Thermal Burns

What is a thermal burn?

A thermal burn is injury of the skin and underlying tissues due to excessive heat from ultraviolet rays (sun), hot liquids, hot objects and fire.

How can I determine the severity of my burns?

Burns are divided in 4 types by severity:

  1. Superficial skin burn (used to be called a “first-degree burnâ€) is the mildest burn. Skin turns red, which may be followed by peeling. Classical example of a superficial burn is sunburn. If the burn area is large you may experience pain with malaise, nausea and fever similar as in flu. Superficial skin burns heal within 6 days without leaving a scar.
  2. Superficial partial-thickness burn (used to be called a “second-degree burnâ€). Your skin may hurt with a light touch or if the air temperature changes. The skin will be red and painful sometimes with blisters and blebs.  Superficial partial-thickness burn takes up to 21 days to heal, and the area of skin that was burned might be darker or lighter than it used to be. The burn might or might not heal with a scar.
  3. Deep partial-thickness burn (used to be called a “third-degree burnâ€). The burn may not hurt, or it will hurt when you press it hard. You will get blisters or blebs. It takes more than 21 days to heal, and will probably heal with a scar.
  4. Full-thickness burn (used to be called a “fourth-degree burnâ€). The burn does not usually hurt, because skin, fat and underlying tissues including nerves are damaged. Burned skin can be white, gray, or black. This burn will likely require surgery with hospital stay.

When should I see my health care provider for burns?

Any superficial partial-thickens burn and beyond should be evaluated by a health care provider. Superficial burn usually does not require visit to your health care provider unless it is over a large area and is causing pain with malaise, nausea and fever similar as in flu. However, you should also see a health care provider promptly if any of the following pertains to your case:

  • You are simply not sure how bad your burn is,
  • It wraps around any part of your body,
  • It involves areas around eyes, nose, mouth and genitalia, hands and feet, or involves joints,
  • You develop fever above 100.4°F (38°C),
  • It looks infected (pus and worsening redness and pain),
  • You had tetanus shot more than 5 years ago,
  • You are younger than 5 years or older than 70 years,
  • You are immunosuppressed (HIV, organ transplant patients), or
  • You have advanced diabetes.

What is the treatment of minor burns?

You should remove any clothing, debris and jewelry from the burned area and promptly start cooling the area with cool tap water (temperature about 55°F or 12°C). The application of ice should not be done, as it can worsen the damage. The burned area should be gently washed with cool water and mild soap. Blisters should be left intact (i.e. they should not be popped or poked since they protect the underlying tissues from infection). Minor burns usually do not require dressings or antibiotic creams. If the burned area really needs to be protected, then non-adherent dressing such as Vaseline gauze or Adaptic covered with fluffed-up dry sterile gauze and gently wrapped with Kerlix bandage may be enough.

If minor burns do not start healing in 2 weeks, then you should be referred to a burn specialist (usually a plastic surgeon in a burn center).

What is the treatment of severe burns?

The treatment of severe burns is best managed at specialized burn centers to avoid worse damage, infection and worse scarring.

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