Burns: Types and Treatments

First degree burn.
Even first-degree burns can cause serious scarring if they aren't properly treated. See more pictures of skin problems.
©iStockphoto.com/Bojan Fatur

It can happen so fast: One minute you're in full dinner prep mode, and the next you're cradling a swollen hand and wondering who moved the stove. If you've ever tangled with something hot and lost, then you know how painful a burn can be. You're not alone. About half a million Americans report burn injuries each year [source: American Burn Association]. More than half of the injuries reported happen to people ages 18 to 64, and the risk for men to get burns is twice that of women [source: Knissl].

There are many types of burns -- not all involve flames, but all can damage the skin and other bodily tissues. For example, scalds, which are liquid or steam burns, are the most common. If you've ever spilled hot coffee on yourself or stepped into a steaming hot shower, then you know the sting of a scald. Luckily, this type of burn doesn't usually cause permanent damage if treated quickly and properly. However, internal chemical burns from ingesting toxic materials can cause damage that's hard to treat. Because so many children are prone to this type of injury, it's important to keep all household cleaners out of reach. Spilling harsh chemicals on the skin can also result in a nasty, superficial burn. Electrical burns, radiation burns and sunburns can also cause damage.


A burn can be major or minor, and its severity is measured by its depth. First-degree burns are the least serious and involve only the top layer of skin. Second-degree burns penetrate the deeper layers, and are a lot more painful than first-degree burns. Third-degree burns are very severe and must be treated by a doctor.

Read on to learn how to assess burn damage and to find some surprising tips about what not to do if you get scorched.


Degrees of Burns

Most burns fall into one of three categories: first-, second-, or third-degree burns. Knowing the difference will help you know how to respond. If you've got a third-degree burn, you'll know it right away; however, first- and second-degree burns can be a little harder to peg. Here's how to tell the three types apart.

First-degree burns affect only the outer layer of skin, known as the epidermis. Often, they produce swelling, pain and redness. This type of burn should be considered minor unless it covers a major joint or a large portion of the hands, feet, face, groin or buttocks [source: Mayo Clinic]. Most first-degree burns heal in about a week or less.


Second-degree burns can be intensely painful. As with first-degree burns, they are recognizable by swelling and redness, but they also produce blisters and can cause the skin around the burn to turn white when pressed. Second-degree burns penetrate the epidermis and the layer of skin underneath it, known as the dermis, which can allow the burns to affect sweat glands and hair follicles, depending on how deep the damage goes [source: WebMD]. Second-degree burns can take several weeks to heal.

Third-degree burns are the most serious because they affect all the layers of skin, and they often cause permanent tissue and nerve damage, which can cause the injury to be relatively painless. Skin burned this badly can look white, black or brown, and it will not heal without extensive scarring.

Not all burns are caused by flames. Keep reading to learn more about the different types of burns.


Types of Burns

You know that fire and steam can singe your skin, and if you've ever been sloshed with hot liquid, then you know how much a scald can hurt. However, there are many burns that don't involve flames or even heat.

Children are highly burn-prone, and there are thousands of reports of pediatric burns every year [source: National Burn Repository]. Many of these burns take place in the kitchen, where liquids boil and toxic cleaners lurk. These cleaners can cause dangerous chemical burns, whether internally if ingested or externally if spilled on the skin.


Because small children tend to operate at outlet-level, they're also prone to electrical burns. And even adults can sometimes forget or not realize that frayed or exposed wiring can send out a jolt, too. To limit your chances of any shocking outcomes, hire an electrician to handle any home electrical work, baby-proof your outlets, and keep all your cords and plugs in good repair.

If you've ever gotten home from a day at the swimming pool looking more like a lobster than a human, then you can probably guess how a radiation burn feels. You can get this type of burn from having too much fun in the sun -- or from spending too much time in a tanning bed [source: Knissl]. Radiation therapy, used to treat some forms of cancer, can also produce internal and external burns.

Finally, friction burns are actually a combination of abrasion and a heat burn, and they can leave skin feeling especially raw. Athletes -- particularly bikers -- are prone to getting themselves into this sort of scrape, which is why it's important to suit up properly while sporting or cavorting [source: Knissl].

Even minor burns can require special care. On the next page, you'll find tips for assessing the severity of a burn and ways how to respond after a scathing spill.


How to Treat Burns

Most minor burns can be treated at home, but there are a few exceptions. For example, if the burn is larger than 3 inches (7.5 centimeters) in diameter, consult a doctor. You should also see a doctor if the burn is on your face, hands, scalp, genitals or joint areas, or if you notice any red streaking near the wound. Chemical burns and electrical burns also need to be checked with a medical professional [source: KidsHealth].

With the proper care, most other minor burns eventually will heal on their own. To treat a first-degree or small second-degree burn, begin by removing any scorched clothing, and then soothe the burn by running it under cool water for a few minutes. Don't ice it, though, as extreme cold can further damage your skin. You should also fight the urge to apply ointment, since these products can also hinder the healing process. Instead, just wrap the area loosely with a clean gauze bandage [source: Mayo Clinic]. You can also take aspirin or ibuprofen to help reduce pain.


To treat an external chemical burn, rinse the area with water for at least five minutes [source: Mayo Clinic]. If possible, rinse it for longer than that. Also, if the chemical was in powder form, brush it off the skin before using water. Don't shed any burned clothes until you've thoroughly flushed the wound. If the chemical burn is internal, follow the directions on the product's packaging and call for emergency help.

For major burns, the first and most important thing to do is call 911. With a major burn, don't remove the singed clothing because it could be stuck to the skin (although do remove jewelry or clothing that's not attached to the burn). Also, don't immerse large burns in cold water because this could trigger shock. If possible, raise the burn above your heart to decrease blood flow to the area and prevent swelling, and then apply a moist, sterile bandage [source: Mayo Clinic]. Never break blisters, which could lead to an infection.

If you've treated a burn, you're probably wondering how to minimize scarring. Learn how to put your skin on the mend on the next page.


How to Prevent Burns from Scarring

Scars are your body's response to trauma, and they're a byproduct of your body's healing process. They're made mostly from the protein collagen, which is found in the dermis, or second layer of your skin. After a burn, your body uses collagen as a framework for repairing your tissues. To minimize scarring, you'll need to take care of your body while your injury is healing as well as afterward.

Though severe scarring requires medical treatment, you can treat less serious scars by taking care of yourself both inside and out. First, be sure to keep the damaged area covered with a bandage, and keep the wound moist and bacteria-free. Also, for more serious burns, consider wearing a pressure garment. Your skin contains three layers; the fibers of the second layer form a mesh-like structure that pushes against the top layer. When the skin is badly burned and the layers aren't balanced, scars can form. Pressure garments restore this balance while the layers of skin grow back [source: Ohio State University Medical Center].


Topical treatments are commonly used to try to prevent scars from appearing. Aloe, for instance, is often used to soothe the burn and smoothe the skin. Applying it a few times daily might help the healing process. You might also try applying calendula topically. Propolis, a resin produced by bees, is a traditional natural burn remedy. As with all new ointments and creams, apply it to a small area first to make sure that your body is on board [source: University of Maryland Medical Center].

Another option is to massage the scar, which can help scars to flatten out over a period of months [source: American Academy of Dermatology]. Rubbing can help loosen webby collagen bonds. Use lotion and massage in a circular pattern several times a day once your skin is dry and there's no danger of reopening the wound.

Keep reading for more about types of burns and how they can be treated.


Lots More Information

Related HowStuffWorks Articles

  • American Burn Association. "Burn Incidence and Treatment in the U.S.: 2007 Fact Sheet." (Accessed 8/18/09)http://www.ameriburn.org/resources_factsheet.php
  • Arizona Burn Center. "Hot Water." (Accessed 8/19/09)http://www.azburncenter.com/BurnTips/HotWater
  • Burn Survivor Research Center. "Burn Statistics." (Accessed 8/18/09)http://www.burnsurvivor.com/burn_statistics.html
  • KidsHealth. "Burns." (Accessed 8/19/09)http://kidshealth.org/parent/firstaid_safe/emergencies/burns.html
  • Mayo Clinic. "Burns: First Aid." Jan. 5, 2008. (Accessed 8/18/09)http://www.mayoclinic.com/health/first-aid-burns/FA00022
  • Mayo Clinic. "Chemical Burns: First Aid." Jan. 5, 2008. (Accessed 9/10/09)http://www.mayoclinic.com/health/first-aid-chemical-burns/FA00024
  • Morales, Tatiana. "Preventing Those Ugly Scars." CBS News. May 27, 2003. (Accessed 8/19/09)http://www.cbsnews.com/stories/2003/05/22/earlyshow/health/main555189.shtml
  • National Burn Repository. "Report of Data from 1998-2009." 2009. (Accessed 9/10/09)http://www.ameriburn.org/2009NBRAnnualReport.pdf
  • Nissl, Jan. "Burns: Topic Overview." WebMD from HealthWise. Jan. 7, 2009. (Accessed 8/18/09)http://firstaid.webmd.com/tc/burns-topic-overview
  • Ohio State University Medical Center. "Using Pressure Garments to Reduce Scarring." Dec. 12, 2007. (Accessed 9/10/09)https://patienteducation.osumc.edu/Documents/UsingPresGarments.pdf
  • University of Maryland Medical Center. "Burns." (Accessed 8/19/08)http://www.umm.edu/altmed/articles/burns-000021.htm
  • WebMD. "Thermal (Heat or Fire) Burns." Aug. 10, 2005. (Accessed 9/10/09)http://www.webmd.com/a-to-z-guides/thermal-heat-fire-burns
  • WebMD. "Cosmetic Procedures: Scars." April 1, 2005. (Accessed 9/10/09)http://www.webmd.com/skin-beauty/cosmetic-procedures-scars