A burn is damage to the skin and sometimes to the underlying tissues. Burns are categorized according to the depth and extent of the damage to the skin:
- Superficial burn (also called first-degree burn)
- Mildest type of burn
- Often caused by ultraviolet light, or very short (“flash") flame exposure
- Affects only the outer layer of the skin (epidermis)
- Normally does not cause scarring
- Takes about 3-6 days to heal
- Superficial partial-thickness burn (also called second-degree burn)
- Often caused by a scald (spill or splash) or short (“flash”) flame exposure
- Affects the outer layer of the skin more deeply, usually causing blistering
- May or may not cause scarring, but often does cause long-term skin color changes
- Takes about 1-3 weeks to heal
- Deep partial-thickness burn (also called second-degree burn)
- Often caused by a scald (spill), may involve flame, oil, or grease
- Affects the outer and underlying layer of skin (dermis), causing blistering
- Usually causes scarring
- Usually takes more than three weeks to heal
- Full-thickness burn (also called third-degree burn)
- Very serious
- Often caused by scald (immersion), may involve flame, steam, oil, grease, chemicals, or high-voltage electricity
- Damages all layers of the skin, and may involve the tissues underneath (muscle and bone)
- Causes scarring
- Will heal only at the wound edges by scarring, unless skin grafting is done
Classification of Skin Burns
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Burns can be caused by:
- Heat or flame (thermal burns)
- Hot foods or drinks such as boiling water, tea, or coffee
- Hot oil or grease
- Hot tap water
- Direct heat such as stoves, heaters, or curling irons
- Direct flame
- Flammable liquids such as gasoline
- Chemicals (chemical burn)—strong acids or strong bases such as:
- Cleaning products
- Battery fluid
- Pool chemicals
- Drain cleaners
- Sunlight (sunburn) or tanning beds
- Electricity (electrical burn)
- Damaged electrical cords
- Electrical outlets
- High-voltage wires
- Radiation (radiation burn)
- Nuclear radiation
- Radiation therapy for cancer treatment
Is it a Serious Burn?
Burn symptoms and signs vary depending on the type of burn.
- Burned area turns red and is painful
- The area blanches (turns white) when you press on it
- The area may swell, but it is dry and there is no blistering
Superficial Partial-Thickness Burn
- The area is moist, red, and weeping
- The area blanches (turns white) when you press on it
- Painful to air and temperature
Deep Partial-Thickness Burn
- Blisters, usually loose and easily unroofed
- The area can be wet or waxy dry
- The skin color can vary from patchy, to cheesy white, to red
- The area does not blanch (turn white) with pressure
- May or may not be painful, can perceive pressure
- Skin can appear waxy white, leathery gray, or charred and blackened
- May not be painful if nerves have been damaged, the only sensation may be deep pressure
Treatment will depend on the cause of the burn, how deep the burn is, and how much of the body the burn covers. Doctors have methods and charts to estimate the total percentage of body surface area (TBSA) affected by the injury. This estimate is age dependent. For example, the head represents a larger percentage of surface area in a baby than in an adult.
Treatment for a burn depends on the cause. Quick treatment is important and can lessen the damage to the tissues. First aid for minor burns may involve:
- Cooling the burn with running water or a cold damp cloth. Do not use ice—this may result in more damage to the skin.
- Do not use butter, grease, oils, or ointments on the burn.
- Cover the burn with sterile gauze or a clean cloth.
- Do not use a fluffy cloth such as a towel or blanket.
- Take an over-the-counter pain reliever, like acetaminophen (Tylenol).
- Do not break or pop any blisters.This may result in an infection.
- If you see signs of an infection, get medical attention. Signs of infection include:
- Increased pain
- Oozing of pus
Once a minor burn is completely cooled, you can consider using a fragrance-free lotion or moisturizer to prevent drying and make the area more comfortable.
For more serious burns, like deep partial-thickness or full-thickness burns, seek medical attention or call 911. Until an emergency unit arrives:
- Do not take off any clothing that is stuck to the burn.
- Make sure the victim is not near, or in contact with, any smoldering materials or exposed to further smoke or heat.
- Do not soak the burn in water, but you can cover the area with a cool, moist sterile bandage or clean cloth.
- As with any severe injury, make sure the person is breathing and administer CPR if necessary.
If you are diagnosed with more than a minor burn, follow your doctor's instructions.
Hospitalization for Burn
A doctor will decide if hospitalization is necessary based on many factors. These include age, the cause of the burn, and the extent and depth of the burn. Reasons to hospitalize a person who has more than a minor burn may include:
- Age: younger than five years or older than 55 years
- Suspected child abuse
- Very small, deep burns on the hands, face, eyes, feet, or perineum (groin/genital area)
- Extensive burn: using TBSA and age charts
- Burns that may require complicated dressing changes, elevation, or continued physician observation
- High-voltage injury or burn
- Suspected or known inhalation injury
- Circumferential burn
- Other medical problems that predispose a person to infection, such as:
- Sickle cell disease
Medical Treatment for Major Burns
If the burn is serious, the following treatments may be administered in a hospital:
- Oxygen to help with breathing
- IV fluids to replace those lost from the burn
- Skin graft
- Splints—placed on joints to help maintain mobility
- Physical therapy, in the case of large burns
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Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.