Sexuality and intimacy

Intimacy is part of recovery

A burn injury or scar can affect much more than the skin. It may change how you experience your body, touch, closeness, relationships and sexuality.

Sexuality does not only mean sexual intercourse. It can also include:

Feeling close to another person
Affection and touch
Feeling attractive or desired
Emotional connection
Sexual thoughts and desire
Sexual activity
How you see yourself as a partner

Some people want to reconnect with intimacy relatively quickly. Others need more time or find that intimacy becomes less important for a while.

Concerns about sexuality, intimacy and body image may occur. You have the right to talk about them and to receive appropriate support during your recovery.

What can change?

The effects are different for every person. They may also change over time.

Your relationship with your body

Scars, changes in skin colour or texture and visible differences may affect how you see yourself. You may feel less confident, feel uncomfortable being seen or want to cover certain areas.

Changes in confidence or concerns about how a partner may respond can sometimes make initiating intimacy feel less natural. Taking things at your own pace and communicating openly can help rebuild comfort, trust and connection.

Body image is about much more than appearance. It also includes how you experience your body, what it allows you to do and how connected you feel to it. This relationship with your body can continue to grow and change throughout recovery.

Skin sensation and physical comfort

Burn scars and newly healed skin can feel different. You may experience complaints such as pain or discomfort, numbness or reduced sensation, increased sensitivity,...

These changes may affect how comfortable certain types of touch, movement or sexual activity feel.

Movement and positioning

Scars near joints or sensitive body areas may restrict movement. Positions that were previously comfortable may become difficult or painful.

This does not necessarily mean that intimacy is no longer possible. Different positions, types of touch or forms of intimacy may help you adapt to changes in movement and sensation.

Energy, desire and sexual function

Recovery can require a great deal of energy. Pain, poor sleep, stress, medication, hormonal changes and physical recovery may contribute to changes in energy, desire, arousal,...

Some medications, including certain pain medicines, antidepressants, antihypertensive medicines and other treatments, may also affect sexual desire or sexual response. Do not stop medication yourself, but discuss possible effects with your doctor.

Emotional and psychological changes

After a burn injury, it is common to experience a range of emotional and psychological changes. Feelings such as anxiety, sadness, post-traumatic stress, changes in self-confidence, or concerns about how others may perceive you can sometimes influence intimacy and relationships. At different stages of recovery, you may find that you:

Feel more aware of changes in your appearance
Wonder how your partner may respond to these changes
Find it challenging to talk about what has changed for you

These experiences are common and do not mean that anything is wrong. They can be a natural part of adjusting to a significant injury, recovery, and changes in your body and daily life. With time, communication, and support, many people find new ways to feel comfortable and confident in (intimate) relationships.

Changes within a relationship

After a burn injury, a partner may temporarily take on a caregiving role, this can change the balance within the relationship.

Both partners may feel uncertain. The person with the burn injury may worry about being rejected, while the partner may be afraid of causing pain or may not know how to start a conversation. Intimacy can sometimes help partners reconnect outside the roles of “patient” and “caregiver”. However, this reconnection usually benefits from time, patience and honest communication.

What can you do yourself?

1. Begin with what feels safe

Intimacy does not need to start with sexual activity.

You can begin with simple forms of closeness, such as:

Sitting or lying close together
Hugging
Giving or receiving gentle touch
Talking about feelings and expectations

Sometimes feeling loved, accepted and safe is enough. Intimacy can gradually develop from there. You are allowed to stop, slow down or change your mind at any time.

2. Talk about what has changed

Your partner cannot always see or understand what you are feeling. Explain which areas feel painful, numb, sensitive or emotionally difficult. Try to talk before an intimate moment rather than only when something goes wrong.

Questions that may help include:

What currently feels comfortable?
Which forms of touch do I enjoy?
Are there areas I do not want to be touched?
What am I worried about?
What would help me feel safer?

In relationships: Do we both feel ready? What kind of closeness do we miss?

It may take some trial and error to discover what works for you now.

3. Focus on your own needs and wishes

Recovery can involve many appointments, exercises and expectations from other people. Intimacy should not become another task that you need to complete. Consider what you want, what feels important to you and what you are not ready for. Small and realistic steps are often more helpful than trying to return immediately to how things were before the injury.

4. Adapt positions and activities

Movement limitations or sensory changes may require a different approach.

You can explore:

Positions that place less tension on scars
Positions that require less strength or energy
Different ways of touching each other

There is no single “correct” way to be intimate. The aim is to find forms of closeness that are comfortable and meaningful for you.

5. Care for newly healed skin

Newly healed skin may be fragile and more likely to become irritated by rubbing or friction.

Regular moisturising can help reduce:

Friction
Itching
Blistering
Shearing or tearing of the skin

Continue to follow the skin and scar-care advice provided by your burn-care team. Discuss persistent pain or skin problems with your healthcare professional.

6. Reconnect with your body

Rebuilding confidence may take time. The goal is not to force yourself to like every change, but to gradually develop a more manageable and compassionate relationship with your body.

Helpful approaches may include:

Positive self-talk

Try to recognise your strengths, progress and resilience rather than focusing only on what has changed.

Exercise and physical activity

Enjoyable physical activity can help you experience what your body can do. It may support strength, confidence, mood and self-esteem.

Keep activities simple and achievable so that they remain motivating.

Mirror use

Some people find it helpful to look at their body in a full-length mirror during dressing changes or after showering. This may help them become more familiar with their changed appearance and regain a sense of ownership over their body.

This is optional. It should never be forced.

Scar coverage

Some people feel comfortable showing their scars, while others prefer to cover them. Both choices are valid.

Options such as clothing, makeup, wigs or decorative coverings may be used when they help you feel more comfortable. The decision should remain yours.

Peer support

Speaking with other burn survivors can reduce feelings of isolation. Hearing how others approached body image, relationships and intimacy may help you feel less alone.

When should you ask for professional help?

Consider speaking to a healthcare professional when:

You simply want information or reassurance about any of these topics
Pain, itching, sensitivity or tightness repeatedly limits intimacy
Your skin is frequently damaged during physical contact
Movement restrictions make comfortable positioning difficult
You experience persistent loss of desire or sexual-function changes
You have menstrual or fertility concerns
Medication appears to affect your sexual wellbeing
Shame, anxiety or negative body image are affecting your daily life
You avoid all forms of closeness because of fear or distress
Intimacy is causing tension within your relationship
You or your partner feel unable to discuss the subject

You do not need to wait until there is a problem. It is appropriate and permitted to raise the subject during rehabilitation or follow-up appointments. Choose a professional with whom you feel comfortable.

Frequently Asked Questions

Is it normal not to feel ready for intimacy?
Can intimacy still be possible when my scars feel painful or sensitive?
Can medication influence sexual desire or function?

Want to read more on this topic? Dive into the research behind it.