Severe and sudden injury to the skin during childhood may damage both the child’s outer appearance and mental state. Such a trauma can provoke a complete and utter breakdown of the core-self and regression to an ‘unintegrated’ state. We present the case of 11-year-old Michael, who played with matches, set a fire and sustained severe burn trauma. Michael was treated in our rehabilitation ward over several months and received skin treatment, physical therapy and psychotherapy. Paediatric burn injury is not only a physical struggle but is often accompanied by intense emotional distress of the child and his family. In describing Michael’s therapeutic process, we show how the restoration of the core-self, alongside the healing of the outer skin, provoke issues concerning early infantile skin formation, normative age-related conflicts and vulnerabilities specific to the child. By integrating psychoanalytic thinking into the clinical work of skin rehabilitation, following burn injury, we demonstrate how the significant relationship between the skin and the self manifest in different practice.