What Are Burns?

Thermal burns are injuries to the skin (and deeper structures) caused by too much heat or certain types of light. Intense heat for a short time (e.g., hot grease) and low heat or light over long times (e.g., heating pads or sun) produce burns. The depth of tissue injury determines burn severity. Thermal burns are usually classified as first, second, and third degree. Fourth-degree burns extend into the muscle below the skin. Electricity and chemicals such as acids and alkali may also cause burns. Chemical burns are more complicated and hard to classify. Electrical burns may be deep enough to reach muscles and bones and are sometimes called fourth-degree (black or char) burns.

What Causes Burns?

Burns can be caused by fire, steam, electricity, sun, chemicals, and hot liquids or objects.

What Are the Symptoms of Burns?

Symptoms vary with the degree of damage to body tissues. First-degree burns produce painful, red areas in the surface (superficial) skin, but no blisters. Second-degree burns affect deeper skin, with blisters and light charring, and are very painful. Third-degree burns damage the whole skin depth, so the skin looks pale, charred, and leathery. These burns aren’t painful because the nerves in the burned area have been damaged.

How Are Burns Diagnosed?

The diagnosis is made by examining the skin. Symptoms will help determine the degree of burn.

How Are Burns Treated?

Small first-degree burns may not require any treatment. Putting the burned area in cold water (not ice) or using wet compresses can reduce pain and swelling of minor burns. Breaking blisters can cause infection, so this should be avoided. Using aloe vera and acetaminophen or ibuprofen can help pain. Protection with dressings and antibiotic ointment may prevent infection.

Medical evaluation and treatment is needed for: (1) second-degree burns larger than the person’s palm; (2) any second-degree burns of hands, feet, face, or genitals; and (3) second-degree burns anywhere on infants. All third- and fourthdegree burns (which are life-threatening) need a doctor’s immediate care. A health care provider should always see chemical burns.

The health care provider will gently remove dead skin layers (débridement), change dressings, and watch for infections. Some severe burns need specialized treatment, including surgical grafting of skin and use of special pressure garments, at special centers.

For severe burns, call 911 for help.

DOs and DON’Ts in Managing Burns:
  • DO change your dressing and apply fresh antibiotic ointment at prescribed times.
  • DO use pain medicines as directed.
  • DO drink extra fluids and eat a healthy diet.
  • DO keep follow-up health care provider appointments.
  • DO call your health care provider if you have fever; chills; increasing pain; or pus, foul odor, or red streaking from your wound.
  • DO call your health care provider if you have a reaction to medicine.
  • DO practice fire safety: wear protection, fireproof your home and business, and teach children safety rules.
  • DON’T ignore second-degree burns.
  • DON’T put butter on burns.
  • DON’T let bandages become dirty or wet.
  • DON’T exercise or return to work until your health care provider says to.
  • DON’T expose healing burns to sunlight (increases scarring).
  • DON’T try to peel dead skin layers.

Contact the following sources:

  • Burn Survivor Resource Center
    Tel: (800) 669-7700
  • American Burn Association
  • American College of Emergency Physicians

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

Ferri’s Netter Patient Advisor