Objective To explore the effect of skin cosmetic nursing in the aesthetic repair of wound surface in patients with second degree burn. Methods From April 2022 to March 2024, 60 patients with second-degree burn who underwent skin cosmetic nursing in the First Ward of Surgery Department of Dongguan Eastern Central Hospital were selected as the research objects. They were divided into reference group and study group by random number table method, with 30 patients in each group. The reference group was given routine nursing, and the study group was given skin cosmetic nursing on the basis of the reference group. The wound healing, scar condition, complications, nursing satisfaction and scar pruritus were compared between the two groups. Results There was no significant difference in wound healing time, hospitalization time and granulation growth area between the two groups (P>0.05). After nursing, the scores of vascular distribution, color, softness and thickness in the study group were lower than those in the reference group (P<0.05). The incidence of complications in the study group was 10.00%, which was lower than 33.33% in the reference group (P<0.05). The nursing satisfaction of the study group was 96.67%, which was higher than 76.67% of the reference group (P <0.05). After nursing, the FHQ score of the study group was lower than that of the reference group (P <0.05). Conclusion Skin cosmetic nursing is effective in the aesthetic repair of wounds in patients with second-degree burns. It can improve wound healing, scar condition and scar itching, reduce the risk of complications, and improve nursing satisfaction. It is worthy of clinical application.