A boy who suffered severe burns to his face and hands may have to spend the next 10 years or more in a full surgical mask, said his parents on Thursday.

Wang Gengxiang, who wears a mask to prevent his facial burns from getting infected, plays with his puppy and Ultraman doll.

Wang Gengxiang, 5, was badly hurt when he fell into a pile of burning straw in a courtyard at his hometown in Fenyang, Shanxi province. He lost most of the skin on his head, as well as his fingertips.

Pictures released of him playing with his puppy while wearing his gray-white elastic headgear, which prevents his scars from becoming infected, touched hearts nationwide.

However, doctors this week revealed they cannot continue his skin-graft surgery until his damaged trachea, or windpipe, is strong enough - which could take more than a decade.

"We have to wait until his trachea is larger, maybe when he's 14 or 19. It depends on his situation," said Shen Chuan'an, deputy director of the burns unit at the First Affiliated Hospital of the People's Liberation Army General Hospital, where Wang - nicknamed Xiangxiang - is receiving treatment.

Along with the financial burden facing the family, the boy's parents are concerned what effect the boy's condition - and mask - will have on his development.

Wang Shouwu, Xiangxiang's father, said many children in the village have refused to play with his son since the accident last November because of the way he looks.

"His friends are afraid of him now. I had to buy snacks for them to play with him," he said, explaining that Xiangxiang spends most time with his 3-year-old brother and puppy.

The boy has even been refused enrollment at the village primary school because the principal is concerned he will frighten other students.

Growing up in the countryside and facing such attitudes "will likely result in Xiangxiang suffering a serious negative impact", said Tian Chenghua, a professor specializing in psychiatric research at Peking University's No 6 Hospital.

"He might learn to avoid society when he grows older," he continued. "People who suffer such disfigurements can grow to resent society for the way they are treated."

Not only does Xiangxiang need extensive physical care, Tian said it is vital he receives psychological support and counseling as he gets older.

For the time being, the farming family is simply trying to cope with the emotional and financial stress.

"His grandmother, who has high blood pressure and heart disease, has been hit very hard and has been sick in bed since the accident. She blames herself because she was taking care of Xiangxiang that afternoon," said mother Wei Yanjun as she played with her son.

Cash donations to help pay the mounting medical costs began flooding in shortly after Xiangxiang's plight was reported in the media, with the total so far standing at more than 300,000 yuan (US$46,000).

On Thursday, a woman who gave her name only as Cao visited the boy in hospital with her husband and gave his parents 500 yuan. As the couple left, Xiangxiang intimated his father by shaking their hands and was still waving goodbye with his burned left hand long after they had disappeared into a nearby elevator.

"The money will go far. We won't give up," said Wang Shouwu, who said the family will return home after the latest round of treatment.