Objective To explore the effect of aesthetic nursing on psychological trauma recovery and scar healing in patients with extensive burn. Methods A total of 80 patients with extensive burn admitted to our hospital from January 2022 to January 2024 were selected. According to the random number table method, they were divided into the reference group and the study group, with 40 patients in each group. The reference group received conventional nursing, and the study group received aesthetic nursing on the basis of conventional nursing. The psychological trauma recovery, self-acceptance and appearance satisfaction, scar healing, nursing satisfaction and quality of life were compared between the two groups. Results After intervention, the scores of PTSD-SS, SAS and SDS in the study group were lower than those in the reference group (P<0.05). The score of BSS in the study group was higher than that in the reference group (P<0.05). The score of VSS in the study group was lower than that in the reference group (P<0.05). The nursing satisfaction score and total score in the study group were higher than those in the reference group (P<0.05). The quality of life score in the study group was higher than that in the reference group (P<0.05). Conclusion Aesthetic nursing is helpful to alleviate psychological trauma, improve quality of life, nursing satisfaction, self-acceptance and appearance satisfaction, and promote scar healing in patients with extensive burn, which is worthy of clinical application.