1
Burns are among the most common and potentially serious injuries. Heat, chemicals, electricity and radiation can burn your skin to varying degrees. Burns are categorized based on the depth of the injury. Minor, or first-degree, burns can usually be managed at home and heal without scarring. Third-degree burns are serious, potentially life-threatening injuries that require intensive medical treatment.
FIRST-DEGREE BURNS
The least serious burns are those involving only the outermost layer of skin, the epidermis. The burned skin is typically bright pink and blanches, or turns white, when you press on it. The affected area may swell. The outer layer of skin peels within a few days, and complete healing occurs within roughly one week without scarring.
SECOND-DEGREE BURNS
A second-degree burn involves the epidermis and a portion of underlying skin layer, the dermis. Blisters are a hallmark feature of second-degree burns, also known as partial-thickness burns. Second-degree burns usually cause severe pain; extensive swelling occurs in the affected area. Healing typically occurs within two to three weeks. The severity of scarring associated with a second-degree burn depends on the depth and size of the burn.
THIRD-DEGREE BURNS
Third-degree, or full-thickness, burns extend through all layers of the skin into the underlying tissue. With severe third-degree burns, fat, muscle and bone may be involved. Because the skin nerves are killed by the injury, full-thickness burns are painless. The area may appear white, charred or brown, depending on the mechanism of the burn. Blisters do not form with these burns. Third-degree burns cause severe scarring; replacement of the damaged skin with a graft is often necessary to close the wound. Healing typically takes months to years.
TREATMENT OF MINOR BURNS
Minor burns, including second-degree burns limited to an area no larger than 2 to 3 inches in diameter, can often be treated at home. Cool the burn by soaking it in cold water or applying a cold compress for at least 5 minutes. Do not use ice, which can cause frostbite and further damage your skin. With chemical burns, flush the chemicals off the skin surface with cool running water for at least 20 minutes. If the chemical is a powder-like substance, such as lime, brush it off the skin before flushing.
Cooling a burn reduces swelling by carrying heat away from the skin. Once a burn is completely cooled, apply a soothing lotion, such as one that contains aloe vera. The lotion helps prevents dryness and may ease your discomfort. Loosely cover the burn with a large bandage or gauze. Do not puncture burn-induced blisters, which act as a natural barrier to infection. Change the bandage daily or if it gets wet. Clean the area with a mild soap and water when you change the dressing. An over-the-counter pain reliever, such as aspirin, acetaminophen, ibuprofen or naproxen, may help alleviate discomfort caused by the burn.
TREATMENT OF SERIOUS BURNS
Third-degree burns and partial-thickness burns affecting an area larger than 2 to 3 inches in diameter require urgent medical care. Call 911 and explain the circumstances; the operator will instruct you how to care for the patient until the emergency medical team arrives. Do not attempt to remove clothing burned in a fire.
WHEN TO CALL YOUR DOCTOR
See your doctor for burns involving the face, hands, feet, genitals or large joints, especially if the burn is larger than 2 to 3 inches in diameter. Call your doctor if signs of infection develop, such as a fever, increased swelling, discharge from the wound and increased pain or redness.
