Burns can result from dry heat (fire), moist heat (steam, hot liquids), electricity, chemicals, and radiation (i.e., sunlight). Treatment for burns depends on:
* The depth of the burn (whether it is first, second, or third degree).
* How much area of the body is affected.
* The location of the burn.
First degree burns affect only the outer skin layer. The area appears dry, red, and mildly swollen. A first degree burn is painful and sensitive to touch. Mild sunburn and brief contact with a heat source such as a hot iron are examples of first degree burns. First degree burns should feel better within a day or two. They should heal in about a week if there are no other problems.
Second degree burns affect the skin’s lower layers as well as the outer skin. They are painful, swollen, and show redness and blisters. The skin also develops a weepy, watery surface. Examples of second degree burns are severe sunburn, burns caused by hot liquids and a flash from gasoline. First aid procedures can be used to treat many second degree burns depending on their location and how much area is affected.
Third degree burns affect the outer and deeper skin layers as well as any underlying tissue and organs. They appear black and white and charred. The skin is swollen and underlying tissue is often exposed. The pain felt with third degree burns may be less than with first or second degree burns. There can also be no pain at all when nerve endings are destroyed. Pain may be felt around the margin of the affected area, however. Third degree burns usually result from electric shocks, burning clothes, severe gasoline fires and the like. They always require emergency treatment. They may result in hospitalization and sometimes require skin grafts.
For First Degree Burns:
* Cool the area right away. Place the affected area in a container of cold water or under cold running water. Do this for at least 5 - 10 minutes or until the pain is relieved. This will also reduce the amount of skin damage. (If the affected area is dirty, gently wash it with soapy water first.)
* Do not apply ice or cold water for too long a time. This may result in complete numbness leading to frostbite.
* Keep the area uncovered and elevated, if possible. Apply a dry dressing, if necessary.
* Do not use butter or other ointments (Example: Vaseline).
* Avoid using local anesthetic sprays and creams. They can slow healing and may lead to allergic reactions in some people.
* Call your doctor if after 2 days you show signs of infection (fever of 101 degrees F or higher, chills, increased redness, swelling, or pus in the infected area) or if the affected area is still painful.
* Take aspirin, acetaminophen, or ibuprofen, or naproxen sodium to relieve pain. (Note: Do not give aspirin or any medication containing salicylates to anyone 19 years of age or younger, unless a doctor tells you to.)
For Second Degree Burns (that are not extensive and less than 3” in diameter):
* Immerse the affected area in cold (not ice)water until the pain subsides.
* Dip clean cloths in cold water, wring them out and apply them over and over again to the burned area for as long as an hour. Blot the area dry. Do not rub.
* Do not break any blisters that have formed.
* Avoid applying antiseptic sprays, ointments, and creams.
* Once dried, dress the area with a single layer of loose gauze that does not stick to the skin. Hold in place with bandage tape that is placed well away from the burned area.
* Change the dressing the next day and every two days after that.
* Prop the burnt area higher than the rest of the body, if possible.
* Call your doctor if there are signs of infection (fever of 101 degrees F or higher, chills, increased redness and swelling, and pus) or if the burn shows no sign of improvement after 2 days.
Revision date: July 8, 2011
Last revised: by David A. Scott, M.D.