Burns

Burns occur when the skin or deeper tissues are damaged by heat, chemicals, electricity, radiation, or friction. They range in severity from minor injuries to life-threatening emergencies. Some burns affect only the outer layer of the skin, while others extend into muscles, nerves, and even bone. Symptoms can appear immediately or may take a day or two to develop, especially with more severe burns.

Burn symptoms vary depending on how deep the skin damage is. It can take one to two days for the symptoms of a severe burn to develop.

• First-degree (superficial) burns: Affect only the outer layer of skin (epidermis). They can cause redness, pain, and mild swelling.
• Second-degree (partial-thickness) burns: Affect both the epidermis and the underlying dermis. These burns often cause red or splotchy skin, severe pain, swelling, and blisters. Deep second-degree burns may cause scarring.
• Third-degree (full-thickness) burns: Extend through all layers of skin and may reach fat or muscle tissue. Burned areas may appear black, brown, or white, and the skin may look leathery. Nerve damage can make these burns less painful despite their severity.

Complications of deep or widespread burns can include:

• Infection
• Fluid loss
• Hypothermia (dangerously low body temperature)
• Breathing problems.
• Arrhythmias (Irregular heartbeats)
• Scars and changes in skin color
• Pain 
• Itching or discomfort related to damaged nerves, causing numbness or tingling
• Bone and joint problems
• Depression and anxiety disorders
• Skin cancer.

Burns can result from flames, hot liquids, steam, electrical currents, chemicals, sun exposure, or radiation. The severity depends on the source, temperature, duration of exposure, and the area of the body affected.

Burns are caused by:

• Fire
• Hot liquid or steam
• Hot metal or glass
• Electrical currents
• Radiation
• Sunlight or other sources of ultraviolet radiation
• Chemicals such as strong acids, lye, paint thinner, or gasoline.

Risk factors for burns include:

• Workplace factors: People who work outdoors and people who work with flames, chemicals and other substances that cause burns are at increased risk of burns. Most burns occur in adults.
• Dementia: Older adults with dementia are more likely to have burns from heat sources, such as too-hot tap water, hot drinks, food fats and cooking oils.
• Being young: Very young children are unable to get away from heat sources or flames. Their burns often come from kitchen, car seat and bath hazards.
• Alcohol: Risk of burns is increased among people who drink alcohol or use other substances that affect judgment.

Call 911 or seek emergency care if a burn:

• Appears deep, dry, leathery, charred, or white/brown/black

• Covers more than 3 inches (8 cm) or affects the hands, feet, face, neck, groin, buttocks, or major joints

• Encircles an arm or leg

• Causes difficulty breathing, headache, nausea, or confusion from smoke or chemical exposure

• Results from chemicals, gunpowder, explosions, or electricity

• Causes rapid swelling or involves severe sunburn with fever, vomiting, or dehydration

Minor burns may still require emergency care if they affect the eyes, mouth, hands, or genitals, or if the patient is a baby or older adult.

When to call your healthcare provider:

• Signs of infection (oozing, streaks, fever)
• Burns or blisters wider than 2 inches (5 cm) or not healing within two weeks
• New or unexplained symptoms
• Burns in someone with diabetes
• If a tetanus booster may be needed (ideally within three days of injury if not received in the last five years).

First-aid care:

While waiting for emergency assistance, minor burns should be cooled with running water, loosely covered with a clean cloth, and kept elevated if possible. Do not apply ice, butter, or other home remedies that may worsen tissue damage.