Skin burns is a type of injury to skin, or other tissues, caused by heat, cold, electricity, chemicals, friction, or radiation. Most burns are due to heat from hot liquids, solids, or fire. While rates are similar for males and females the underlying causes often differ. Among women in some areas, risk is related to use of open cooking fires or unsafe cook stoves. Among men, risk is related to the work environments. Alcoholism and smoking are other risk factors. Burns can also occur as a result of self harm or violence between people.
Types of Skin Burns
Thermal
In the United States, fire and hot liquids are the most common causes of burns. Of house fires that result in death, smoking causes 25% and heating devices cause 22%. Almost half of injuries are due to efforts to fight a fire.Scalding is caused by hot liquids or gases and most commonly occurs from exposure to hot drinks, high temperature tap water in baths or showers, hot cooking oil, or steam. Scald injuries are most common in children under the age of five and, in the United States and Australia, this population makes up about two-thirds of all burns.Contact with hot objects is the cause of about 20–30% of burns in children. Generally, scalds are first- or second-degree burns, but third-degree burns may also result, especially with prolonged contact. Firework are a common cause of burns during holiday seasons in many countries.This is a particular risk for adolescent males.
Chemical
Chemicals cause from 2 to 11% of all burns and contribute to as many as 30% of burn-related deaths. Chemical burns can be caused by over 25,000 substances, most of which are either a strong base (55%) or a strong acid(26%).Most chemical burn deaths are secondary to ingestion. Common agents include: sulfuric acid as found in toilet cleaners, sodium hypochlorite as found in bleach, and halogenated hydrocarbons as found in paint remover, among others. Hydrofluoric acid can cause particularly deep burns that may not become symptomatic until some time after exposure. Formic acid may cause the breakdown of significant numbers of red blood cells.
Electrical
Electrical burns or injuries are classified as high voltage (greater than or equal to 1000 volts), low voltage (less than 1000 volts), or as flash burns secondary to an electric arc. The most common causes of electrical burns in children are electrical cords (60%) followed by electrical outlets (14%). Lightning may also result in electrical burns.[29] Risk factors for being struck include involvement in outdoor activities such as mountain climbing, golf and field sports, and working outside.[16] Mortality from a lightning strike is about 10%.[16]
Radiation
Radiation burns may be caused by protracted exposure to ultraviolet light (such as from the sun, tanning booths or arc welding) or from ionizing radiation (such as from radiation therapy, X-rays or radioactive fallout). Sun exposure is the most common cause of radiation burns and the most common cause of superficial burns overall.There is significant variation in how easily people sunburn based on their skin type. Skin effects from ionizing radiation depend on the amount of exposure to the area, with hair loss seen after 3 Gy, redness seen after 10 Gy, wet skin peeling after 20 Gy, and necrosis after 30 Gy. Redness, if it occurs, may not appear until some time after exposure. Radiation burns are treated the same as other burns.Microwave burns occur via thermal heating caused by the microwaves. While exposures as short as two seconds may cause injury, overall this is an uncommon occurrence.
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Burns may also produce emotional and psychological distress.
| Type | Layers involved | Appearance | Texture | Sensation | Healing Time | Prognosis | |
|---|---|---|---|---|---|---|---|
| Superficial (1st-degree) | Epidermis | Red without blisters | Dry | Painful | 5–10 days | Heals well.Repeated sunburns increase the risk of skin cancer later in life. | |
| Superficial partial thickness (2nd-degree) | Extends into superficial (papillary) dermis | Redness with clear blister.Blanches with pressure. | Moist | Very painful | 2–3 weeks | Local infection (cellulitis) but no scarring typically | |
| Deep partial thickness (2nd-degree) | Extends into deep (reticular) dermis | Yellow or white. Less blanching. May be blistering. | Fairly dry | Pressure and discomfort | 3–8 weeks | Scarring, contractures (may require excision and skin grafting) | |
| Full thickness (3rd-degree) | Extends through entire dermis | Stiff and white/brown.No blanching. | Leathery | Painless | Prolonged (months) and incomplete | Scarring, contractures, amputation (early excision recommended) | |
| 4th-degree | Extends through entire skin, and into underlying fat, muscle and bone | Black; charred with eschar | Dry | Painless | Requires excision | Amputation, significant functional impairment and in some cases, death. |
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Home Remedies For Skin Burns
First aid for a burn involves cooling the burn with cool running water, removing clothing or jewelry that’s not stuck to burned skin, loosely covering the burn with cling film, and keeping the person warm with a blanket. Applying a cold moist towel and pain medication can lessen pain. Aloe vera, potato peel dressings, and honey can help with minor burns while serious burns need medical attention.
A momentary lapse of attention and you could burn yourself, be it at the stove or through scalding tea or a hot iron. This can cause a painful burn and may result in reddened peeling skin, swelling, blisters, and charred or white skin. So what are your immediate options for first aid and relief?
Burns are typically classified into 3 levels. First-degree burns cause redness, swelling, and pain and are limited to the outer layer of your skin. Second-degree burns affect the outer skin as well as the layer underneath. These cause redness, swelling, and pain as well as blistering of the skin. Third-degree burns, the most serious kind, go through to deep layers of your skin. The can result in burned, blackened, or white skin. With this kind of burn, your skin tends to become numb. That’s why the intensity of pain you feel here is not always indicative of how serious your injury is.
Serious burns require medical attention and you should rush to the emergency room. Other minor burns can be effectively treated at home.
Home Remedies For Skin Burns
Here are some first-aid tips and home remedies for burns you can try.
Cool Your Skin
- The first thing to do is cool your skin by holding it under tepid or cool running water for about 15 minutes. Ideally, this should be done within 20 minutes of getting burned.
- Take care not to use iced water or put ice on the burn as this can cause damage. Also avoid using greasy substances like creams or butter to soothe the injury.
Chill The Pain
- Holding a cold, clean, moist towel against the burn can help lessen pain. You can also use over-the-counter pain relief medication. But do keep in mind that aspirin should not be given to children under the age of 12.2
Remove Jewelry And Clothing
- Try to remove jewelry and clothing near the area that has been burned. Do this as soon as you can, immediately if possible, before the area starts to swell. Don’t try to take off anything which is stuck to burned skin.
Keep Warm
- Use clothing or a blanket to keep warm and avoid hypothermia. This condition, where your temperature can drop below 95°F, is a risk if you’re cooling a large area that has been burned, especially in elderly people and children.
- Even as you bundle up to avoid hypothermia, make sure you don’t cover the area that’s been burnt.
Cover With Cling Film
- Cover the burned area with cling film to protect it. However, take care that the covering is loose – do not wrap the burn tightly as this can make things worse. You can also use a clean and clear plastic bag if your hand is burned.3
Use These Natural Remedies To Heal And Soothe Burns
Aloe Vera
- Aloe vera gel can help burned skin heal faster. It can lessen inflammation and also help in the long run with new tissue formation, thus reducing scarring.4 Break open an aloe leaf, scoop out the gel inside, and apply it gently on the burn. An aloe vera ointment can also be helpful.
Honey
- Honey has been used for ages to treat wounds. This sticky sugar is thought to work because of its antibacterial properties. Research which specifically looked at honey for the treatment of burn wounds has also been positive, with some studies indicating that applying honey instead of conventional dressings can lessen the time taken to heal a burn by 4.68 days. Try applying medical grade honey to heal mild or moderate burns.5
Boiled Potato Peels
- Here’s an unusual dressing you wouldn’t have considered for your burn – boiled potato peels! One study compared the use of a boiled potato peel dressing to the use of a gauze dressing after the topical application of an antibiotic and found that potato peels were able to retain moisture better in the skin.
- They also hastened skin regeneration. Do keep in mind, though, potato peels don’t have any antibacterial properties so you need to supplement this with an ointment. It is also important to sterilize them properly by boiling them in water before use.
Oat Meal
- Burn injuries can sometimes feel itchy as they heal. And one remedy for tackling this problem is sitting right on your kitchen shelf. One study which looked at acute burn patients who used a bath oil that contained colloidal oatmeal found that it was able to significantly reduce itchiness in them.
- Colloidal oats is finely ground oatmeal with gluten. When added to water, it turns into a sticky mass that coats your skin and prevents moisture loss.8 This is why it’s great for soothing dry, itchy skin. So add a cup of colloidal oats to your bath water and lose that scratchy feeling.
How To Deal With A Chemical Burn
- If you’ve been burnt by a chemical like acid or bleach, remove the chemical from your skin by holding the affected area under cool running water for about 20 minutes. If the chemical is in the form of a powder, brush it off before you wash. Rewash the wound if the sensation of burning increases.
- Also, remove jewelry or clothing that’s been contaminated by the chemical. Don’t forget to wear protective gloves so your hands don’t come in contact with the chemical. And remember, it’s always advisable to seek medical attention for a chemical burn.
How To Deal With An Electrical Burn
- If you get hurt via an electrical shock, turn off the power (or have someone do it for you) and use a nonconductor of electricity like a wooden stick or wooden broom handle to push the source away. Electrical burns can be extremely damaging even when they don’t look serious. So you need to get medical help immediately.10
Burn Wounds: What Not To Do
Here are some things to avoid if you get burned:
- Don’t try home remedies if the burn is severe. Also avoid applying ice, ointment, medicines, or butter to the burn.
- Don’t blow, cough, or breathe on a burn. This can transfer germs which may then cause an infection.
- Don’t disturb dead skin or burst blisters as this can infect the skin as well.
- Don’t try to remove clothing that’s stuck to burned skin.
- Don’t use cold water on a severe burn as this may lead to shock.
- Don’t take anything, including water, by mouth if you’ve suffered a severe burn. This could up the risk of choking if you go into shock.
- If you’ve scalded your mouth, avoid things like alcohol, hot food, spicy food, and smoking so you don’t irritate the wound.
- Don’t elevate the head with a pillow or other means if there’s been an airway burn – this can block the airway. Your airways can get burned when you breathe in steam, hot air, smoke, or chemical fumes. Look out for symptoms like trouble breathing, coughing, wheezing, dark mucus, changes to the voice, and burns on the neck, face, eyebrows, nose hairs, lips, mouth, or head.
When To Seek Medical Attention
- While minor burns can be easily treated at home, in some cases you will need medical attention.
It’s a Serious Burn
- If the burn is large, that is, about the size of your hand or if there are third-degree burns, you need to seek immediate medical attention. And if you’re not sure how serious the burn is, err on the side of caution and seek medical help.
You See Signs Of Shock
- Shock is a condition that develops when your blood flow is hampered. Since blood delivers oxygen and nutrients to your organs and cells, this means they can’t function properly. Shock can be fatal and requires immediate medical attention.12 Signs like clammy or pale skin, blue fingernails and lips, weakness, and diminishing alertness can be indicative of shock.
You See Signs Of Dehydration
- Thirst, decreased urination, dry skin, dizziness, headache, and nausea are signs of dehydration. If a burn is accompanied by these signs, do check in with your doctor immediately.
There’s Smoke Inhalation
- Smoke from a fire can damage your body by depriving you of oxygen. Irritating chemicals and heat carried in by the smoke can also damage your airways. If you have inhaled smoke, you need medical attention.
You’ve Suffered A Chemical Or Electric Burn
- It’s always best to get electrical and chemical burns assessed by a doctor.
Signs Of Infection Develop
- You need to see a doctor if you notice signs of infection like pus, fluid discharge, increased pain, swollen lymph nodes, red streaks that radiate from the burn, or fever. It’s also a good idea to seek medical attention if your wound doesn’t heal within a couple of weeks.
The American Burn Association recommends burn center referrals for patients with
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partial thickness burns greater than 10% total body surface area
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full thickness burns
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burns of the face, hands, feet, genitalia, or major joints
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chemical burns, electrical, or lighting strike injuries
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significant inhalation injuries
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burns in patients with multiple medical disorders
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burns in patients with associated traumatic injuries
Patients being transferred to burn centers do not need extensive debridement or topical antibiotics before transfer. Whether transferring or referring to a burn center, you should contact them before beginning extensive local burn care treatments.[rx][rx]
Minor burns which you plan to treat can be approached using the “C” of burn care:
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Cooling – Small areas of burn can be cooled with tap water or saline solution to prevent progression of burning and to reduce pain.
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Cleaning – Mild soap and water or mild antibacterial wash. Debate continues over the best treatment for blisters. However, large blisters are debrided while small blisters and blisters involving the palms or soles are left intact.
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Covering – Topical antibiotic ointments or cream with absorbent dressing or specialized burn dressing materials are commonly used.
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Comfort – Over-the-counter pain medications or prescription pain medications when needed. Splints can also provide support and comfort for certain burned areas.
References
