Overview

Burns can be minor medical problems or life-threatening emergencies. Many people die each year from fire-related burn injuries. Electricity and chemicals also cause severe burns. Scalding liquids are the most common cause of burns in children.

Treatment of burns depends on the location and severity of the injury. Sunburns and small scalds can usually be treated at home. Deep or widespread burns need immediate medical attention.

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

Symptoms

Burns don't affect the skin uniformly, so a single injury can reach varying depths. Distinguishing a minor burn from a more serious burn involves determining the extent of tissue damage.

The following are three classifications of burns:

  • First-degree burn. This minor burn affects only the outer layer of the skin (epidermis). It may cause redness, swelling and pain. It usually heals with first-aid measures within several days to a week. Sunburn is a classic example.
  • Second-degree burn. This type of burn affects both the epidermis and the second layer of skin (dermis). It may cause red, white or splotchy skin, pain, and swelling. And the wound often looks wet or moist. Blisters may develop, and pain can be severe. Deep second-degree burns can cause scarring.
  • Third-degree burn. This burn reaches into the fat layer beneath the skin. Burned areas may be charred black or white. The skin may look waxy or leathery. Third-degree burns can destroy nerves, causing numbness. A person with this type of burn may also have difficulty breathing or experience smoke inhalation or carbon monoxide poisoning.

When to see a doctor

Seek emergency medical assistance for:

  • Burns that cover the hands, feet, face, groin, buttocks, a major joint or a large area of the body
  • Deep burns, which means burns affecting all layers of the skin and even other tissues
  • Burns caused by chemicals or electricity
  • Difficulty breathing or burns to the airway

Minor burns can be cared for at home, but call your doctor if you experience:

  • Large blisters
  • Signs of infection, such as oozing from the wound, increased pain, redness and swelling
  • A burn or blister that doesn't heal in several weeks
  • New, unexplained symptoms
  • Significant scarring

Causes

Many things can cause burns, including:

  • Fire
  • Hot liquid or steam
  • Hot metal, glass or other objects
  • Electrical currents
  • Radiation from X-rays or radiation therapy to treat cancer
  • Sunlight or ultraviolet light from a sunlamp or tanning bed
  • Chemicals such as strong acids, lye, paint thinner or gasoline
  • Abuse

Complications

Deep or widespread burns can lead to many complications, including:

  • Infection. Burns can leave skin vulnerable to bacterial infection and increase your risk of sepsis. Sepsis is a life-threatening infection that travels through the bloodstream and affects your whole body. It progresses rapidly and can cause shock and organ failure.
  • Low blood volume. Burns can damage blood vessels and cause fluid loss. This may result in low blood volume (hypovolemia). Severe blood and fluid loss prevents the heart from pumping enough blood to the body.
  • Dangerously low body temperature. The skin helps control the body's temperature, so when a large portion of the skin is injured, you lose body heat. This increases your risk of a dangerously low body temperature (hypothermia). Hypothermia is a condition in which the body loses heat faster than it can produce heat.
  • Breathing problems. Breathing hot air or smoke can burn airways and cause breathing (respiratory) difficulties. Smoke inhalation damages the lungs and can cause respiratory failure.
  • Scarring. Burns can cause scars and ridged areas caused by an overgrowth of scar tissue (keloids).
  • Bone and joint problems. Deep burns can limit movement of the bones and joints. Scar tissue can form and cause shortening and tightening of skin, muscles or tendons (contractures). This condition may permanently pull joints out of position.

Prevention

Be alert to burn risks outside the home, especially if you work in places with open flames, chemicals or superheated materials.

To reduce the risk of common household burns:

  • Never leave items cooking on the stove unattended.
  • Turn pot handles toward the rear of the stove.
  • Keep hot liquids out of the reach of children and pets.
  • Keep electrical appliances away from water.
  • Test food temperatures before serving a child. Don't heat a baby's bottle in the microwave.
  • Never cook while wearing loosefitting clothes that could catch fire over the stove.
  • If a small child is present, block his or her access to heat sources such as a stove, outdoor grill, fireplace and space heater.
  • Before placing a child in a car seat, check for hot straps or buckles.
  • Unplug irons and similar devices when not in use. Store them out of reach of small children.
  • Cover unused electrical outlets with safety caps. Keep electrical cords and wires out of the way so that children don't chew on them.
  • If you must smoke, avoid smoking in the house and especially never smoke in bed.
  • Check your smoke detectors and change their batteries regularly.
  • Keep a fire extinguisher on every floor of your house.
  • Keep chemicals, lighters and matches out of the reach of children.
  • Set your water heater's thermostat below 120 F (48.9 C) to prevent scalding. Test bath water before placing a child in it.
Aug. 01, 2015
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