Published on Nov 28, 2019 and last reviewed on Aug 09, 2023 - 6 min read
Abstract
Learn about the types, causes, symptoms, and ways to prevent burns. This article also includes home remedies and first aid care for burns and the available treatment options for burn scars.
Any tissue damage due to overexposure to heat, sun, and other radiation, or coming in contact with a chemical or an electrical source is called a burn. The damage caused can be minor or can be life-threatening and result in fatal complications
There are various treatment options for burns depending on its severity and location. Mild burns due to the sun’s rays usually only need home remedies. Deeper burns need immediate debridement and medical treatment. Such burns can cause severe tissue damage and disfigurement, which needs multiple corrective surgeries and months of hospital and follow-up care.
Depending on the cause, the types of burns are:
Sunburn - Burns that result from overexposure to the sun’s rays.
Thermal Burns - Exposing the skin or touching a very hot substance like hot metals or liquid, hot vessels, and fire, results in the death of the skin cells due to high temperatures.
Friction Burns - The tissue damage caused due to the heat produced by an object rubbing the skin is called friction burns. Examples include bike accidents and carpet burns.
Cold Burns - It is otherwise called frostbite. Extreme cold can damage the skin and cause cold burns. The skin will turn bluish to purplish when exposed to freezing temperatures for a prolonged time.
Radiation Burns - Burn that results from radiations such as X-rays or radiotherapy.
Chemical Burns - Touching strong acids or solvents can burn the skin.
Electrical Burns - The type of burn caused by a person coming in contact with electrical current, is called electrical burns.
Based on how deep the skin damage is, the various levels of burn are:
1) First-degree Burn - It is otherwise called superficial burns, and it is caused by minimal or mild damage to the outermost skin layer. The signs of a first-degree burn are redness, slight swelling or inflammation, and pain. The skin becomes dry and scaly as it heals.
As it is only superficial, the skin returns to its original texture and color ones the topmost layer is shed, which takes around 7 to 10 days. Consult a doctor if the burn has affected more than 3 inches of the skin or if it has affected the face or joints, as it will take time to heal.
2) Second-degree Burn - These are more serious and damage layers below the topmost skin layer. The skin becomes very red and painful, and might see blisters. These blisters burst open and make the burn area wet. Once it heals, thick scar tissue may develop over it, which is called fibrinous exudate.
Consult the doctor immediately, as the wound needs to be cleaned and bandaged to prevent infection. It can sometimes take longer than 2 to 3 weeks for a second-degree burn to heal, but the skin color mostly does not return to normal.
3) Third-degree Burn - Here, the burn damages most layers of the skin including the fat layer. As it causes nerve damage and numbness, this type of burn is not that painful. The skin becomes white or waxy, charred, leathery, and dark brown in color. If left untreated, it can cause severe infection and severe scarring. It usually requires excision and skin grafting.
4) Fourth-degree Burn - The burn extends to the underlying fat, muscles, and bones. The skin looks charred and dry. Like the third-degree burn, this is also painless, as the nerve endings are damaged. Amputation of the affected part might be needed, and it can also be fatal.
Consult a doctor in the following cases:
If the burn covers more than 3 inches of the hands or feet, face, or a major joint.
If the skin becomes oozy, it causes severe pain, and swelling, as these are signs of an infection.
If the burn appears to have damaged the deeper layers of the skin.
If the skin looks leathery.
If the burn was caused by an electric shock.
If one finds it difficult to breathe.
If the skin is charred or has patches of black or brown.
If the skin takes more than 2 weeks to heal.
If healing resulted in a big scar.
Protect yourself and the victim from further harm by moving away from the source of burn. Make sure the victim is breathing, if not, perform CPR. Remove belts and jewelry from the burned area immediately, as the area might swell and restrict blood flow.
Always cover the burnt area with a cool and wet cloth, and do not use cotton as it will stick to the skin. Avoid immersing the areas that are severely burnt in water, as it can result in hypothermia. If one notices the signs of infection or shock, take the victim to the emergency room immediately.
First of all, to reduce pain, apply a cold and wet cloth on the burn or hold it under running water.
Remove all jewelry from the area before it swells.
Avoid popping the blisters. In case a blister bursts open, apply antibiotic ointment.
Once he area is cool, apply a moisturizer or lotion containing aloe vera.
If needed, cover the area with a gauze bandage loosely.
For pain, over-the-counter painkillers like Ibuprofen and Acetaminophen can be used.
Minor burns commonly heal in a week or two with these home remedies. If it does not, then please consult a doctor.
The medicines and therapies used to help the skin heal are:
Ultrasound mist therapy - The wound tissue is cleaned and stimulated.
IV fluids - To prevent dehydration.
Pain medications - Morphine or other strong medicines are prescribed.
Ointments - Ointments containing Bacitracin and Silver sulfadiazine, prevent infection.
Wound dressing - The area is covered with dry gauze.
Tetanus injection.
Breathing assistance - In cases where the airway gets shut due to swelling, the doctor inserts a pipe through the windpipe to supply oxygen to the lungs. A ventilator machine will help the patient breath.
Feeding tube - In severe cases, where the patient has extreme burns and cannot eat and is undernourished, a feeding tube is inserted through the nose to the stomach.
Skin grafts - If the scar tissue covers a large area of a body part, then it is replaced with sections of healthy tissue taken from somewhere else on the patient’s body. Sometimes, skin from a cadaver or pigs are used temporarily.
Plastic surgery - To improve appearance of the scar and to make the joints more flexible, plastic reconstruction can be done.
Complications are commonly seen with third and fourth-degree burns. Some of the possible complications are:
Sepsis - The infection from the skin can result in bacteria moving to the bloodstream.
Hypothermia - The body’s temperature becomes dangerously low.
Breathing problems.
Contractures - The scar near a major joint can shorten and tighten the surrounding skin, muscles, and tendons.
Hypovolemia - Fluid and blood loss.
Keloids - The scar tissue can overgrow.
Some of the preventive measures include:
Keep lighters and matches away from kids.
Do not let the kids enter the kitchen alone when the stove is on.
Always keep the handles of the pot facing the back of the stove.
Check if the smoke detectors are working periodically, and replace them every 10 years.
Check the temperature of the water before taking a shower.
Wear protective clothing while working with chemicals.
Avoid going out during peak sunlight and always wear sunscreen.
Clean the lint traps from the dryer often.
Cover all exposed wires in the house.
Keep a fire extinguisher handy.
Practice escaping through the fire escape every month.
Keep all electrical appliances far from a water source.
Avoid cooking while wearing loose clothes.
Conclusion:
A lot of hospitals have a dedicated burn unit or center, and some places are just used for the recovery of burn patients. Modern burn units and facilities, extensive burn rehabilitation services, integrated medical care, and advances in the knowledge and treatment of burns have all helped to raise the survival and recovery rates for burn patients.
The first aid that has to be given for burns include:
- Cool the burnt area by placing it under running water for at least 10 minutes.
- Do not apply butter or ointments, as it can cause some infection.
- Please do not break the blister because it will protect the burn from infection. But if it breaks, wipe it with a clean cloth.
- Take an over-the-counter drug for pain.
- If the burn is severe, call the emergency helpline.
Vaseline does not actually heal a burn, but acts as a skin barrier, and it does not get absorbed by the skin. Vaseline seals the skin with a protective water barrier, and it helps to heal the skin and retain moisture. It is beneficial in case of first and second-degree burns.
To heal a burn quickly, you need to eat foods rich in Vitamin E and Vitamin C, or you should at least take 1000 IU of Vitamin E and 2000 mg of Vitamin C for a week. You can also break the Vitamin E capsule and apply it directly on the burn.
We should not apply ice cubes or ice water directly on the burns because it can make the skin too cold and cause frostbite and damage the tissues. Therefore, we can treat it by placing it under running water.
The throbbing pain from a burn injury depends on the level of nerve damage (the nerves that innervate the skin). Pain can be managed by placing the burnt area under running water and by taking an over-the-counter drug like Ibuprofen, Acetaminophen, or Aspirin. Medications like Gabapentin and Pregabalin can be used in case of neuropathic pain. People with burn injuries should watch out for infection because the infection is the primary cause of pain.
The burn should be kept moist and protected because moist wounds can cause tissue regeneration and promote faster healing with less scarring. The burn wounds, when covered, will retain moisture and protect it from the elements that cause infection.
For a burn to stop hurting, it may take from minutes to months. Minor burns can only cause fleeting pain and may disappear within an hour, but most burns may go away within days to weeks. But in case of severe burns, the pain can be more and may take several months to heal.
A burnt area hurts because the affected skin will try to eliminate the heat as soon as possible. It does it by opening up the capillaries wide. These capillaries, when opened for a more extended period, may get damaged and cause pain. Some burn injuries may put some stress on them during the recovery phase. This type of stress can cause muscle tension and might increase pain.
Blisters are the collection of fluids formed to protect the affected skin from infection, which can be formed immediately or take some time to form fully. Burnt areas can form blisters in case of a deep partial-thickness burn. The second-degree burns, which is the partial-thickness burn, affect the dermis and epidermis, and therefore, can cause pain, swelling, and blisters.
When the skin becomes white, and if you still feel pain, it is a second-degree burn. And if the skin turns white immediately after the burn, it is a third-degree burn. Both these cases may take time to heal and need medical attention.
In oil burns, you should place the affected skin under running water until it cools. You should not apply ice directly to it since it may cause further damage to the tissues. It is better to cover it with a wet cloth, which will soothe the pain and discomfort. You can apply creams or lotions to moisturize the skin and prevent further damage to the tissues. It should be left as it is to promote faster healing.
You can try the following steps to prevent scars from a burn, but it will be effective only in case of first and second-degree burns. In case of severe burns like third and fourth-degree, it is better to seek medical assistance.
Rinse the wound immediately after the burn.
Apply antibiotic cream and cover with a bandage.
- Try to move and stretch the area.
- Do not rush to cut the blister.
- Be aware of the infection.
- Avoid exposure to the sun.
- Apply petroleum jelly to the burn.
- Massage the area.
- Wear pressure garments.
- Apply honey over the area.
Once the burn is completely cool, a lotion containing aloe vera or a moisturizing agent can be applied on the wound. Then, secure the area with a loose bandage without giving pressure to the burn wound, which helps prevent dryness and allow it to heal faster.
Second-degree burns need surgery, which involves removing the dead skin in an operating room with the help of a procedure called surgical excision or wound debridement. But, it does not require any skin grafting as these burns will heal with no or little scarring.
The home remedies for burns include:
- Placing the burnt area under cool water.
- Cool compresses.
- Application of lotions rich in aloe vera.
- Antibiotic ointments.
- Reducing sun exposure.
- Honey.
- Do not pop blisters.
- Take an over-the-counter pain reliever.
The burn caused by boiling water usually occur on the superficial or outer layer of the skin, and it should be treated in the following way:
- You can continue the treatment at home if the symptoms start to go off.
- Aloe vera can be applied, which is a good remedy for burns on superficial skin.
- Anti-inflammatory or an over-the-counter drug for pain.
- If it causes any blisters, do not pop it, or if no blisters, secure it with a wet bandage during the day to prevent infection.
- Remove any dead skins with a saline wet gauze after seven days.
Last reviewed at:
09 Aug 2023 - 6 min read
RATING
Dermatology
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