Burns

Burns are a type of skin injury. The severity of a burn is based on the following criteria:

• The affected area
• The depth
• The extent
• The cause

Some burns can be treated at home, while others require emergency medical attention.

Causes and triggers

• Heat (e.g., fire, a very hot object or boiling liquid, steam, lit cigarette)
• Radiation (e.g., sunburn)
• Chemicals (e.g., household products, flammable liquid)
• Electricity (e.g., lightning, electric shock).

The more time the skin spends in contact with the burn source, the more severe the injury will be.

Symptoms

Burn symptoms vary depending on the severity of the burn. We can divide burns into three degrees of intensity:

First-degree burns

First-degree burns affect the skin’s outer layer. The affected area is painful, red, swollen, and dry. Generally, no blisters will form and the skin will remain intact. For this reason, the risk of infection is low. The skin will heal on its own within a few days without leaving a scar. Sunburns and coming into contact with hot objects are the most common examples of this type of burn.

Second-degree burns

Second-degree burns involve the first two layers of the skin. The burn site is very painful, appears pink or white, and is blistered. A clear fluid may drain from the wound. Since the inner layers of the skin are exposed, there is a risk of infection. These burns can take several weeks to heal and may permanently change the colour of the affected skin. Severe sunburn or scalding are the most common reasons for this type of burn.

Third-degree burns

These burns affect all three layers of the skin. The skin can range in colour from red to white or black. Any pain felt is minimal (due to damage to the nerve endings responsible for pain). Depending on the extent and location of the wound, third-degree burns can be fatal. The risk of infection is very high since the barrier between the inside and outside of the body is eliminated. This type of burn never heals on its own and typically requires surgery. Scarring is inevitable. The most common causes of third-degree burns are exposing the skin to fire or concentrated chemicals.

Treatment

First aid and treatment may vary depending on the type of burn:

• First-degree burns
  • Rinse the wound under cold tap water for 15 to 20 minutes to cool the area.
  • Gently clean the wound with mild soap and water if debris is present.
  • Apply an unscented water-based moisturizer to the wound (e.g., CeraVe or Aveeno creams).
  • Apply a sterile, non-adherent dressing if the burn is in an area covered by clothing. If not, let the skin air dry.
• Second-degree burns
  • Rinse the wound under cold tap water for 15 to 20 minutes to cool the area.
  • Avoid popping any blisters. If they burst, gently clean the area with a mild soap.
  • Cover the wound with a sterile, non-adherent dressing. Change the dressing daily and watch for signs of infection.
  • For pain relief, take acetaminophen (e.g., Tylenol) or ibuprofen (e.g., Motrin or Advil) as needed.
  • Contact a health care professional to see if a tetanus vaccination is necessary.
• Third-degree burns
  • Go to the hospital emergency room IMMEDIATELY.
  • Do not apply water or any other product to the wound.
  • Remove all clothing that may come into contact with the wound. If they seem stuck, do not remove them, however.
  • Cover the wound with a clean, dry dressing to prevent contamination.
  • Keep the person warm.

Generally, it is not recommended to clean burns with antiseptic or disinfectant, as these products are irritating. In the presence of dirt or debris, you can simply use water and mild soap. It's also important not to apply ice or grease to the wound (e.g., ointment, oil, butter).

Over-the-counter antibiotic and anesthetic creams are generally not recommended. These products are not very effective and can slow down the healing process. Anesthetic creams are known to be particularly irritating and allergenic.

Burned skin is more sensitive to the rays of the sun and can easily be burned again or turn permanently brown. For this reason, it's important to avoid exposing the burn area to the sun until the wound is fully healed. You can protect the area by covering it with a piece of cloth or applying a sunscreen with an SPF of 30 or higher.

When should I see a health care professional?

Consult your health care provider in the following cases:

• The burn is larger than the size of your hand.
• The burn is on the face, ears, feet, or genitals.
• You observe signs of infection: redness, heat, swelling, fever, pus.
• The burn is the result of an electric shock, inhalation of toxic fumes, or chemical exposure.
• The burn victim is under the age of 5 or over the age of 60.