What Is a Burn?
Skin burns are a common type of injury that can result from exposure to a number of sources, including flames or hot objects, hot water, steam, chemicals, electricity, or overexposure to the sun.
There are different types of burns. In the past, burns were classified as first, second, third, or fourth degree, but the current categorization is used to better describe which burns require surgical treatment.
- Superficial skin burn (formerly "first-degree burn"): affects only on the top layer of skin
- Superficial partial-thickness burn (formerly "second-degree burn"): affects the top 2 layers of skin, but does not go deep into the second layer
- Deep partial-thickness burn (formerly "third-degree burn"): also affects the top 2 layers of skin, but is deeper than a superficial partial-thickness burn
- Full-thickness burn (formerly "fourth-degree burn"): affects all the layers of the skin and often the fat and muscle underneath
The classification of a burn can change over a few days. A burn may appear superficial initially, then become deeper over time.
What Are Symptoms of a Burn?
The symptoms of a burn depend on how badly the skin is burned:
- Superficial skin burn
- Skin dryness, redness, and pain
- When the burn is pressed, it turns white
- Superficial skin burns heal in 3 to 6 days and do not leave a scar
- Superficial partial-thickness burn
- Skin is painful to a light touch or air temperature changes
- Skin redness
- Skin leaks fluid
- Blisters may occur
- When the burn is pressed, it turns white
- Superficial partial-thickness burns take one to three weeks to heal, and the area of skin that was burned might be darker or lighter than it used to be when it heals
- May or may not leave a scar
- Deep partial-thickness burn
- Hurts when pressed hard
- Does not turn white when pressed
- Deep partial-thickness burns take more than three weeks to heal
- Will probably leave a scar
- Full-thickness burn
- Does not usually hurt
- Skin can be white, gray, or black
- Skin feels dry
- Treated with surgery, possible hospitalization, and medications
Seek medical attention immediately for a burn if you are not sure how bad it is, or if the burn:
- Is on the face, hands, feet, or genitals
- Is on or near a joint
- Goes all the way around a part of the body
- Measures more than 3 inches across or goes deep into the skin
- Is accompanied by fever of at least 100.4° F (38° C)
- There are other signs of infection (infected skin is more red, painful, and may leak pus)
- Goes deeper than the top layer of skin and you have not had a tetanus shot in more than 5 years
- Occurs on a person younger than 5 years or older than 70 years
- Occurs on a person who has a compromised immune system such as a person who has HIV or cancer
What Causes a Burn?
Burns can be caused by a number of sources coming into contact with unprotected skin:
- Steam or other hot liquids
- Heated objects
How Is a Burn Diagnosed?
A burn is diagnosed with a skin examination to determine the severity of the burn.
In more severe cases, a doctor may send patients to a burn center. The American Burn Association recommends patients be sent to a burn center in the following instances:
- A burn covers more than 10% of the total body surface area
- The burn involves the face, hands, feet, genitalia, or major joints
- Deep partial-thickness burn ("third-degree burn")
- Electrical burns, including lightning injury
- Chemical burns
- Inhalation burns
- Burn injury in patients with preexisting medical conditions that could complicate treatment or recovery
- Burns are accompanied by trauma (such as fractures) in which the burn injury has a higher risk of death from the injuries.
- If trauma is a greater risk the patient may be initially stabilized in a trauma center before being transferred to a burn unit.
What Is the Treatment for a Burn?
For minor burns that do not require a doctor visit, there are steps you can take to help prevent infection, treat pain, and help the burn heal more quickly.
If your burn is not too severe, you can take the following steps:
- Clean the burn
- Remove clothing covering the area; if clothing sticks to the burn, see a doctor
- Wash the burned area gently with plain soap and cool water
- Disinfecting the skin with alcohol, iodine, or other cleansers is not needed
- Cool the burn
- After cleaning, use a cool compress or cool cloth on the skin
- Do not use ice on burned skin
- Prevent infection
- Wash the burn daily with plain soap and cool water
- If the burn is deeper than the top layer of skin, to help prevent infection apply topical aloe vera or an antibiotic such as bacitracin
- Do not apply home remedies such as mustard, egg whites, mayonnaise, lavender oil, or toothpaste to skin burns
- If the burn blisters, cover it with a clean, non-stick bandage and change the bandage once or twice daily as needed
- Do not pop blisters, because that can increase the risk of infection
Get a tetanus booster vaccine if you have not had a tetanus shot in the past five years and the burn is superficial partial-thickness (formerly called second-degree) or deeper
- If pain is not controlled with OTC pain relievers, contact your doctor
- Topical numbing medications should not be used regularly on burn wounds, because they may irritate the skin
- Elevate burns on the hand or foot to above the level of the heart to help prevent swelling and pain
Avoid scratching a burn
- Scratching can increase the risk of infection
- Use a moisturizing lotion to hydrate skin and prevent dryness that can cause itching
- Over-the-counter (OTC) antihistamines such as diphenhydramine (Benadryl) may help relieve itch
More serious burns need to be treated by a doctor, and severe burns may require hospitalization or treatment at a burn center.
Medical treatments for severe burns may include:
How Do You Prevent a Burn?
Ways to reduce the chances of getting burned:
- Keep children away from hot stoves, fireplaces, ovens, candles, matches, and lighters
- Keep hot objects such as foods, beverages, or pots away from the edge of the table or stove
- Install a smoke detector on each floor of the home
- Set the hot-water heater no higher than 120° F (49° C)
- Cover car seats and seat belts with cloth if the car sits in the sun on a hot day or use a windshield sun shade
- Use sunblock when outside to prevent sunburn