Diagnosis

During the physical exam, your doctor will examine your burned skin and determine what percentage of your total body surface area is involved. In general, an area of skin roughly equal to the size of your palm equals 1 percent of your total body surface area. For people ages 10 to 40, the American Burn Association defines a severe burn as one that involves 25 percent total body surface area or any burn involving the eyes, ears, face, hands, feet or groin.

You'll also be examined for other injuries and to determine whether the burn has affected the rest of your body. You may need lab tests, X-rays or other diagnostic procedures.

Treatment

Treatment of burns depends on the type and extent of the injuries. Most minor burns can be treated at home using over-the-counter products or aloe. They usually heal within a few weeks.

For serious burns, after appropriate first aid care and wound assessment, your treatment may involve medications, wound dressings, therapy and surgery. The goals of treatment are to control pain, remove dead tissue, prevent infection, reduce scarring, regain function and address emotional needs.

You may need months of additional treatments and therapy. This may be done during a hospital stay, on an outpatient basis or at home. Factors affecting this choice include your wishes, other conditions and abilities, such as whether you're able to change bandages.

Medications and wound healing products

For major burns, various medications and products are used to encourage healing.

  • Water-based treatments. Your care team may use techniques such as ultrasound mist therapy to clean and stimulate the wound tissue.
  • Fluids to prevent dehydration. You may need intravenous (IV) fluids to prevent dehydration and organ failure.
  • Pain and anxiety medications. Healing burns can be incredibly painful. You may need morphine and anti-anxiety medications — particularly for dressing changes.
  • Burn creams and ointments. Your care team can select from a variety of topical products for wound healing. These help keep the wound moist, reduce pain, prevent infection and speed healing.
  • Dressings. Your care team may also use various specialty wound dressings. These create a moist environment that fights infection and helps the burn heal.
  • Drugs that fight infection. If you develop an infection, you may need IV antibiotics.
  • Tetanus shot. Your doctor might recommend a tetanus shot after a burn injury.

Physical and occupational therapy

If the burned area is large, especially if it covers any joints, you may need physical therapy exercises. These can help stretch the skin so the joints can remain flexible. Other types of exercises can improve muscle strength and coordination. And occupational therapy may help if you have difficulty doing your normal daily activities.

Surgical and other procedures

You may need one or more of the following procedures:

  • Breathing assistance. If you've been burned on the face or neck, your throat may swell shut. If that appears likely, your doctor may insert a tube down your windpipe (trachea) to keep oxygen supplied to your lungs.
  • Tube feeding. Your metabolism goes into overdrive when your body starts trying to heal your burns. To provide adequate nutrition for this task, you doctor may thread a feeding tube through your nose to your stomach.
  • Easing blood flow around the wound. If a burn scab (eschar) goes completely around a limb, it can tighten and cut off the blood circulation. A scab (eschar) that goes completely around the chest can make it difficult to breathe. Your doctor may cut the eschar in several places to relieve this pressure. This procedure is called decompression.
  • Skin grafts. A skin graft is a surgical procedure in which sections of your own healthy skin are used to replace the scar tissue caused by deep burns. Donor skin from cadavers or pigs can be used as a temporary solution.
  • Plastic surgery. Plastic surgery (reconstruction) can improve the appearance of burn scars and increase the flexibility of joints affected by scarring.

Lifestyle and home remedies

To treat minor burns, follow these steps:

  • Cool the burn. Run cool (not cold) tap water over the burn for 10 to 15 minutes or until the pain eases. Or apply a clean towel dampened with cool tap water. Don't use ice. Putting ice directly on a burn can cause further damage to the tissue.
  • Remove rings or other tight items from the burned area. Try to do this quickly and gently, before the area swells.
  • Don't break small blisters (no bigger than your little fingernail). If blisters break, gently clean the area with mild soap and water, apply an antibiotic ointment, and cover it with a nonstick gauze bandage.
  • Apply moisturizer or aloe vera lotion or gel. This may soothe the area and prevent dryness as the wound heals.
  • If needed, take an over-the-counter pain reliever. Nonprescription products include ibuprofen (Advil, Motrin IB, others), naproxen (Aleve) and acetaminophen (Tylenol, others).
  • Consider a tetanus shot. Make sure that your tetanus booster is up to date. Doctors recommend people get a tetanus shot at least every 10 years.

Whether your burn was minor or serious, use sunscreen and moisturizer regularly once the wound is healed.

Coping and support

Coping with a serious burn injury can be a challenge, especially if it covers large areas of your body or is in places readily seen by other people, such as your face or hands. Potential scarring, reduced mobility and possible surgeries add to the burden.

Consider joining a support group of other people who have had serious burns and know what you're going through. You may find comfort in sharing your experience and struggles and meeting people who face similar challenges. Ask your doctor for information on support groups in your area or online.

Preparing for your appointment

Seek emergency medical care for burns that are deep or involve your hands, feet, face, groin, buttocks, a major joint or a large area of the body. Your emergency room physician may recommend examination by a skin specialist (dermatologist), burn specialist, surgeon or other specialist.

For other burns you may need an appointment with your family doctor. The information below can help you prepare.

List questions you want to ask your doctor, such as:

  • Do I need treatment for the burn?
  • What are my treatment options and the pros and cons of each?
  • What are the alternatives to the primary approach that you're suggesting?
  • Can I wait to see if the burn heals on its own?
  • Do I need prescription medication, or can I use over-the-counter medications to treat the burn?
  • What results can I expect?
  • What skin care routines do you recommend while the burn heals?
  • What kind of follow-up, if any, will I need?
  • What changes in my skin might I expect to see as it heals?

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

  • How did the burn occur?
  • Do you have other symptoms?
  • Do you have underlying health conditions, such as diabetes?
  • What at-home burn treatments have you used, if any?
  • Have you noticed any changes in the appearance of the burn?
Aug. 01, 2015
References
  1. Goldsmith LA, et al., eds. Thermal injuries. In: Fitzpatrick's Dermatology in General Medicine. 8th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://accessmedicine.com. Accessed June 9, 2015.
  2. AskMayoExpert. Burn rehabilitation (adult and pediatric). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015.
  3. Burns. Merck Manual Professional Version. http://www.merckmanuals.com/professional/injuries-poisoning/burns/burns. Accessed June 2, 2015.
  4. Purdue GF, et al. Acute assessment and management of burn injuries. Physical Medicine and Rehabilitation Clinics of North America. 2011;22:201.
  5. Marx JA, et al. Thermal burns. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa.: Mosby Elsevier; 2014. http://www.clinicalkey.com. Accessed June 9, 2015.
  6. Kowalske KJ. Burn wound care. Physical Medicine and Rehabilitation Clinics of North America. 2011;22:213.
  7. Goldman L, et al. Medical aspects of trauma and burn care. In: Goldman's Cecil Medicine. 24th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.clinicalkey.com. Accessed June 9, 2015.
  8. Morgan ED, et al. Treatment of minor thermal burns. http://www.uptodate.com/home. Accessed June 9, 2015.
  9. Murphy F, et al. Treatment for burn blisters: Debride or leave intact? Emergency Nurse. 2014;22:24.
  10. Mass casualties: Burns. Centers for Disease Control and Prevention. http://emergency.cdc.gov/masscasualties/burns.asp. Accessed June 9, 2015.
  11. Burns. American College of Emergency Physicians. http://www.emergencycareforyou.org/Content.aspx?id=25990. Accessed June 9, 2015.
  12. Avoiding household burns. American College of Emergency Physicians. http://www.emergencycareforyou.org/Content.aspx?id=25990. Accessed June 9, 2015.
  13. Leon-Villapalos J, et al. Principles of burn reconstruction: Overview of surgical procedures. www.uptodate.com/home. Accessed June 9, 2015.
  14. Protect yourself against fire and treat burns. National Safety Council. http://www.nsc.org/learn/safety-knowledge/Pages/safety-at-home-fires-burns.aspx. Accessed June 9, 2015.
  15. Torpy JM. Burn injuries. JAMA. 2009;302:1828.
  16. Peck MD. Prevention of fire and burn injuries. http://www.uptodate.com/home. Accessed June 9, 2015.
  17. Medline plus http://www.nlm.nih.gov/medlineplus/burns.html. Accessed June 9, 2015.
  18. Shelov SP, et al. Day to day. In: Caring for Your Baby and Young Child: Birth to Age 5. 5th ed. New York, N.Y.: Bantam Books; 2009:65.
  19. Gauglitz GG, et al. Overview of the management of the severely burned patient. www.uptodate.com/home. Accessed June 9, 2015.