings towards your skin.

Medication Side Effects

If you suspect that your medication is affecting your sexual function, discuss this issue with your doctor. Sometimes different dosing or an alternate medication may be prescribed.

Decreased Energy Levels

Plan intimate times for periods of the day when your energy levels are high. Save your energy for these times by prioritizing your tasks.

Decreased Mobility, Fragile Skin and Pain

Stiff or painful skin and joints may affect your comfort during sexual activity. Take your pain medication about ½ to 1 hour before to ensure you are in a pain free state. Making sure your skin is well moisturized may improve your mobility. Take time to stretch before or as a part of sex. Avoid positions which put pressure on newly healed grafts. Be creative and experiment with which positions are most comfortable and can accommodate for stiff joints, fragile skin and amputations.

Concerns with Sexual Health

It is common for menstruation to be interrupted after a burn injury, but most women find it starts again spontaneously. Pregnancy can occur during this time, so use appropriate birth control.

Many burn survivors have concerns about breastfeeding and pregnancy. Many females with scarring on their breasts and/or abdomen have healthy pregnancies and have successfully breastfed their children. If you have concerns about pregnancy and/or breastfeeding, find an OB/GYN who you are comfortable with who can address your concerns.

Psychological Effects

Recovering from a burn injury can be stressful, and stress can interfere with feelings of sexuality and intimacy. Exercise, meditation, music, and relaxation techniques are examples of ways to cope with stress in a positive way.

Meeting new people and reconnecting with friends after your injury can cause feelings of anxiety and uncertainty. Your occupational therapists can help you to accept your burn injury and learn ways to feel more comfortable in public. 

Fear of rejection is a common feeling burn survivors have when beginning to date again after a burn injury. Don’t fall into the trap of “blaming the burn.” It is important to remember that rejection is a normal part of dating, and is experienced by everyone, with or without a burn injury. Taking some risks, opening yourself up to new experiences and allowing yourself to be vulnerable are all part of healthy dating and finding a lasting relationship.

If your burn is “hidden”, you will need to decide when and how you will tell a potential romantic partner about your scars. Many burn survivors wear clothing to expose some of his or her scars to allow easier communication about the scars.

If your burns are hidden by your clothing, be sure to discuss your scars with your partner prior to beginning intimate activity. The conversation is much less awkward at this time than it would be when engaged in a sexual encounter. It may be helpful to practice what you are going to say to your partner ahead of time with a trusted friend or your occupational therapists.

Changes in Your Relationship

A burn injury can be hard on relationships. Energy focused on recovering can take time away from your partner and your relationship. Your partner may have a large caregiver role as he or she helps in your recovery. It is a challenge to have the dual roles of caregiver and lover. Make sure to take time to be together as a couple and share activities that you both enjoy. Try to incorporate a lot of non-sexual touching, holding and hugging into your time together.

Feeling depressed, withdrawn and irritable is common while recovering from a burn injury and your partner needs to know that it will get better. Your partner may take this personally, and feel confused or anxious. 

Additionally, your partner may avoid intimacy for fear you're not ready or that they will cause you pain. Communication is an essential part of working through relationship and intimacy issues – from experimenting with comfortable sexual positions to dealing with feelings of withdrawal and confusion. Do not expect your partner to read your mind. Seek the help of a counselor if your relationship issues feel overwhelming.

You're not alone.

Talking with other burn survivors can be valuable for exchanging information and experience. Your occupational therapists will provide you with information on our Peer Support Program, Burn Support Group Meetings and other resources available to you.

Please do not hesitate to discuss any questions or concerns regarding intimacy or sexuality with burn unit staff.