Psychological impact and stigma after facial burns: A systematic review

Facial burns pose complex challenges for survivors, encompassing significant physical, psychological, and social burdens. This systematic review aimed to identify the key factors influencing the stigma, social integration, and psychological wellbeing of individuals with facial burns. A comprehensive search was conducted across three major databases: PubMed, EMBASE, and Web of Science. Studies that examined the psychosocial impact of facial burns, including stigmatisation and interventions for recovery, were included. Twenty-two studies with a combined total of 1927 participants, published between 1976 and 2024, met the eligibility criteria. Methodological quality was assessed using the Newcastle-Ottawa Scale, with an average score of 5.8, indicating moderate quality. Results demonstrated that visible scarring, functional impairments, and low socioeconomic status were associated with more severe stigma and greater psychological distress. Children, women, and individuals with financial insecurities were particularly vulnerable to negative psychosocial outcomes. Interventions such as psychological counselling, resilience training, and reconstructive surgery were shown to improve social reintegration and reduce stigma. Community education and structured reintegration programmes played an essential role in supporting recovery. Despite these advances, addressing the stigma associated with facial burns remains challenging. A multidisciplinary approach combining medical, psychological, and community-based interventions is crucial to improving outcomes. Standardised stigma assessment tools should be implemented to identify patients at risk and provide early support. Further research is needed to evaluate long-term psychological trajectories and the effectiveness of stigma-reduction strategies to optimise recovery and quality of life for survivors of facial burns.