Burns: causes, symptoms and treatment

Burns involve tissue damage caused by heat, overexposure to the sun or other radiation, or contact with chemicals or electricity. Burns can be minor medical issues or life-threatening emergencies.

Treatment for burns depends on the location and severity of the injury. Sunburns and minor burns can usually be treated at home. Deep or extensive burns require immediate medical attention. Some people require treatment at specialized burn centers and months of follow-up care.

Burn symptoms vary depending on the degree of skin damage. Signs and symptoms of a severe burn may take a day or two to develop.

First degree burn.

This mild burn only affects the outer layer of the skin (epidermis). This can cause redness and pain.

Second degree burn.

This type of burn affects both the epidermis and the second layer of skin (dermis). This can cause swelling and make the skin look red, white, or blotchy. Blisters may form and the pain may be severe. Deep second-degree burns can leave scars.

Third degree burn.

This burn reaches the layer of fat under the skin. Burned areas may be black, brown, or white. The skin may have a leathery appearance. Third-degree burns can destroy nerves, causing numbness.

Consult an emergency doctor in the following cases:

Burns that involve the hands, feet, face, groin, buttocks, a major joint or a large part of the body Deep burns, i.e. burns that affect all layers of the skin or even deeper tissue Burns that make the skin look rough Burns that have a charred appearance or black, brown, or white spots Burns caused by chemicals or electricity Difficulty breathing or burns to the airways

Take first aid measures while waiting for emergency help.

Call your doctor if you have any of the following symptoms:

Signs of infection, such as discharge from the wound, increased pain, redness, and swelling A significant burn or blister or one that does not heal within two weeks New, unexplained symptoms Visible scarring

If you see a doctor for treatment of a burn, the professional will assess the severity of the burn through a skin exam. May recommend referral to a burn center if the burn covers more than 10% of total body surface area, is very deep, has occurred on the face, feet, or groin, or responds to other criteria established by the American Burn Association.

Your doctor may examine you for other injuries and may order lab tests, X-rays, or other diagnostic procedures.

Most minor burns can be treated at home. They usually heal within a few weeks.

For severe burns, after proper first aid and wound assessment, treatment may involve medication, dressing, therapy, and surgery. The goals of treatment are to control pain, remove dead tissue, prevent infection, reduce the risk of scarring, and restore function.

People with severe burns may require treatment at specialized burn centers. They may need skin grafts to cover large wounds. They may also need emotional support and months of follow-up care, such as physical therapy.

After you receive first aid for a severe burn, your medical care may include medications and products to promote healing.

Water-based treatments.

The healthcare team may use techniques such as minimally invasive surgical treatment (or MIST therapy) with ultrasound to clean and stimulate the wound tissue.

Fluids to prevent dehydration.

You may need intravenous fluids to prevent dehydration and organ failure.

Medicines for pain and anxiety.

Healing from burns can be extremely painful. You may need morphine and anti-anxiety drugs, especially when changing your dressings.

Ointments and creams for burns.

If you are not being referred to a center for treatment of burns, your health care team may choose treatment from a variety of topical wound healing products, such as bacitracin and silver sulfadiazine (Silvadene). These help prevent infection and prepare the wound for closure.

Dressings.

The healthcare team may also use various special dressings to prepare the wound for closure. If you are taken to a burn center, your wound will probably only be covered with dry gauze.

Medicines that fight infections.

If you get an infection, you may need antibiotics

intravenously

.

Tetanus.

Your doctor may recommend that you get a tetanus shot after a burn.

If the burned area is large, especially if it involves joints, you may need physical therapy exercises. These exercises can help stretch the skin so that the joints remain flexible. Other types of exercise can improve muscle strength and coordination. Occupational therapy can be helpful if you have difficulty performing your normal daily activities.

You may need one or more of the following procedures:

respiratory support.

If you have been burned on your face or neck, your throat may close up and become inflamed. If this happens, the doctor may insert a tube into the trachea to maintain the supply of oxygen to the lungs.

feeding tube.

People with extensive burns or malnutrition may need nutritional support. The doctor may pass a feeding tube through your nose and into your stomach.

Facilitate blood circulation around the wound.

If a scab (eschar) from a burn extends all the way around an extremity, it can harden and cut off blood flow. A sore that spans the entire chest can make it difficult to breathe. Maybe the doctor cuts the eschar to release that pressure.

Skin grafts.

A skin graft is a surgical procedure in which parts of the person’s healthy skin are used to replace scar tissue caused by deep burns. As a temporary solution, the skin of a deceased donor or pig can be used.

Plastic surgery.

Plastic surgery (reconstruction) can improve the appearance of burn scars and increase the flexibility of joints affected by scarring.