How to treat a first-degree, minor burn
Although first-degree burns are not as serious as higher-degree burns, they can hurt quite a bit and can leave a scar if not properly treated. To treat a first-degree burn at home, follow these tips from dermatologists.
First-degree burns are very common and frequently occur after one accidentally touches a hot stove, curling iron, or hair straightener. Sunburn can also be a first-degree burn. Unlike second- or third-degree burns, which are more severe, first-degree burns only involve the top layer of the skin. If you have a first-degree burn, your skin may be red and painful, and you may experience mild swelling.
Most first-degree burns can be treated at home; however, it’s important to know what to do. Although first-degree burns aren’t as serious as higher-degree burns, they can hurt quite a bit and can leave a scar if not properly treated.
To treat a first-degree burn, dermatologists recommend the following tips:
Cool the burn. Immediately immerse the burn in cool tap water or apply cold, wet compresses. Do this for about 10 minutes or until the pain subsides.
Apply petroleum jelly two to three times daily. Do not apply ointments, toothpaste or butter to the burn, as these may cause an infection. Do not apply topical antibiotics.
Cover the burn with a nonstick, sterile bandage. If blisters form, let them heal on their own while keeping the area covered. Do not pop the blisters.
Consider taking over-the-counter pain medication. Acetaminophen or ibuprofen can help relieve the pain and reduce inflammation.
Protect the area from the sun. Once the burn heals, protect the area from the sun by seeking shade, wearing protective clothing or applying a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher. This will help minimize scarring, as the redness from a burn sometimes persists for weeks, especially in those with darker skin tones.
First-degree burns usually heal on their own without treatment from a doctor. However, if your first-degree burn is very large, if the victim is an infant or elderly person, or if you think your burn is more severe, go to an emergency room immediately.
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In this Article
- Call 911 if:
- For All Burns
- For First-Degree Burns (Affecting Top Layer of Skin)
- For Second-Degree Burns (Affecting Top 2 Layers of Skin)
- For Third-Degree Burns
Call 911 if:
- The burn penetrates all layers of the skin.
- The skin is leathery or charred looking, with white, brown, or black patches.
- The person is an infant or a senior.
For All Burns
1. Stop Burning Immediately
- Put out fire or stop the person’s contact with hot liquid, steam, or other material.
- Help the person “stop, drop, and roll” to smother flames.
- Remove smoldering material from the person.
- Remove hot or burned clothing. If clothing sticks to skin, cut or tear around it.
2. Remove Constrictive Clothing Immediately
- Take off jewelry, belts, and tight clothing. Burns can swell quickly.
Then take the following steps:
For First-Degree Burns (Affecting Top Layer of Skin)
1. Cool Burn
- Hold burned skin under cool (not cold) running water or immerse in cool water until the pain subsides.
- Use compresses if running water isn’t available.
2. Protect Burn
- Cover with sterile, non-adhesive bandage or clean cloth.
- Do not apply butter, oil, lotions, or creams (especially if they contain fragrance). Apply a petroleum-based ointment two to three times per day.
3. Treat Pain
4. When to See a Doctor
Seek medical help if:
- You see signs of infection, like increased pain, redness, swelling, fever, or oozing.
- The person needs tetanus or booster shot, depending on date of last injection. Tetanus booster should be given every 10 years.
- The burn blister is larger than two inches or oozes.
- Redness and pain last more than a few hours.
- The pain gets worse.
- The hands, feet, face, or genitals are burned.
5. Follow Up
- The doctor will examine the burn and may prescribe antibiotics and pain medication.
For Second-Degree Burns (Affecting Top 2 Layers of Skin)
1. Cool Burn
- Immerse in cool water for 10 or 15 minutes.
- Use compresses if running water isn’t available.
- Don’t apply ice. It can lower body temperature and cause further pain and damage.
- Don’t break blisters or apply butter or ointments, which can cause infection.
2. Protect Burn
- Cover loosely with sterile, nonstick bandage and secure in place with gauze or tape.
3. Prevent Shock
Unless the person has a head, neck, or leg injury, or it would cause discomfort:
- Lay the person flat.
- Elevate feet about 12 inches.
- Elevate burn area above heart level, if possible.
- Cover the person with a coat or blanket.
4. See a Doctor
- The doctor can test burn severity, prescribe antibiotics and pain medications, and administer a tetanus shot, if needed.
For Third-Degree Burns
2. Protect Burn Area
- Cover loosely with sterile, nonstick bandage or, for large areas, a sheet or other material that that won’t leave lint in wound.
- Separate burned toes and fingers with dry, sterile dressings.
- Do not soak the burn in water or apply ointments or butter, which can cause infection.
3. Prevent Shock
Unless the person has a head, neck, or leg injury or it would cause discomfort:
- Lay the person flat.
- Elevate feet about 12 inches.
- Elevate burn area above heart level, if possible.
- Cover the person with a coat or blanket.
- For an airway burn, do not place a pillow under the person’s head when the person is lying down. This can close the airway.
- Have a person with a facial burn sit up.
- Check pulse and breathing to monitor for shock until emergency help arrives.
4. See a Doctor
- Doctors will give oxygen and fluid, if needed, and treat the burn.
CDC: вЂњMass Casualties: Burns.вЂќ
Family Doctor: вЂњFirst Aid: Burns.вЂќ
Subbarao, I. AMA Handbook of First Aid and Emergency Care, Random House Reference, 2009.
University of Rochester Medical Center: вЂњHot Tips: First Aid for Burns.вЂќ
Merck Manual: вЂњBurns.вЂќ
New York-Presbyterian: вЂњBurns.вЂќ
Thermal Burns Information from eMedicineHealth
First-degree burns damage the outer layer of skin, leaving a red and painful area at the burn site. Second-degree burns harm both the outer and inner skin layers. These painful burns can include swelling and oozing blisters. Third-degree burns, characterized by charred skin that turns white or creamy in color, need a physician’s care. You can treat most first- and second-degree burns at home.
Rinse the burned area with cold water for 15 to 30 minutes until the pain subsides. If clothing is stuck to the burned area, run cold water directly over the clothing and see a doctor to remove the material. Before flushing a chemical burn, read the label of the product that caused the burn, as water can make some chemical burns worse.
Take an over-the-counter pain reliever like aspirin, ibuprofen, naproxen or acetaminophen.
Cool down the burn with a room fan if the pain remains after the first 30 minutes of applying cold water and taking an over-the-counter pain reliever. Aim the fan directly at the damaged area of your skin.
Wash any blisters that pop open on their own with soap and water and apply an antibiotic ointment.
Cleanse the burned skin gently with soap and water or a Betadine solution once per day after 24 hours elapses to help the injured skin heal. Keep the area covered with dry, clean gauze between washings. Do not use adhesive-type bandages.
Apply an over-the-counter sunburn cooling spray like Solarcaine to treat burns resulting from too much sun.
Apply an over-the-counter lotion containing aloe, or even better, break off a leaf of the aloe plant and peel back the outer leaf layer, rubbing the gel-like sap on the injury. Place the unused portion of the aloe leaf in a plastic bag and put in the refrigerator to repeat as needed.
Smear on an over-the-counter antibiotic ointment containing polymyxin B sulfate or bacitracin ingredients. This will ward off infections and speed up the healing process.
Break open a Vitamin E capsule, as the damaged skin is starting to heal, and drip the oil over the burned area. This will help prevent scarring.
Any large burn (more than 3 inches in diameter), or any burn worse than second-degree, must be attended to by a physician. See a doctor, also, if the burned area is on the face, pelvic or pubic area, or in the eyes.
Do not pop blisters that can appear with second-degree burns.
Do not apply butter to burns. Butter will actually hold the heat in the burnt area of the skin, making the injury worse.
Stay safe when using fires or hot liquids
Be careful when drinking hot liquids to avoid getting burned.
Ouch! I Burned My Skin, Now What?
- Put the affected area in cool water or apply a cold, wet compress
- Apply petroleum jelly a few times each day
- Consider taking over-the-counter pain medicine like acetaminophen or ibuprofen to ease pain
- Protect the affected area from the sun
- Follow all first degree burn treatment recommendations
- Don’t break any blisters
- Apply a bandage if the skin or blisters are likely to become irritated by clothing or daily activity, or if the blisters have broken open
- Seek immediate medical attention
- While waiting for medical help to arrive, cover the affected area in a clean bandage and attempt to raise the affected area above the heart
How to Avoid Getting Burned
It’s likely you’ll experience a burn at some point. Accidents happen! However, there are some steps you can take to reduce the risk of injuring you or those around you.
- Keep hot foods and beverages away from table edges
- Don’t leave hot beverages or cooking pots and pans unattended around children or pets
- If using a travel mug be sure to use a spill-proof lid
- Don’t overfill cups or bowls
- Warn others when a hot liquid or dish is being served
- Use oven mitts when cooking or handling hot food and drinks
- Warn others when household appliances such as a stove or iron may be hot
MedlinePlus, National Library of Medicine, National Institute of General Medical Sciences, US Fire Administration
This blog post is based on scientific evidence, written and fact checked by our doctors.
Our team of dermatologists and formulators strive to be objective, unbiased and honest.
This article contains scientific references. The numbers in the parentheses are clickable links to research papers from reputed academic organizations.
How often have you touched a hot, burning oven or dropped some scalding water or oil on yourself while cooking in the kitchen? If you can relate with this, you must definitely be having burn scars scattered all over your hands, right?
Burn scars can also be caused by exposure to certain chemicals, UV rays and severe fire accidents. While some burn scars fade away on their own, the others take a long time to heal and may even become a permanent part of your skin.
In this article, we tell you immediate steps to follow after a burn to prevent and treat scars.
- Why Do Scars Form After Burns?
- Types Of Burn Scars
- Treatments For Burn Marks
- How To Prevent Burn Scars From Forming?
- Complications Related To Burn Marks
Why Do Scars Form After Burns?
Burns cause your cells to die, after which the skin produces a fibrous protein to repair itself. This fibre is called collagen. As your skin heals, it leaves discolored patches of skin on the wounded area. These areas are usually thick and are what we call scars. Depending on the depth of the burn, these scars may be temporary and sometimes even permanent.
Types Of Burn Scars
Firstly, let us look at the types of burns:
1. First-Degree Burns
First-degree burns are usually associated with a damaged epidermis (surface of the skin). You may also notice some redness, pain and inflammation.
2. Second-Degree Burns
Second degree burns damage the first two layers of your skin. This causes your skin to turn red and get inflamed. You may also find them quite painful.
3. Third-Degree Burns
These burns are the more severe kinds of burns. Along with damaging the layers of your skin, they may also penetrate your skin to reach your tissues and muscle structures. Your skin may change color as well. These burns can also restrict joint movement.
Now, here are the types of scars that burns can leave behind:
1. Hypertrophic Scars
These scars are usually red or purple in color. They tend to be raised and itchy.
2. Contracture Scars
These scars usually tighten the skin and muscles. If you have a contracture scar, you may notice difficulty in moving.
3. Keloid Scars
These kinds of scars form shiny, hairless bumps on the skin.
Treatments For Burn Marks
The ideal treatments for burn scars depends on how severe it is and the degree of burns.
For first-degree burns, apply an antibiotic cream to the affected area. This will help the wound heal faster and will also reduce inflammation and discomfort. Use a piece of gauze to cover your burn mark to prevent infection.
For second/third-degree burns, wearing a compression garment can help heal your skin faster. These are usually tight garments that may have to be worn for many months till your burn marks heal. Some may even prefer a skin graft. This technique involves using the skin from one area (donor) of your body to cover the burned area.
Here are some other therapies/treatments for burn marks:
1. Laser Therapy
Laser light therapy uses UV rays to target blood vessels in the excess scar tissues. This can help in reducing bumps and redness associated with scarring (1).
In case you decide on going in for laser therapy, make sure your doctor has experience in scar removal treatments using the same.
2. Steroid Injections
Corticosteroid injections can be used to soften the appearance of a scar. They work well to reduce the appearance of certain hypertrophic and keloid scars (2).
Talk to your doctor about whether or not these injections can be used to treat your burn scars.
This technique uses liquid nitrogen to freeze the developing scars. It can be used on keloid scars to soften them before they completely emerge. Cryotherapy has shown some promising results in treating keloid scars (3).
Surgery may be used to treat a scar if it is very prominent on your skin or to improve movement.
Surgery can help soften the appearance of your scar and make it less noticeable. It can also help loosen a tight scar that prevents movement of a joint.
This procedure is an invasive technique that may not suit everybody. Based on your doctor’s recommendations, you can choose whether or not to go in for surgery.
Physiotherapy may help improve your movement in areas that have been tightened after the burn marks.
6. Silicone Gels
These help in effectively softening a scar. They can be used on healing scars (not open wounds). Silicone gels to address scarring has become a popular method in the recent past (4).
Moisturizers may not treat the scar. However, it can soften the appearance of it. These need to be used consistently for three months for about 12 hours everyday. Talk to your dermatologist about the right silicone gel treatment for your scar.
How To Prevent Burn Scars From Forming?
As Soon As The Burn Occurs, A Person Can
- Rinse it with cool water and let it dry.
- Use an antibiotic ointment.
- Cover the area using a nonstick bandage and a piece of gauze.
You Can Also Try To
- Stretch the affected area gently to prevent the skin from sticking together.
- Cover the affected area for a few months to prevent sun damage.
Visit your doctor regularly till your burn heals. Make sure that you address your burn as soon as it occurs. If you notice too much redness and don’t see it heal, visit your doctor.
Complications Related To Burn Marks
A burn is an open wound that allows bacteria and other microbes to enter the body, if not treated properly. This can result in minor or severe infections. It can also result in sepsis, if these microbes enter your bloodstream, which can be life-threatening.
When you burn your skin, it is likely that your body will lose some fluids. If left untreated, burn marks can also cause dehydration.
3. Restricted Movement Or Contractures
This can be the result of a third-degree burn. Contractures occur when the skin is healing, which may cause it to feel tight. This may restrict the movement of your joints.
4. Muscle And Tissue Damage
Severe burns can sometimes damage your tissue muscle structures.
5. Emotional Health
The appearance of burn marks or any other complications may take a toll on a person’s mental health. It is advised to seek professional help if these marks are interfering with your quality of life or your emotional state of mind.
Treatment for burn scars are classified depending on their depth and how many layers of your skin they affect. Complications of burn marks include contractures, infections, emotional health issues, muscle damage and dehydration. Remember to take immediate precautions and visit your doctor soon after a burn.
If you have ever burned your tongue you know how aggravating it can be. It’s the only thing you can think about until it has healed. It hurts, it prevents you from eating and drinking normally, and it may last longer than you think it should. It’s possible to burn your tongue on any food or drink if you underestimate its temperature. But what occurs physically when you burn your tongue and why does it hurt so much? Here are the facts.
The tongue is actually quite sensitive
For all we put it through; eating foods that are rough, hard, or scratchy, and drinking liquids that range from icy cold to steaming hot, the tongue is actually a very sensitive organ – it has to be in order to taste hundreds of different flavors and feel myriad textures. The surface of the tongue is made up of tiny round bumps called papillae that contain the taste buds. Inside the bumps are microvilli that look like tiny hairs – hundreds of thousands of them1 – that sense temperatures, tastes and textures on the tongue. The microvilli send messages to the brain where they are decoded to tell us what we are tasting or feeling in our mouth. It is these tissues, the papillae, that can be burned and injured by extreme heat or cold.
When the tongue is burned the taste buds become swollen and traumatized. This can disrupt the ability of the microvilli to accurately detect what it is tasting or sensing. That is why when the tongue is burned, food and drink may taste different until it has healed. The taste buds for sour things are located on either side of the tongue. The taste buds for salty/sweet things are located on the front of the tongue and bitter taste buds are on the back of the tongue. These tastes will be affected temporarily depending on exactly where you burn your tongue.
Three different types of burns
For the majority of people, burns to the tongue are superficial and heal quickly, but there are three types of burns that can be sustained:
- First-degree burn: Involves the top layer of the tongue and makes it red and swollen.
- Second-degree burn: Involves the top layer and the under layer of the tissue. The tongue is red and swollen and blisters may form.
- Third-degree burn: Involves deep tissues of the tongue. It may be white or black with numbness and/or severe pain.
If you suffer a first degree burn on the tongue some simple first aid steps will help:
- Rinse your tongue or gargle with cool water
- Hold a cool cloth to the tongue
- Use popsicles or ice chips to reduce pain
- Avoid liquids and food that are warm or hot as they might aggravate the burn
- Take over-the-counter medications to address the pain, such as acetaminophen and/or ibuprofen (it’s always a good idea to consult with your ENT doctor before taking any medication)
Second and third degree burns on the tongue are more serious and should be checked immediately by an ear, nose, throat doctor to ensure that infection does not set in.
The tongue can heal quickly
There is no way to say precisely how long it will take a tongue burn to heal, but in general it should take two weeks or less. The tongue, lips, and tissues in the oral cavity heal quickly for several different reasons.
- They are mucous tissues that have a simpler composition than skin tissue. As a result, the cells regenerate faster, resulting in a shorter healing time.
- Mucous tissue also contains many different blood vessels and increased blood flow means increased oxygen to the area, which hastens healing.
- Saliva may lead to rapid healing. One study2 showed that a protein contained in saliva may increase healing. In fact, a wound created in a culture of that protein healed in just over 16 hours whereas a similar wound in a non-treated culture never healed completely.
Burning the tongue hurts. The good news is that for most burns of the tongue, simple first aid steps can reduce the discomfort and the burn will heal in a short period of time. The important thing to remember is if you do burn your tongue and it is not getting progressively better, contact an ear, nose, throat specialist right away. Protecting your tongue is essential for speech and taste, and you want to make sure that a hidden illness or infection is not affecting its function.
- Medical Author: Benjamin Wedro, MD, FACEP, FAAEM
- Medical Editor: Melissa Conrad Stöppler, MD
- Medical Editor: William C. Shiel Jr., MD, FACP, FACR
Introduction to burns
The skin has an important role to play in the fluid and temperature regulation of the body. If enough skin area is injured, the ability to maintain that control can be lost. The skin also acts as a protective barrier against the bacteria and viruses that inhabit the world outside the body.
The anatomy of the skin is complex, and there are many structures within the layers of the skin. There are three layers:
- Epidermis, the outer layer of the skin
- Dermis, made up of collagen and elastic fibers and where nerves, blood vessels, sweat glands, and hair follicles reside
- Hypodermis or subcutaneous tissue, where larger blood vessels and nerves are located. This is the layer of tissue that is most important in temperature regulation.
The amount of damage that a burn can cause depends upon the type of burn, its location, its depth, and how much body surface area that it involves.
How are burns classified?
Burns are classified based upon their depth.
A first-degree burn is superficial and causes local inflammation of the skin. Sunburns often are categorized as first-degree burns. The inflammation is characterized by pain, redness, and a mild amount of swelling. The skin may be very tender to touch.
Second-degree burns are deeper and, in addition to the pain, redness and inflammation, blistering of the skin also occurs.
Third-degree burns are deeper still, involving all layers of the skin, in effect killing that area of skin. Because the nerves and blood vessels are damaged, third-degree burns appear white and leathery and tend to be relatively painless.
Burns are not static and may mature. Over a few hours a first-degree burn may involve deeper structures and become second degree. Think of a sunburn that blisters the next day. Similarly, second-degree burns may evolve into third-degree burns.
Regardless of the type of burn, inflammation and fluid accumulation in and around the wound occur. Moreover, the skin is the body’s first defense against infection by microorganisms. A burn is also a break in the skin, and the risk of infection exists both at the site of the injury and potentially throughout the body.
Only the epidermis has the ability to regenerate itself. Burns that extend deeper may cause permanent injury and scarring and not allow the skin in that area to return to normal function.
First, Second, & Third Degree
The treatment of burns depends on the depth, area and location of the burn. Burn depth is generally categorized as first, second or third degree. A first-degree burn is superficial and has similar characteristics to a typical sunburn. The skin is red in color and sensation is intact. In fact, it is usually somewhat painful. Second-degree burns look similar to the first-degree burns; however, the damage is now severe enough to cause blistering of the skin and the pain is usually somewhat more intense. In third-degree burns the damage has progressed to the point of skin death. The skin is white and without sensation.
What is the significance of the amount of body surface area burned?
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In addition to the depth of the burn, the total surface area of the burn is significant. Burns are measured as a percentage of total body area affected. The “rule of nines” is often used, adjusted for infants and children. This calculation is based upon the fact that the surface area of the following parts of an adult body each correspond to approximately 9% of total (and the total body area of 100% is achieved):
- Head = 9%
- Chest (front) = 9%
- Abdomen (front) = 9%
- Upper/mid/low back and buttocks = 18%
- Each arm = 9%
- Each palm = 1%
- Groin = 1%
- Each leg = 18% total (front = 9%, back = 9%)
As an example, if both legs (18% x 2 = 36%), the groin (1%) and the front chest and abdomen were burned, this would involve 55% of the body.
Only second- and third-degree burn areas are added together to measure total body burn area. While first-degree burns are painful, the skin integrity is intact and it is able to do its job with fluid and temperature maintenance.
If more than 15%-20% of the body is involved in a burn, significant fluid may be lost. Shock may occur if inadequate fluid is not provided intravenously. As the percentage of burn surface area increases, the risk of death increases as well. Patients with burns involving less than 20% of their body should do well, but those with burns involving greater than 50% have a significant mortality risk, depending upon a variety of factors, including underlying medical conditions and age.
How important is the location of a burn?
Burn location is an important consideration.
If the burn involves the face, nose, mouth, or neck, there is a risk that there will be inhalation injury and enough inflammation and swelling to obstruct the airway and cause breathing problems.
If there are circumferential burns to the chest, as the burn progresses, the tissue involved may not allow enough motion of the chest wall to allow adequate breathing to occur. If circumferential burns occur to arms, legs, fingers, or toes, the same constriction may not allow blood flow and put the survival of the extremity at risk. Burns to areas of the body with flexion creases, like the palm of the hand, the back of the knee, the face, and the groin may need specialized care. As the burn matures, the skin may scar and shorten, preventing full range of motion of the body area.
What about electrical burns?
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Electrical burns may cause serious injury that is not readily apparent. Often the entry and exit points for the electrical shock may not be easily identified.
Electricity flows more easily through tissues in the body that are designed to deal with electricity. Nerves and muscles are “wired” for this task and often are damaged. If significant muscle damage occurs, muscle fibers break down and chemicals can be released into the bloodstream causing electrolyte disturbances and kidney failure.
What about chemical burns?
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Burns can also occur when chemicals are spilled onto the body and generate a reaction that creates heat. Chemical burns may be classified by their pH or acidity.
- Acids are those with pH less than 7 and include common household compounds like acetic acid, hydrochloric acid, or sulfuric acid.
- Bases or alkali compounds have a pH greater than 7. Ammonia is a common alkali found in the home.
What is a burn? It’s a form of injury to body tissues which is caused by heat, corrosive substances or friction. There is another form of burn, which is known as scald; it results from exposure to hot water or steam.
There are three degrees of burns, explained below.
First degree burn: It’s the least serious burn. The injury is limited only to the outer layer of skin (epidermis), but not all the way through. The skin is usually red with swelling and pain sometimes present. First degree burns are always considered minor burns.
Second degree burn: The injury is inflicted to the first layer of skin (epidermis) and the second layer of skin (dermis). Blisters usually develop with this type of burn. Severe pain and swelling are very common. Second degree burns could be considered minor burns if they affect less than 15% of body surface area, otherwise they would be considered major burns.
Third degree burn: It’s the most serious form of burn. The injury extends very deep into the skin. The affected area appears very dark or extremely white. Due to destruction of nerves in this type of burn, the patient usually doesn’t feel pain. This type of burn may be fatal if it’s not properly treated. Third degree burns are always considered major burns.
When You Should Get Immediate Medical Attention
- When there’s a large significant second degree burn.
- When there’s any third degree burn.
- When there’s any neck or facial burns, no matter the degree.
- If there’s difficulty in breathing (smoke may induce severe lung injury).
- If the burn was due to exposure to electricity (heart problems area common with such cases).
- If the burn was due to exposure to chemicals, e.g. acids or alkalis.
What You Should Do Until Medical Care Is Available
Step 1 Step 1 Get away fast
To prevent further damage to the skin and underlying tissue, quickly move away from the hot water or fire—the less exposure, the lesser the burn.
Step 2 Step 2 Expose the burnt skin
Exposing the burn is very important, as it gives you a better chance to asses the type and extent of the burn. Remove any clothes covering it. Also, removing clothes covering the burn is essential for the next step.
Step 3 Step 3 Cool the burn site
Cool tap water is sufficient to prevent further damage to the tissue. Never put ice on burns; as ice induces narrowing of small blood vessels in the site of the burn, leading to ischemia and more tissue damage.
Step 4 Step 4 If it’s a 1st degree burn
If it looks like a 1st degree burn, one with red skin but no blisters, you may manage that burn at home by yourself if you have the knowledge to do so.
- Never apply a bandage to this type of burn.
- Wash the skin with any antiseptic solution, e.g. Betadine.
- Cover the burn with any pain relieving ointment containing local anaesthetic, e.g. 1% lidocaine.
- You may take one tablet of aspirin to reduce the pain.
- It would take 4-6 days to heal completely.
- Go to the physician when blisters start to appear in the site of the burn.
Step 5 Step 5 If it’s a 2nd degree burn
If you see blisters, it’s probably a 2nd degree burn. Generally, after putting it under tap water and cleaning it with antiseptic solutions, do the following.
- Local pain relieving ointment may be used.
- Never break the blisters (for fear of infection).
- Sterile vaseline gauze is used to cover the site of blister (never use cotton or classic gauze, as they may become adherent to the tissue, leading to more injury when they get removed).
- Change the bandage every 1-2 days. But before putting down the new bandage, make sure to wash the burn with water and antiseptic solution.
- Look for any sign of infection that may superimpose the site of burn, e.g. fever, unexplained increases in pain at the site of burn or any abnormal discharge like pus.
- Never treat a 2nd degree burn if it’s located on the face or neck.
- Never treat a 2nd degree burn if its size is more than 3cm wide.
Step 6 Step 6 If it’s a 3rd degree burn
Don’t treat yourself. Seek medical attention immediately.
Step 7 Step 7 Seek medical care
If it’s third degree, seek care immediately. If it’s first or second and you’re worried about it, never hesitate to go to your own physician to make sure everything is okay.
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By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS
Health care professionals encounter burns in their patient populations frequently, and must be able to differentiate between types of burns, as well as know how to treat burn injuries using current practice standards. The following is an overview of first and second degree burns, including pathophysiology and treatment.
First Degree Burns
First degree burns, often referred to as superficial burns, affect only the epidermis or outermost layer of skin. They are dry, red and can be very painful. When touched, skin that is burned superficially will blanch. The injured epidermis will slough off after a few days. These burns generally heal quickly and do not cause scarring.
First degree burns are not considered to be open wounds; therefore, they require no dressings. Cool compresses may provide some relief from pain. In addition, moisturizers may increase comfort. Analgesics may be required for patients who experience large first degree burns. Some patients may even require hospitalization briefly in order to control pain. Antimicrobials are not required for first degree burns. Patients may be advised to apply a moisturizer containing a sun block to the burned area(s) until the burns have healed entirely.
Second Degree Burns
Second degree burns, also referred to as partial-thickness burns, are divided into two categories:
- Superficial partial-thickness burns – these burns involve the epidermis and the dermis. The dermis is only involved superficially. Second degree burns are moist and red. There may be blister formation. These burns are very painful due to the fact that nerve endings are intact but are exposed due to loss of the epidermis. Scarring may result, but is generally minimal. Superficial partial-thickness burns normally heal in approximately two weeks.
- Deep partial thickness burns – these burns involve the epidermis and extend through most of the dermis. They are less red and are drier than superficial second degree burns. They may also be less painful. These burns may take up to a month to heal, and scarring may be extensive.
It is important to remember that burns often contain a mixture of burn depths; therefore it is possible for a patient to have areas of both first and second degree burns.
There are two schools of thought in regards to how to treat blisters associated with second degree burns. Some experts favor leaving blisters intact, as they believe that blister formation protects the wound bed, keeping it moist, protected and clean, and that purposefully breaking or debriding blisters increases the risk of infection. Experts in favor of puncturing or debriding blisters believe that the fluid contained in blisters may provide a medium for bacterial growth, and that this fluid also inhibits immune function. There are valid arguments on both sides of the issue. Whether to leave blisters intact should be decided on an individual basis.
Dressing second degree burns should take into account keeping the wound bed moist and protected, as well as clean. In addition, patient comfort must be considered. The following are some points to keep in mind when considering dressing options for second degree burns:
- Avoid occlusive dressings, as they do not allow drainage of exudates and may provide an environment conducive to the development of infection.
- Silver sulfadiazine may be used for deep partial thickness burns. It is a broad spectrum antimicrobial. Do not use if the patient is allergic to sulfa drugs, is pregnant, or is an infant less than two months of age.
- Wrap fingers individually when dressing burn wounds to fingers.
- When dressing burns that are over a joint, be sure to allow full range of motion.
- Hydrofibers, alginates and foam dressings may be used on superficial partial thickness burns. These products may require fewer dressing changes. In addition, they absorb exudate and keep the wound bed moist.
- Bacitracin may be used on superficial partial thickness wounds. The ointment should be covered with a non-adherent dressing and dry gauze to secure it in place. Dressings may require changing twice a day, but should be changed once per day at a minimum.
- Burns should be cleansed initially with a commercial wound cleanser or a gentle soap and water.
It may be a simple matter to differentiate between first and second degree burns, but it is often more difficult to differentiate between superficial and deep partial-thickness burns. Deep second degree burns sometimes require grafting and a surgeon should be consulted if there is any doubt, particularly when burns are extensive.
Moss, L. (2010) Treatment of the burn patient in primary care. Advances in Skin and Wound Care 2010, 23: 517- 524.
About The Author
Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS is a Certified Wound Therapist and enterostomal therapist, founder and president of WoundEducators.com, and advocate of incorporating digital and computer technology into the field of wound care.
The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.
A burn is damage to your skin, most often caused by fire/flame or steam and hot liquids. Burns can also be caused by chemicals, heated objects, or even electricity. They range from minor to severe, and while serious injuries can be life-threatening, any burn that causes a break in the skin can result in an infection, which can lead to sepsis.
Sometimes incorrectly called blood poisoning, sepsis is the body’s life-threatening response to infection. Sepsis kills and disables millions and requires early suspicion and treatment for survival.
Sepsis and septic shock can result from an infection anywhere in the body, such as pneumonia, influenza, or urinary tract infections. Worldwide, one-third of people who develop sepsis die. Many who survive are left with life-changing effects, such as post-traumatic stress disorder (PTSD), chronic pain and fatigue, organ dysfunction (organs don’t work properly), and/or amputations.
Types of burns
Burns are categorized according to their severity:
These are the types of burns that most people experience at some time. They are minor injuries that affect just the outer layer of skin, called the epidermis. They can be painful, causing redness to the skin and some swelling. Mild sunburns are a common type of first degree burn.
These injuries are deeper than first degree burns, affecting the epidermis and the second layer of the skin, called the dermis. If the burn is small, less than two to three inches wide, it is considered minor, but more extensive second degree burns are treated as major burns. Second degree burns are also considered major if they are on the face, hands, feet, a major joint, groin/genitals, or buttocks.
Second degree burns are usually painful and cause redness and swelling. They may cause blistering and breaks in the skin, increasing your risk of developing an infection. Sunburns that blister and are very painful are considered to be second degree burns.
These are serious injuries, even if they are small. They can be life-threatening. These burns go through the layers of the skin to the fat below. There may be no pain in the area because the nerves may be destroyed, although there will likely be pain around the site, where the burns are not as deep.
People with third degree burns are at particular risk for dehydration, infection, and sepsis.
Burns on your face
Burns on your face, regardless of the severity, may also cause internal burns in your airway, which can be life-threatening. Facial burns can happen as part of a larger burn, but your face can get burned if you are too close to the flame when you light a barbecue or pilot light, or even if you suddenly release steam from a pot, for example. If you have burned in your airway, you may experience:
- Burns on your lips and mouth
- Difficulty breathing
- Changes in your voice
Major burns must be treated as medical emergencies. Seek emergency help or call 9-1-1 if you have a third-degree or a second-degree burn that covers more than two to three inches in width or is on your face, hands, feet, a major joint, groin, genitals, or buttocks.
- Soak the burned area in water
- Put ice on the burned area
- Apply any ointments or creams to the burned area
- Remove any clothing or fabric that is stuck to the burned area
If a chemical causes the burn, rinse the area with clean running or poured water to try to flush the chemical away. By running or pouring water over the burn, the chemical may be pushed off and away from the skin. If possible, loosely cover the burn with a clean or sterile cloth or bandage.
Treatment for severe burns may include:
- Intravenous (IV) fluids to keep you hydrated
- Medications, particularly for pain
- Burn creams and ointments, and special burn dressings
- Antibiotics to treat infections
Care for less serious burns
First degree and smaller second degree burns are usually managed well at home. First aid may include soaking the burned area in clean, cool (not cold) water for a few minutes to stop the burning process and then drying gently. Pat to dry, do not rub. Creams, such as aloe vera or burn ointments, may help relieve some of the pain or discomfort. Keep the burns clean and loosely covered, and monitor for breaks in the skin and signs of infection. Do not break any blisters that may form.
If you show any of the following signs of infection, contact your doctor or go to an urgent care clinic, so your burn can be evaluated and treated:
- Pus or discharge from the burn site
- Increase in pain
- Change of color around the burned area
If you suspect sepsis, call 9-1-1 or go to a hospital and tell your medical professional, “I AM CONCERNED ABOUT SEPSIS.”
Would you like to share your story about sepsis or read about others who have had sepsis? Please visit Faces of Sepsis, where you will find hundreds of stories from survivors and tributes to those who died from sepsis.
M3 India Newsdesk Nov 15, 2020
Dr. Sunil Keswani, an acclaimed Cosmetic Surgeon provides the treatment protocol and clinical management tips for treating burn injuries, commonly reported during Diwali.
Diwali, a religious and cultural festival celebrated all over India as well as outside the country has people lighting earthen lamps and bursting firecrackers. But, there are also many burn injuries reported during this season, especially during the first 3 days of the festival.
Research studies have shown that 70% burns in the age group of 10 to 15 is from firecrackers (64% are from flowerpots, 13% from bombs, and 9% from chakras). Flowerpots, bombs, and chakras are the main causative agents of firecracker burns in India.
The hands, face, and eyes are more commonly affected body parts during such accidents. Careless lighting of crackers during Diwali or lighting crackers as part of a competition among children often leads to these mishaps. Lack of adult supervision, use of synthetic clothing and flammable flowing fabrics add to the problem.
Flame burns and treatment
In flame burn wounds, subjective and objective evaluation is needed.
- Subjective evaluation of burn wound is based on the external features of the wound such as wound appearance, capillary refill, and burn wound sensibility to touch and pinprick
- Objective evaluation is based on the base of the wound site, size and depth, and age of the patient
Most of Diwali burns are minor- less than 10%.
Wound assessment and treatment
The wound site is assessed based on the anatomical part that is affected.
- Size of the burn is usually represented as a percentage of total body surface area (%TBSA) by using Wallace rule of nines, Lund and Browder chart, and the rule of palm
- Depth of the burn wound is measured from the visible area to the deepest area
Wound depth is categorised as follows:
- Superficial Dermal- usually pink, moist, blistered, blanch on pressure and are very painful
- Mid-Dermal- difficult to assess on the first look, but after 10-14 days the wounds reveal their true depth (second look)
- Deep Dermal- wound is dry and pearly (waxy) and white in color
- Full-thickness- visible thrombosed capillaries, venules, or other blood vessels, leathery in appearance, painless, leads to loss of hair follicles, sebaceous and sweat glands
- Small blisters ( 5cm) should be ruptured if it is in an odd part (over joints) or if they produce functional impairment at the time of initial dressing
Assessing degree of burns
There are three types or levels of burns:
- First degree:
- It involves only the epidermis and this can be treated by antibacterial cream
- It heals spontaneously in 7 days
- Second degree: A second-degree burn involves the whole epidermis and varying depth of dermis and is classified into superficial and deep burn
- Second-degree superficial burn can be treated by regular dressing with antibacterial cream under aseptic precautions and it heals spontaneously in 7 to 14 days
- Second-degree deep burn requires surgical intervention in the form of early skin excision and grafting with autograft or homograft
- Third-degree: It does not heal spontaneously and requires surgical intervention
Acute burn management protocol
- Water should be poured on burn wounds for 3 to 4 hours or till the burning sensation subsides, but ice-cold water is not recommended on burn wounds because it can be dangerous
- In case water is not available, the patient should be wrapped in a clean thick blanket or cloth and the victim should be made to rest on the floor
Treatment according to the anatomical part
Face, eyes and hand burns are more commonly reported during Diwali.
- Eye burns:
- Ophthalmic opinion is required to rule out corneal injury and per orbital oedema
- Treatment involves irrigation with copious normal saline and maintenance of adequate lubrication by use of antibiotic drops or ointment
- Face burns: Lips and mouth burn wounds should be treated with local application of lubricant cream or ointment to prevent cracking and bleeding
- Hand burns:
- Wound should be treated with close sterile dressing using Soframycin cream and dressing needs to be changed every alternate day
- Kollagen-M dressing should be done for superficial burns
- Hands and feet should be elevated, especially if the wounds are in the extremities
- The patient should be advised complete bed rest
- Oral antibiotics, anti-inflammatory, and analgesic drugs should be prescribed for healing
- To prevent functional deformities, physical rehabilitation (physiotherapy) should be advised for 15 days after complete wound healing
This article was originally published on November 6, 2018.
Disclaimer- The views and opinions expressed in this article are those of the author’s and do not necessarily reflect the official policy or position of M3 India.
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- WebMD – Burn
- Mayo Clinic – Burn
- burn and scald – Children’s Encyclopedia (Ages 8-11)
- burn and scald – Student Encyclopedia (Ages 11 and up)
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- WebMD – Burn
- Mayo Clinic – Burn
- burn and scald – Children’s Encyclopedia (Ages 8-11)
- burn and scald – Student Encyclopedia (Ages 11 and up)
Read a brief summary of this topic
burn, damage caused to the body by contact with flames, hot substances, certain chemicals, radiation (sunlight, X rays, or ionizing radiation from radioactive materials), or electricity. The chief effects of contact with flame, hot water, steam, caustic chemicals, or electricity are apparent promptly. There is a delay of several hours before the full effects of sun or ultraviolet burns are apparent and a delay of 10 to 30 days before the full effects of ionizing radiation burns are apparent.
The severity of a burn depends largely on the depth of tissue destruction and the amount of body surface affected. Other factors—including the patient’s age and prior state of health, the location of the burn wound, and the seriousness of any associated injuries—can also influence recovery from a burn.
For an appreciation of how depth and size of a burn affect the severity of the injury, some understanding of the anatomy and physiology of the skin is necessary. Human skin is composed of two layers: an upper layer called the epidermis, and a lower layer known as the dermis (or corium). The largest of the body’s organs, skin performs a number of vital functions. Its foremost job is to separate the external environment from the body’s interior. The epidermis, the outer surface of which consists of dead, cornified cells, prevents infectious microorganisms and other harmful environmental agents from gaining entrance to the body. The dermis, by contrast, is made up of fibrous connective tissues that prevent the evaporation of body fluids. Embedded within the dermis and opening to the skin surface are the sweat glands. These secrete perspiration, the evaporation of which helps regulate body temperature. Perspiration also contains small amounts of sodium chloride, cholesterol, aluminum, and urea; it thus plays a role in regulating the composition of body fluids. The dermis also contains all of the skin’s blood vessels and nerves, including sensory nerve endings that respond to touch, pressure, heat, cold, and pain. The skin therefore also serves as a sense organ that enables a person to adjust to changing environmental conditions. One final function of the skin is the synthesis of vitamin D, a compound essential to growth and maintenance, particularly of bone. Vitamin D is formed by the action of sunlight on certain cholesterol compounds in the dermis. Destruction of the skin by deep or extensive burns can disrupt all of these functions, subjecting the victim to serious complications.
Physicians have traditionally categorized burns as first-, second-, or third-degree injuries, according to the depth of skin damage (see illustration ). In a first-degree burn, only the epidermis is affected. These injuries are characterized by redness and pain; there are no blisters, and edema (swelling due to the accumulation of fluids) in the wounded tissue is minimal. A classic example of a first-degree burn is moderate sunburn.
The damage in a second-degree burn extends through the entire epidermis and part of the dermis. These injuries are characterized by redness and blisters. The deeper the burn the more prevalent the blisters, which increase in size during the hours immediately following the injury. Like first-degree burns, second-degree injuries may be extremely painful. The development of complications and the course of healing in a second-degree burn depend on the extent of damage to the dermis. Unless they become infected, most superficial second-degree burns heal without complications and with little scarring in 10 to 14 days.
Third-degree, or full-thickness, burns destroy the entire thickness of the skin. The surface of the wound is leathery and may be brown, tan, black, white, or red. There is no pain, because the pain receptors have been obliterated along with the rest of the dermis. Blood vessels, sweat glands, sebaceous glands, and hair follicles are all destroyed in skin that suffers a full-thickness burn. Fluid losses and metabolic disturbances associated with these injuries are grave.
Occasionally burns deeper than a full thickness of the skin are incurred, as when part of the body is entrapped in a flame and not immediately extricated. Electrical burns are usually deep burns. These deep burns frequently go into the subcutaneous tissue and, at times, beyond and into the muscle, fascia, and bone. Such burns are of the fourth degree, also called black (because of the typical colour of the burn), or char, burns. Fourth-degree burns are of grave prognosis, particularly if they involve more than a small portion of the body. In these deep burns toxic materials may be released into the bloodstream. If the char burn involves only a small part of the body, it should be excised down to healthy tissue. If an extremity is involved, amputation may be necessary.
Surgeons measure the area of a burn as a percentage of the body’s total skin area. The skin area on each arm is roughly 9 percent of the body total, as is the skin covering the head and neck. The percentage on each leg is 18, and the percentage on the trunk is 18 on the front and 18 on the back. The percentage of damaged skin affects the chances of survival. Most people can survive a second-degree burn affecting 70 percent of their body area, but few can survive a third-degree burn affecting 50 percent. If the area is down to 20 percent, most people can be saved, though elderly people and infants may fail to survive a 15 percent skin loss.
Severe burns cause immediate nervous shock. The victim grows pale and is confused, anxious, and frightened by the pain and may faint. Much more dangerous is the secondary shock that comes a few hours later. Its chief features are a dramatic fall in blood pressure that leads to pallor, cold extremities, and eventual collapse. This secondary shock is precipitated by loss of fluid from the circulation, not just the fluid lost in the destroyed tissue but fluid that leaks from the damaged area that has lost its protective covering of skin.
Burns kill not just by damaging tissue but by allowing this leakage of fluid and salts. If more than a fifth of the blood volume is lost to the circulation, insufficient blood returns to the heart for it to maintain blood pressure. And the loss of salts, particularly sodium and potassium salts, not only disturbs their balance in the body but changes the osmotic balance of the blood and body fluids. The significance of these physiological changes was understood in 1905, but not until the 1930s were doctors able to correct them with transfusions of blood or plasma.
Every year for National Burn Awareness week, the American Burn Association brings attention to burn injuries that result in over 40,000 hospitalizations per year. While a very large majority of these burns actually occur in the home, workplace burns are a very preventable source of injury. Awareness, hazard prevention and protection can dramatically lessen the risk of burns in the workplace.
Types of Workplace Burns
Thermal Burns — Thermal burns are burns caused by the heat from liquids (called “scalding” burns), open flames, hot objects and explosions. The most important priority with thermal burns is controlling and stopping the burning process. Thermal burns can be prevented by wearing Personal Protective Equipment, using fire prevention tactics, and by having procedures and emergency action plans related to fire detection and protection.
Chemical Burns — Chemical burns are the result of skin or eyes coming into contact with strong acids, alkaloids or other corrosive or caustic materials that eat away or “burn” skin and deeper tissue. In the workplace, these accidents can occur after exposure to industrial cleaners (such as rust removers or drain cleaners), chemicals in laboratories or manufacturing workplaces. One of the best ways to prevent chemical burns is to make sure all workers are well-versed in Hazard Communication, which covers the symbols and labels that will communicate chemical risk. These labels will also include the important information on the steps workers can take to prevent burns if they come into contact with dangerous chemicals. Workers who will come into contact with chemicals should consider Hazard Communication training and should also take refresher courses as these standards can be updated often.
Electrical Burns — Current travels through body and meets resistance in tissue, resulting in heat burn injuries. To avoid burns from electrical sources, high-voltage areas and machinery should be clearly marked. Workers should also make sure to identify live wires, avoid contact with water while working with electricity, and wear the personal protective equipment necessary to avoid burns by electricity. Our Electrical standards course is a great overview of the types of electrical hazards workers may find on a worksite and the OSHA standards that help avoid accidents.
Sun Exposure Burns — While these could technically be considered a thermal burn, sun exposure burns are worthy of special consideration. Employees who work under the sun should be well versed in the sun safety practices that will keep them safe, and should take precaution to reduce hours under harsh direct sun, seek shade if possible, and wear sun-protective work clothing, hats and sunscreen to reduce the risk of burns from sun exposure.
First-degree burns cause minimal skin damage and are considered superficial since they affect the top layer of the skin. A mild sunburn is an example of this type of burn, where the burn site is red, painful, dry and without blister.
The damage from a second-degree burn extends beyond the top layer of the skin and can often cause the skin to blister or become extremely red and sore.
Third-degree burns destroy both the epidermis and the dermis, and they can also go as deep as to destroy tissue underneath. These burns can appear white or charred.
In a fourth-degree burn, all skin layers are affected, and there is also potential for damage to muscle, tendons and bone. Skin grafts do not work on these severe burns, so much so that fourth-degree burns may require amputation if injury occurs in a limb or extremity.
Under the OSH law, employers have a responsibility to provide a safe workplace. This overarching responsibility is broken down, but at the end of the day, if a worker is not safe, the employer is likely at risk. When it comes to burns, here are a few ways employers can help to provide safe workplaces.
Making sure employees have the proper training is one of the most important steps an employer can take. Training should cover not only the hazards that the employee might face on their worksite, but also an overview of OSHA standards and how to identify hazards that may not have been covered. OSHA 10-hour training is a great way to get a baseline of safety standards training before an employee ever even starts receiving worksite-specific training. Then, employers should make sure that the employees are trained on their specific job functions, including in-depth safety training with any machinery, chemicals or other worksite hazards specific to their job.
In addition to training before ever even starting a job, employers should regularly update training so that employees are kept up-to-date with standard changes and so that important concepts are kept at top-of-mind. Certificate training courses are a great way to re-train employees, and our online standards training topics can be taken 100% online for efficient and inexpensive refresher training.
Color codes, posters, labels or signs to warn employees of potential hazards are an employer requirement under the OSH Act, and these vital pieces of Hazard Communication are extremely important in burn prevention. Workers should be trained on how to recognize symbols and other hazard communication codes, and GHS communication standards should be used to identify material hazards in a consistent and easily recognizable way. When hazardous chemicals are found in the workplace, employers are also required to produce and provide a written Hazard Communication plan. These requirements, as well as an overview of GHS and the symbols now utilized in the United States, can be found in our Hazard Communication overview course.
Workplace Burn Prevention Game
Want a great workplace burn prevention game to share with your employees? Check out our Workplace Burn Prevention Game!
What Are Common Causes of Burns?
The first step in helping to protect kids from burns is to understand how common burns happen:
- Thermal burns: These burns raise the temperature of the skin and tissue underneath. Thermal burns happen from steam, hot bath water, tipped-over coffee cups, hot foods, cooking fluids, etc.
- Radiation burns: These happen from exposure to the sun’s ultraviolet rays (a sunburn because skin isn’t well-protected in the sun) or from radiation such as during an X-ray.
- Chemical burns: These happen from swallowing strong acids (like drain cleaner or button batteries) or spilling chemicals (like bleach) onto the skin or eyes.
- Electrical burns: These are from contact with electrical current and can happen from things like biting on electrical cords or sticking fingers or objects in electrical outlets, etc.
What Are the Types of Burns?
Knowing the type of burn a child has can help with first-aid measures. All burns should be treated quickly to lower the temperature of the burned area and reduce damage to the skin and tissue underneath (if the burn is severe).
First-Degree (Superficial) Burns
Superficial (shallow) burns are the mildest type of burns. They’re limited to the top layer of skin:
- Signs and symptoms: These burns cause redness, pain, and minor swelling. The skin is dry without blisters.
- Healing time: Healing time is about 3–6 days; the superficial skin layer over the burn may peel off in 1 or 2 days.
Second-Degree (Partial Thickness) Burns
These burns are more serious and involve the top layer of skin and part of the layer below it.
- Signs and symptoms: The burned area is red and blistered, and can swell and be painful. The blisters sometimes break open and the area is wet looking with a bright pink to cherry red color.
- Healing time: Healing time varies depending on the severity of the burn. It can take up to 3 weeks or longer.
Full Thickness Burns
These burns (also called third-degree burns or fourth-degree burns) are the most serious type of burn. They involve all layers of the skin and the nerve endings there, and may go into underlying tissue.
- Signs and symptoms: The surface appears dry and can look waxy white, leathery, brown, or charred. There may be little or no pain or the area may feel numb at first because of nerve damage.
- Healing time: Healing time depends on the severity of the burn. Most need to be treated with skin grafts, in which healthy skin is taken from another part of the body and surgically placed over the burn wound to help the area heal.
What Should We Do for Burns?
Get medical help right away when:
- You think your child has any burn other than a superficial one.
- The burned area is large (2–3 inches wide), even if it seems like a minor burn. For any burn that appears to cover a large part of the body, call for medical help. Do not use wet compresses or ice because they can cause the child’s body temperature to drop. Instead, cover the area with a clean, soft cloth or towel.
- The burn comes from a fire, an electrical wire, a socket, or chemicals.
- The burn is on the face, scalp, hands, genitals, or on skin over a joint.
- The burn looks infected (with swelling, pus, increasing redness, or red streaking of the skin near the wound).
For superficial burns:
- Remove the child from the heat source and take clothing off the burned area right away.
- Run cool (not cold) water over the burned area (if water isn’t available, any cold, drinkable fluid can be used) or hold a clean, cold compress on the burn for 3–5 minutes (do not use ice, which can cause more damage to the injured skin).
- Do not apply butter, grease, powder, or any other “folk” remedies to the burn, as these can make the burn deeper and increase the risk of infection.
- Apply aloe gel or cream to the affected area. This may be done a few times during the day.
- Give your child acetaminophen or ibuprofen for pain. Follow the label directions for how much to give and how often.
- Keep the affected area clean. You can protect it with a sterile gauze pad or bandage for the next 24 hours. Do not put adhesive bandages on very young kids, though, as these can be a choking hazard if they get loose.
For partial thickness burns and full thickness burns:
Call for emergency medical care. Then, follow these steps until help arrives:
- Keep the child lying down with the burned area raised.
- Follow the instructions for first-degree burns.
- Remove all jewelry and clothing from around the burn (in case there’s any swelling after the injury), except for clothing that’s stuck to the skin. If you have trouble removing clothing, you may need to cut it off or wait until medical help arrives.
- Do not break any blisters.
- Apply cool water over the area for at least 3–5 minutes, then cover the area with a clean dry cloth or sheet until help arrives.
For electrical and chemical burns:
- Make sure the child is not in contact with the electrical source before touching him or her, or you also may get shocked.
- For chemical burns, flush the area with lots of running water for 5 minutes or more. If the burned area is large, use a tub, shower, buckets of water, or a garden hose.
- Do not remove any of the child’s clothing before you’ve begun flushing the burn with water. As you continue flushing the burn, you can then remove clothing from the burned area.
- If the burned area from a chemical is small, flush for another 10–20 minutes, apply a sterile gauze pad or bandage, and call your doctor.
- Chemical burns to the mouth or eyes need to be checked by a doctor right away after being thoroughly flushed with water.
Chemical burns and electrical burns might not always be visible, but can be serious because of possible damage to internal organs. Symptoms may vary, depending on the type and severity of the burn and what caused it.
If you think your child may have swallowed a chemical substance or an object that could be harmful (for instance, a button battery), first call poison control at (800) 222-1222. Then, call 911 for emergency medical help.
It helps to know what chemical product the child has swallowed or has been exposed to. You may need to take it with you to the hospital.
Keep the number for poison control, (800) 222-1222, in an easily accessible place, such as on the refrigerator.
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By Amanda Schaffer
- May 2, 2006
At 5 o’clock one morning in late March, Linda Dixon stood in the stream of an open fire hydrant as emergency medical workers flushed her chest, arms and face with water.
Ms. Dixon, a 42-year-old home health aide in Queens, said her estranged boyfriend, the father of her three children, had gone into her bedroom and thrown acid on her after a confrontation.
Ms. Dixon was taken to the NewYork-Presbyterian/Weill Cornell hospital, where she underwent two surgeries for the worst of her injuries, a third-degree burn across her chest. The surgical team’s first priorities were to remove as much of the burned skin as possible (it can easily become infected) and to cover the wound temporarily with skin from a cadaver.
Cadaver skin is removed from donors shortly after their deaths, then processed and distributed by skin and tissue banks. It has long been the preferred option for a patient with the most severe burns until a graft of the patient’s own skin can be applied. Although some synthetic skin has come on the market in the last 20 years, new products have not appeared as quickly as some experts expected.
And experts now realize that cadaver skin is unlikely to be replaced as a treatment option anytime soon.
“Cadaver skin still is probably the No. 1 substitute for the patient’s own skin” in acute cases, said Dr. Roger Yurt, professor of surgery and director of the Hearst Burn Center. Dr. Yurt also oversees the hospital’s dedicated skin bank, called the New York Firefighters Skin Bank.
Dr. Palmer Bessey, professor of surgery and associate director of the burn center, said cadaver skin was particularly valuable in cases like Ms. Dixon’s, when the burn may penetrate deeper than is immediately apparent. Initially, it may not be clear whether the bed of the wound will be able to accept a graft, and under such circumstances, synthetics are more prone to infection than cadaver skin, Dr. Bessey said.
In Ms. Dixon’s case, Dr. Bessey decided to use strips of cadaver skin, which had been frozen at the hospital’s skin bank. In the operating room, these strips were thawed in a small tub of saline.
They were rolled through a meshing machine, which created a pattern of small holes, like the pattern in fishnet stockings. This allowed the cadaver skin to be stretched to cover a broader area of Ms. Dixon’s chest. It also allowed for better drainage of the wound because blood clots or fluid could seep through the perforations and not get stuck under the graft.
Donated skin can help prevent infection, reduce pain and maintain body temperature. Patients with severe burns do not initially reject cadaver skin, because their immune systems are suppressed, Dr. Bessey said.
Each strip is about 12 one-thousandths of an inch thick, roughly the thickness of sunburned skin. The strip includes the dull outer layer, or epidermis, and a small portion of the shiny inner layer, or dermis. Both are destroyed in a third-degree or full-thickness burn.
When a skin bank receives a call about a potential donor, an extensive screening process begins — for risk factors associated with H.I.V., hepatitis, cancer, mad cow disease and even Chagas’ disease, a parasitic infection.
“A large proportion of potential donors are rejected,” said Nancy Gallo, the administrative director of the Firefighters Skin Bank and a registered nurse.
When donors are accepted and their families consent, a team from the skin bank goes to the hospital and surgically removes roughly four square feet of a cadaver’s skin. The skin is taken to the skin bank, trimmed into bandage-like strips and cryogenically preserved. Cadaver skin can be stored in a freezer for up to five years, although it is invariably needed sooner.
“We are always in need of more skin,” Ms. Gallo said, adding that the skin bank is now facing a declining number of donors. “Right now there is a national shortage.”
She added that she frequently received calls from people planning to undergo gastric bypass surgery, a surgical treatment for obesity, who would like to donate skin. But given current skin harvesting procedures, this is not an option.
According to Dr. Bessey, Ms. Dixon responded well to the graft of donated skin, which integrated into her body and helped the area begin healing. Dr. Bessey then performed a second operation, removing the cadaver material and replacing it with Ms. Dixon’s own skin, taken from her thigh.
“I was very scared,” Ms. Dixon said. But she added that she was in less pain then than she was before the operations.
Most of the less severe burns on Ms. Dixon’s face are healing naturally. The burn on her right eyelid was too deep to heal by itself, and a graft of her own skin was applied during the second operation, Dr. Bessey said.
Richard Kagan, professor of surgery at the University of Cincinnati College of Medicine and chief of staff at the Shriners Burns Hospital in Cincinnati, said that for temporary wound coverage for acute burns, cadaver skin has been the best option for more than 40 years.
“The development of a permanent, off-the-shelf skin replacement has been much slower than had been anticipated,” he said, although, he added, “some of the synthetics do have advantages.”
Integra artificial skin products, from Integra LifeSciences, are among the most widely used synthetics. Its first skin product received approval from the Food and Drug Administration in 1996 and consisted of two layers: an inner scaffold on which the dermis could redevelop and an outer layer of silicone.
Other skin products, approved in 2002, made small improvements but were not substantially different, according to a company spokeswoman.
Integra’s artificial skin products have advantages over cadaver skin in that they are easier to store. Because they help to rebuild the inner, structural layer of skin, they can improve the appearance of a scar. They can also reduce the amount of scarring that contracts around a joint or other areas that requires mobility.
But these products cost more than cadaver skin, Dr. Kagan and others say. The products can also be hard to handle and may be more prone to infection, particularly when placed on a wound of questionable viability. And, like patients given cadaver skin, those given artificial skin products must eventually receive grafts of their own skin.
A product called Epicel, introduced by Genzyme Biosurgery in the 1980’s, offers a permanent replacement for a patient’s outer skin. It consists of a sheet of epidermis, grown and cultured over several weeks from a sample of a patient’s own skin cells.
Along similar lines, Steven Boyce, professor of surgery at the University of Cincinnati and a senior researcher at the Shriners Burns Hospital, has developed a laboratory process in which both epidermis and some dermis can be produced in about a month using cells isolated from a patient’s skin and grown in culture.
This product, PermaDerm, is being developed by the Cambrex Corporation. It is not available now on a large scale. But even it is not a skin replacement that can be used immediately for any permanent wound closure. And for many researchers, such a product remains the dream.
Lecturer Medical Sciences, University of Wollongong
Theresa Larkin does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
University of Wollongong provides funding as a member of The Conversation AU.
Why don’t burns bleed? – from the year three and four students at Islington Public School in NSW
Hello year three and four students – thanks for your excellent question!
To understand burns, we need to understand some things about the skin. Did you know your skin is made up of three different layers?
You might have heard of burns being called first-degree, second-degree or third-degree burns.
This tells us how many layers of skin are affected and how deep the burn is.
A first-degree burn affects just the outer layer of the skin, which is called the epidermis.
The epidermis protects the inside of our body, including our muscles, bones and organs.
It stops the sun’s harmful rays, sharp objects and water from getting through and damaging the inside of our body.
Could you imagine if we didn’t have a waterproof outer layer? You would fill with water and burst the next time you hopped in the bath!
When we have a first-degree burn, this affects just the outer layer of skin.
A first-degree burn, such as sunburn, is red, warm and painful to touch because the cells have been damaged.
So why doesn’t a first-degree burn bleed? Because there actually isn’t any blood travelling in the epidermis.
The blood vessels, which carry blood around our body, are in the next layer down.
This second layer is called the dermis.
A second-degree burn affects the outer two layers of the skin: that is the epidermis and the dermis.
The dermis has blood vessels that carry our blood around our body.
Now, you might think that because of the blood vessels in the dermis, a second-degree burn would bleed.
If you cut yourself into the dermis, say, with a deep paper cut, it might bleed.
The difference with a burn is the heat actually stops the blood from flowing.
A small bit of blood may ooze out at first, but it won’t actually bleed much.
The dermis also has nerves that make us feel pain if they’re damaged.
A second-degree burn is the most painful burn because it damages the nerves of the skin.
Third degree burns
The third and deepest layer of our skin is called the hypodermis. This is mostly fat, but there are also blood vessels and nerves in this layer.
The veins that you can see on the back of people’s hands are in the hypodermis layer of the skin.
A third-degree burn affects all three layers of skin. This is very deep and will need medical treatment.
A third-degree burn doesn’t just damage cells like first-degree and second-degree burns, it actually kills them. The redness of sunburn, and even blisters, will gradually get better and return to normal. But dead cells cannot repair.
A third-degree burn also doesn’t bleed because it completely destroys the blood vessels and the heat stops the blood from flowing.
Even though a third-degree burn causes the most damage, it is actually not painful at that location because it has completely killed the nerves.
Think of a jacket
Our skin is like our own three-layered waterproof, padded jacket.
The outer layer (epidermis) is thin and protects against water.
The middle layer (dermis) is the material and threading holding the jacket together.
The deepest layer (hypodermis) is thick and padded to keep us warm just like our fat.
In this Article
- What Is a Burn?
- Burn Symptoms
- Burn Causes
- Burn Treatment
- Managing Burn Pain
- Burn Complications
- Burn Prevention
What Is a Burn?
A burn is when you have tissue damage, usually after contact with heat.
There are three types of burns:
- First-degree burns (superficial burns) are mild compared to other burns. They causeВ pain and reddening of the epidermis (outer layer of the skin).
- Second-degree burns (partial thickness burns) affect the epidermis and the dermis (lower layer of skin). They cause pain, redness, swelling, and blistering.
- Third-degree burns (full thickness burns) go through the dermis and affect deeper tissues. They result in white or blackened, charred skin that may be numb.
- Fourth-degree burns go even deeper than third-degree burns and can affect your muscles and bones. Nerve endings are also damaged or destroyed, so thereвЂ™s no feeling in the burned area.
The symptoms of burns depend on the cause and type of burn:
- Red, painful skin
- No blisters
- Red, painful skin
- White, black, deep red or charred skin
- May be painful but could be numb
- No feeling in the area
- Destroyed skin tissue, fat, muscle and possibly bone
Depending on how bad the burn is, some people may go into shock. Symptoms of shock may include pale and clammy skin, weakness, bluish lips and fingernails, and a drop in alertness.
First- and second-degree burns usually get better on their own, but third- and fourth-degree burns need medical attention right away. Call your doctor if a second-degree burn is deep and doesnвЂ™t start to feel better soon.
Thermal burns are the most common kind of burns. These burns happen when flames, hot metals, scalding liquids, or steam come into contact with skin. This can happen in manyВ circumstances, including house fires, vehicle accidents, kitchen accidents, and electrical malfunctions.
Other things that can cause burns include:
- Heated objects
- The sun
Burn treatment depends on the type of burn.
- First-degree burns can usually be treated with skin care products like aloe vera cream or an antibiotic ointment and pain medication such as acetaminophen (Tylenol).
- Second-degree burns may be treated with an antibiotic cream or other creams or ointments prescribed by a doctor.
- Third-degree and fourth-degree burns may need more intensive treatments such as intravenous (IV) antibiotics to prevent infection or IV fluids to replace fluids lost when skin was burned. They may also need skin grafting or the use of synthetic skin.
If the burn is serious, youвЂ™ll need to call 911. There are some things you can do until medical professionals get there:
- Get the person away from the cause of the burn. If the cause was something electrical, make sure the power is off before getting close to them.
- Check to see if the person is breathing. If not, start rescue breathing (mouth-to-mouth resuscitation) if you know how.
- Take off anything that might keep them from moving freely and easily, like jewelry or a belt.
- Cover the burned area with a clean, cool washcloth or a slightly wet bandage. Don’t put a large, serious burn in water — that can cause a sudden drop in body temperature and lead to hypothermia.
- Keep the burned area raised above heart level if you can.
- Keep a close eye out for signs of shock, like fainting or dizziness, pale skin, and shallow breathing. If you notice any of these, try raising their feet and legs a bit but donвЂ™t move them. If they start to throw up, turn them on their side.
Managing Burn Pain
Burn pain can be intense and prolonged. ItвЂ™s difficult to control because of its unique characteristics, its changing patterns, and its various components.
In addition, thereвЂ™s pain involved in the treatment of burns, as the wounds must be cleansed and the dressings changed. Studies show that aggressive treatments for pain are needed with serious burns.
ItвЂ™s important to get treatment for major burns right away because they can lead to serious health issues, including:
- Sepsis (a kind of infection that happens when bacteria get into your bloodstream)
- Tetanus (a disease caused by a certain type of bacteria that get into your body through an open wound)
- Hypovolemia (a dangerous loss of body fluids, like blood)
- Hypothermia (a severe drop in body temperature)
- Breathing issues from smoke or hot air
- Bone and joint problems caused by scar tissueвЂ™s effects on skin, muscles or tendons
You can take some simple steps to prevent burns at home, especially in the kitchen:
- Always pay close attention to anything on the stove, and turn pot and pan handles toward the back so you donвЂ™t accidentally hit them.
- DonвЂ™t hold your baby or young child while youвЂ™re cooking, and keep them away from any appliance that can get hot. Cover electrical outlets with caps.
- Keep a fire extinguisher on every floor of your house and make sure there are working batteries in your smoke and carbon monoxide detectors.
- DonвЂ™t smoke in bed.
- Set the maximum temperature of the hot water in your house to less than 120 degrees, and always check the temperature of the water before putting your child in the bathtub.
- Check the temperature of any buckles or straps before putting your child in the car, especially if the car has been parked in the sun.
- Be careful with chemicals, and wear protective goggles when you use them. When youвЂ™re not using them, keep them away from kids and out of the house, ideally locked in a secure, child-proof place.
- DonвЂ™t put electrical appliances anywhere near water, unplug them when theyвЂ™re not in use, and put them in a safe place away from kids.
Stanford ChildrenвЂ™s Health: вЂњClassification of Burns.вЂќ
Mayo Clinic: вЂњTreating Major Burns,вЂќ вЂњShock: First Aid,вЂќ вЂњBurns: First Aid,вЂќ вЂњBurns.вЂќ
University of Rochester Medical Center: вЂњClassification of Burns.вЂќ
Centers for Disease Control and Prevention: вЂњTetanus.вЂќ
Feeling the burn? Hopefully not!
Unfortunately, accidents happen. While getting any type of burn is unpleasant, it’s important to know how to treat a burn. Otherwise, you might end up in the hospital later to receive the treatment you truly need.
Approximately 486,000 burn injuries receive medical treatment at hospitals, community health centers, or private medical offices each year.
While these tips can help you learn how to treat a burn, it’s still important to visit a medical professional if needed.
Keep reading to learn the five steps for treating a steam burn.
1. Stop the Source
Steam burns, which are also known as scalds, are burns associated with hot liquids or steam. This type of burn often occurs at home. For example, you might develop this type of burn while you’re cooking.
At a glance, steam burns don’t seem severe compared to a fire-attributed burn. While these burns don’t look as damaging, it’s important you don’t underestimate a steam burn.
Though it’s only hot air, steam can still penetrate the skin’s outer layer.
Reaching beyond this layer can cause you to develop severe burns to the lower layers of your skin. The severity depends on:
- The water or steam’s temperature
- The amount of time your skin was exposed to the steam or water
- How much skin was burned
- Where the burn is located
The first step for how to treat a burn is to remove yourself from the source. If you were cooking, turn off the stove. That way, you can focus on treating yourself without causing another accident.
Next, remove any hot or constricting clothing. You’ll want to take off belts and jewelry as well. Severe burns can cause your skin to swell quickly.
Once you’ve removed unnecessary clothing, hold the burned skin under cool, running water. You can also submerge the burn in cool water until the pain subsides. If you don’t have access to running water, use a compress instead.
3. Protect & Prevent
After cooling the skin, protect the burned area with a sterile, non-adhesive bandage. You can also use a clean cloth.
Make sure you don’t apply lotions, oils, or creams to the skin.
Instead, use a petroleum-based ointment to help the burn heal.
If the burn is second-degree or higher, you might need to prevent shock. Make sure to elevate the burn area above heart level if you can.
About 50,000 burn injuries require hospitalization. Of these, 33 to 50% of these are steam burns.
To treat a first-degree steam burn at home instead of a hospital, take an over-the-counter pain reliever.
5. See a Doctor
In severe cases, you’ll need to visit a doctor. Schedule an appointment if:
- There are signs of infection
- The burn blister oozes
- Redness and pain last more than a few hours
- The hands, feet, face, or genitals are burned
A doctor can prescribe antibiotics and pain medication to help you heal.
Seek Treatment for Sever Steam Burns
If left untreated, a steam burn can leave you in severe discomfort and cause scarring. Instead, use these steps or see a doctor for treatment.
Visit our urgent care center today for immediate treatment for your steam burn.
Still have questions?
Call us at 985-709-0136
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1411 St Charles St.,
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- How to Treat a Kitchen Burn
- How to Prevent Scarring From a Steam Burn
- How to Heal a Light Skin Burn
- How to Treat a Hot Glue Gun Burn
- How to Treat Steam Burns
- Cool the Skin
- Evaluate the Burn
- Continue Home Care
- Warnings and Precautions
Approximately 486,000 people in the US visit hospital emergency rooms each year for burn injuries, according to the American Burn Association 1. Scalds — burns caused by steam or hot liquids — are the second most common type of burn injury in adults and the leading type among young children.
Most scalds due to boiling water are first- or second-degree burns. Small scald injuries can often be treated at home, although larger burns and those involving certain parts of the body require immediate medical evaluation.
Cool the Skin
Immediately remove any clothing that got splashed with the boiling water. Also remove any jewelry in the area of the burn, if possible. Place the scalded area under gently running cold water from a faucet for 20 minutes to dissipate the heat in the skin and arrest the burning process.
If this isn’t feasible, such as with a crying child, fill a pitcher with cold water. Place the scalded area over a catch basin or large pot and gently pour the water over the burned skin. Refill the pitcher as needed. Continue pouring cold water over the burned skin for 20 minutes.
Do not place ice or ice water on the burned area as this could further damage the skin. Gently pat the skin dry after cooling.
- Immediately remove any clothing that got splashed with the boiling water.
- Place the scalded area over a catch basin or large pot and gently pour the water over the burned skin.
Evaluate the Burn
How to Treat a Kitchen Burn
After cooling the skin, evaluate the burn. Seek medical care right away at the nearest emergency room or urgent care center if any of the following apply:
- The burn is larger than the size of the burned person’s hand.
- The scalded area blisters and involves the face, hands, arms, feet, legs or genitals.
- The pain remains severe.
- The burned person is feeling unwell or has diabetes.
- You are unsure about whether medical evaluation is needed, especially if a child has been burned.
Cover the burn with piece of plastic wrap and gently secure in place with first aid tape or adhesive bandages. Do not wrap the plastic all the way around the involved area as this could reduce circulation if swelling occurs. If the boiling water scalded the hand, you can place it in a new plastic storage bag rather than plastic wrap.
- After cooling the skin, evaluate the burn.
- Seek medical care right away at the nearest emergency room or urgent care center if any of the following apply: * The burn is larger than the size of the burned person’s hand.
* The scalded area blisters and involves the face, hands, arms, feet, legs or genitals.
Continue Home Care
If the burn does not require medical evaluation, you can continue with home treatment. Loosely cover the burn with a nonstick bandage to protect the damaged skin and reduce the chance of infection.
Do not apply any type of grease or butter, or any creams or ointments to the burn. Change the bandage at least daily or more frequently if it gets wet. Do not rupture or drain any blisters that might form. Keep the burn covered until it has healed.
An over-the-counter pain reliever such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can be used for burn-related pain if the medicine has been previously okayed by your doctor.
Follow the home care instructions provided to you by the hospital or urgent care center if you sought medical evaluation and treatment for the burn.
- Medical Author: Dr. Jasmine Shaikh, MD
- Medical Reviewer: Pallavi Suyog Uttekar, MD
Second-degree burns are a type of burns that are severe than the first-degree burns (minor burns that affect the superficial layer of the skin) but milder than the third-degree burns (that cause major loss of the skin). They affect the epidermis as well as the layer (dermis) that is deeper to the epidermis.
Also known as deep partial-thickness burn, second-degree burns take longer to heal and are serious. Second-degree burns can be so bad that they can cause complications such as:
- Infection of the burned area
- Photo-sensitivity of the burnt skin (during healing)
- Loss of normal skin color or darkening of the skin in the burnt area
- Scarring (if not treated properly)
- Restricted joint movements or joint contractures (due to scarring)
Complications such as joint contracture may require skin grafting to prevent joint disability.
Second-degree burns can become life-threatening if:
- They affect larger areas of the body
- The genitals or buttocks are involved
- The joints are affected
- If you suffer from diseases such as AIDS in which your immunity is weakened
- If you have severe diabetes in which there is delayed wound healing
What can cause a second-degree burn?
A second-degree burn is commonly caused by:
- Severe sunburn (usually in fair-skinned persons)
- Spilling of boiling water
- Exposure to a flash of flame (such as from ovens and stoves)
- Grabbing a falling curling iron by the heated end
- Chemicals such as bleaching agents and acids
What are the signs and symptoms of a second-degree burn?
A second-degree burn has two sub-types: superficial second-degree burns and deep second-degree burns. It exhibits an irregular pattern and usually looks like a wet-looking wound.
A Superficial second-degree burn is confined to the upper part of the dermis layer. Its signs and symptoms include:
- It ranges in color from pink to bright red
- Blisters that are variable in size which upon bursting release a watery substance
- Extremely painful (since nerve endings are still intact)
- A highly sensitive skin (even a breeze of air causes pain)
- Temporary thickening of the skin with no loss in its elasticity
Signs and symptoms of deep second-degree burns include:
- Smaller blisters
- Slightly moist skin
- Decreased sensation to pinprick but deep pressure sensations are retained
- Less elastic skin
How is a second-degree burn treated?
A second-degree burn is an emergency condition and needs medical attention. While you wait for the doctor, the following steps can be initiated:
- Allow the burn to cool by pouring cool water on it. But avoid using ice.
- Stay hydrated (drink plenty of water or electrolytedrinks).
- Cover the burn with a loose dressing.
- Avoid applying butter or oil immediately on the burnt skin.
Medical treatment depends on how severe the burn is and where it is located.
- A doctor applies an antibiotic cream after cleaning the burn wound.
- If there are chances of the burn wound getting infected, the doctor may prescribe oral antibiotics or inject the same through your veins (intravenously).
- The doctor will administer intravenous fluids for rapid rehydration.
- Skin grafting may be needed in deeper second-degree burns. This means the burnt skin will be replenished with healthy skin (removed from another region of your body).
How long does it take for a second-degree burn to heal?
A second-degree burn can take anywhere between five days to three weeks to heal itself. If there are complications, recovery might take longer.
To hasten the recovery, you can try the following strategies:
- Keep the burn clean and protected with a dressing.
- Avoid rubbing or scratching the skin; trim your nails regularly
- Moisturize the burnt skin after the wound heals to prevent scarring (petroleum jelly can be used twice-thrice a day).
- Increase your protein intake.
- Drink plenty of water.
- Wear a hat and long-sleeved tops and apply a sunscreen lotion while in the sun.
- Wear loose clothes.
Ask your doctor if you can use antibiotic creams or painkillers for faster healing of the wound and pain relief.
A burn is an injury to the tissue of the body, typically the skin. Burns can vary in severity from mild to life-threatening. Most burns only affect the uppermost layers of skin, but depending on the depth of the burn, underlying tissues can also be affected. Traditionally, burns are characterized by degree, with first being least severe and third being most. However, a more precise classification system referring to the thickness or depth of the wound is now more commonly used. For the sake of this article, burns will be described by thickness. For a comparison of the two classification systems, see the table below.
Superficial, or first-degree burns only affect the epidermis (the outermost layer of skin), and typically the epidermis remains intact. This is important in that the epidermis helps regulate temperature and protects the body from infection.
Another contributing factor to burn severity is how much of the body is affected. The “rule of nines” is a method of approximation used to determine what percentage of the body is burned. Partial- or full-thickness burns on more than 15% of the body require immediate professional medical attention. The following approximations can be used for adults:
Head (front and back)
Front of the torso
Back of the torso
Each leg (front and back)
Each arm (front and back)
Additionally, the palm (not including the fingers or wrist area) is approximately 1% of the total surface area of the body, and can be used to approximate noncontiguous burn areas.
Symptoms of Superficial (First-Degree) Burns
With superficial burns, the skin will typically be red (erythema), swollen, dry, itchy, and sensitive to the touch. Blanching of the skin will occur when it is lightly pressed. These burns do not form blisters.
Burns can be caused by a large variety of external factors. The most common types of burns are:
- Thermal: Caused by fire, hot objects, steam or hot liquids (scalding).
- Electrical: Caused by contact with electrical sources or, in much more rare circumstances, by lightning strike.
- Radiation: Caused by prolonged exposure to sources of UV radiation such as sunlight (sunburn), tanning booths, or sunlamps or by X-rays, radiation therapy or radioactive fallout.
- Chemical: Caused by contact with highly acidic or basic substances.
- Friction: Caused by friction between the skin and hard surfaces, such as roads, carpets or floors.
- Respiratory: Damage to the airways caused by inhaling smoke, steam, extremely hot air, or toxic fumes.
- Infection: One of the main functions of the skin is to act as a barrier against outside infection. However, this physical barrier is broken with partial- or full-thickness burn wounds. With severe burns, hard, avascular eschar forms, providing an environment prone to microbial growth. In addition, eschar makes it more difficult for antibodies and antibiotics to reach the wound site.
- Circumferential burns: In cases where a full thickness burn affects the entire circumference of a digit, extremity, or even the torso, this is called a circumferential burn. These are particularly problematic because when relatively pliable skin is replaced by dry, tough eschar it can affect circulation to the distal area and result in compartment syndrome. To reduce the risk from the resulting edema, an escharotomy will be performed, making a surgical incision through the thick eschar down to the subcutaneous tissue.
- Hypovolemic and Hypothermic Shock: Other key functions of the skin are to regulate fluid loss due to evaporation and regulate body heat. When large areas of the skin are burned, the risk of hypovolemia (decreased blood volume) rises substantially and can send the patient into shock. Additionally, hypothermia is part of the “trauma triad of death” which, along with lactic acidosis and coagulopathy, significantly increases mortality rates in patients with severe trauma.
- Wound progression:Swelling and decreased blood flow to the affected tissue at burn sites can result in partial-thickness burns developing into full-thickness burns.
- Tetanus: Burn sites are specifically susceptible to tetanus. If the patient hasn’t been immunized in the past 5 years, generally a booster shot is recommended.
Treatments & Interventions for Superficial Burns
The three major goals for treating any burn are to prevent shock, relieve pain and discomfort, and reduce the risk of infection.
For superficial burns the first step is to run cool (not cold) water over the area for about 10 minutes then loosely cover the area with a sterile, non-adhesive bandage. Protect the affected area from pressure or friction during the healing process. Over-the-counter pain relievers can help reduce pain and inflammation.
The following precautions should be observed in dealing with any type of burn:
- Do not apply ice to the affected area. Doing so can cause further damage to the wound and increase the risk of hypothermia.
- Do not apply butter, ointment, petroleum jelly, oil, or grease on the burn. Not only do wounds need air to heal, but these also trap heat at the burn site and can further damage deeper tissues.
- Do not peel off dead skin, as this can result in further scarring and infection.
- Do not cough or breathe directly on the affected area.
Knowing how to treat a burn at home and understanding the difference between a first-, second-, and third-degree burn will reduce scarring and speed healing time. Here’s what to do, and when a burn requires a doctor’s care.
You’re transferring that hot kettle of boiling water to your tea mug and bam—the scorching water spills on your arm. Suddenly you’re in a lot of pain, and you start to notice redness and swelling on your skin, the telltale signs of burn.
The scary part of getting a burn is that you risk permanent scarring, infection, and other consequences depending on the type of burn you have. Yet figuring out fast which degree the burn is and then knowing how to treat it can minimize damage.
If the burn penetrates all layers of the skin, the skin is leathery or charred, the hands, feet, face, or genitals are burned, or if the affected person is a child or elderly, you’ll need to call an ambulance for urgent medical care. But less severe burns can be treated at home. Here’s how to know what type of burn you’re dealing with, what to do immediately to reduce damage, the recovery time you can expect, and the home remedies that can speed healing.
How to treat a first-degree burn
“Burns are classified by degrees of how deeply they have injured the skin,” explains Sonia Batra, MD, dermatologist and co-host of the television show The Doctors. A burn can be differentiated usually just by looking at your skin’s reaction after the burn occurs, says Dr. Batra.
A first-degree burn is a superficial burn that can cause the skin to turn red and swell slightly but does not eventually result in blistering.
Here’s how to treat a first-degree burn. “First-degree burns can typically be taken care of at home by running the affected area under cool (not cold) water and taking acetaminophen or ibuprofen for minor pain,” says Dr. Batra. Do this immediately and keep the area around the burn clean and clear. Cover with a sterile, non-adhesive bandage or cloth and avoid sunlight.
First-degree burns typically heal within 7 to 10 days. To help it heal, never put ice on it; this can actually make it worse. A cool (not cold) compress is a better idea to soothe any lingering pain.
Scarring occurs depending on the depth of the burn, as deeper burns require new tissue formation to restore the skin’s outer seal. While the new tissue formed may not appear to match the surrounding skin in color or texture, “first-degree burns rarely scar since only the top layer of epidermis is affected,” says Dr. Batra.
How to treat a second-degree burn
A second-degree burn can cause pain and initial swelling, and then blisters, reddening, soreness, and thickening of the skin.
“Second-degree burns can be treated by running the affected area under cool (not cold) water for at least 15 minutes and taking over-the-counter pain meds,” says Dr. Batra. A cool compress can also be used, but again, don’t use ice.
As blisters form, do not pop or break the new blisters. These blisters can become infected and lead to further damage and scarring if they are broken or not treated properly.
Here’s how to treat a burn blister. “Any blisters that form should be covered with antibiotic ointment and non-stick dressings that are changed once or twice a day,” advises Dr. Batra. “Because second-degree burns can cause open wounds, refrain from using cotton balls or anything that can leave fibers in the affected area and increase the risk of infection.”
As it heals, you might want to see a doctor to test for severity and to prescribe antibiotics, just to be on the safe side.
Second-degree burns usually heal in about three weeks, but can vary depending on how deep the burn is, she says. Second-degree burns affect both the epidermis and dermis, and these may scar if the burn is deep enough, says Dr. Batra.
What’s more, people with olive-tone or pigmented skin are more likely to have lasting discoloration after a burn, as inflammation tends to alter pigment production in darker skin types, she explains. The scarring will improve gradually, though. “Remember that all wounds continue to remodel, and scars improve for 6-12 months after the injury,” she says.
Use strict sun protection on the healing site for a month after the burn to help minimize the risk of pigment change. “If the texture remains firm or raised, silicone-based gels or sheeting may help soften the scar,” adds Dr. Batra.
How to treat a third-degree burn
A third-degree burn is the most severe and deepest of the three types, causing the skin to turn dark brown in color and thicken greatly, sometimes taking on a white, waxy, leathery appearance, explains Dr. Batra.
“Third-degree burns can cause serious wounds and have long-term consequences; as such, if you suspect you have a third-degree burn, call 911 immediately,” warns Dr. Batra. “While awaiting medical attention, raise the injury above your heart and refrain from treating it on your own,” she advises, the latter to avoid an infection.
A third-degree burn can result in shock, so monitor the person’s breathing and pulse rate. If you suspect they’re going into shock, lay the person flat, elevate their feet while keeping the burned area elevated if possible, and cover the person with a blanket.
“Blankets and radiant warmers are useful to help conserve heat and to lower risk of shock,” says Robert Glatter, MD, an assistant professor of emergency medicine at Northwell Health and attending emergency physician at Lenox Hill Hospital in New York City.
Third-degree burns can vary greatly in healing time due to the severity of the burn, explains Dr. Batra. “Sometimes skin grafting may be required, which is when a piece of unburned skin is surgically removed from elsewhere and then moved to cover the burned area,” she says.
“Other problems caused by a severe third-degree burn can affect deep skin tissue, bones, and organs, which may need to be treated with surgery, physical therapy, or rehabilitation,” she adds.
Unfortunately, third-degree burns will scar. “Third-degree burns affect all layers of skin. Due to the extent of the damage to tissue and nerve endings, these burns will scar,” says Dr. Batra. “As the dead skin cells begin to regenerate, they will often create an area of thickened, red, shiny skin, and a skin graft may be needed to cover the burned area.”
When to see a doctor
If there are subsequent signs of infection, like oozing, swelling, or a fever, the best thing to do is check in with your doctor or urgent care facility, rather than relying on burn remedies that can be done at home or waiting it out.
And if the affected person hasn’t had a tetanus shot in years, they need to get one. “All burns to the skin are tetanus-prone, and must be treated as such. A tetanus shot is given every 7-10 years,” explains Dr. Glatter.
If the pain worsens, or the burn blister is larger than two inches, you should seek medical attention. “Burns involving more than 20%-25% of the total body surface area require IV fluid resuscitation,” says Dr. Glatter. That’s because burns are a thermal injury that can result in fluid loss, and that may lead to dehydration—which can be dangerous, he adds.
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