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| Burning |
Heat is the most obvious cause of burn injuries, but burns can also be caused by chemicals, electricity, the sun's rays or other types of radiation, friction (rubbing or chafing) or extreme cold.
Burns usually affect the skin, but other important areas of the body can also be injured. For example, the airways and lungs can be damaged as a result of inhaling hot fumes and gases. |
| Types of Burn |
The severity of a burn depends on how deeply it has affected the tissue (see diagram). There are three categories of burn: superficial, partial thickness and full thickness. These were previously referred to as first, second and third-degree burns.
Superficial burn
This is a burn that only affects the surface of the skin (epidermis). The skin appears red and slightly swollen, and the burn is almost always painful. A common cause of this type of burn is too much exposure to sunlight ie sunburn (for more information, see the separate BUPA health factsheet, Sun care.)
Partial thickness burn
This is a deeper burn, but it does not affect the whole depth of the skin. The epidermis is destroyed and the dermis - the layer of skin tissue below the epidermis - is also damaged to varying degrees. The skin appears deep red or purple, swollen and blistered. The surface may have a weeping, wet appearance. The skin is extremely painful and hypersensitive, even to air movement.
Full thickness burn
The full depth of the skin is damaged and the skin appears dry and leathery. The skin may be pale or blackened. These burns are surprisingly painless, because the nerve endings within the skin are also destroyed, although there is usually pain in the surrounding areas if they are affected by partial thickness burns.
If the burn is deep enough to damage muscle, fat and bone they are sometimes called fourth degree burns.
Other burn sites
Burns to the face, singeing of eyebrows or nasal hair and black deposits in the mouth or sputum indicate that the airways may be burnt and immediate medical attention should be sought. Changes in voice can also indicate this. |
| What to do if someone is burnt |
Your own safety should be your first priority when offering first aid to a person with burns. It's important to be aware of any ongoing risks of fire, chemicals or electricity. There may also be a risk of toxic fumes or explosion eg, a nearby petrol or gas supply.
If the cause of the burning is no longer there, and it is safe to proceed, carefully remove any clothing that isn't stuck to the burn. You should then flood the affected areas with cold water until medical help, if necessary, is available.
The skin usually swells after a burn, so it's important to remove anything constricting such as jewellery.
Don't try and burst any blisters that form on burnt skin.
If a burn has been caused by a chemical, the chemical should be removed, by brushing it away if it is a dry powder, or flooding with large amounts of cold water.
Home treatment
Very minor burns can be treated at home. Superficial burns usually don't need any dressings. Moisturiser, or aftersun lotion, followed by calamine lotion, can ease some of the discomfort.
Simple painkillers, like the kind you would usually use to treat a headache, may also help. Superficial burns usually settle in a matter of days, perhaps with a little skin peeling.
When to seek medical help
Medical help is needed:
for all partial and full thickness burns for superficial burns covering an area larger than the palm of the hand for burns that are over a joint or on the face, hands or groin if you aren't sure about the extent of the burn or how to deal with it For severe burns call 999 (UK only) and ask for an ambulance. While waiting for specialist help, valuable treatment can still be given as described . |
| Hospital Treatment |
At the hospital, doctors will continue first aid measures and protect the damaged skin with dressings.
Healthy skin prevents loss of fluid from the tissues underneath and is also a very effective barrier to infection. These functions are lost when the skin is burned. After severe burns, large quantities of fluid can be lost through the skin. This can have a serious affect on the heart and circulation. This is why people with serious burns need to be closely monitored and often require intravenous fluids to help their circulation.
People with severe burns need to be cared for in specialist burn units where other specialist treatments can be given to help look after them.
Burns may become infected because the skin is less able to protect itself from bacteria. This is why more serious burns need to be dressed and kept clean whilst the skin heals. If infection is suspected, treatment with antibiotics may be needed.
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| Recovering from burns |
The time taken for burns to heal depends on how serious they are. Most superficial burns heal within about two weeks and don't usually leave a scar.
Deeper burns take longer to heal, usually leave scars, and sometimes require skin grafts. This is a plastic surgery technique. It uses skin from an unaffected part of the body to repair an injured area of skin that isn't going to be able to heal itself. Full thickness burns tend to result in scars that can be difficult to treat. In these cases, plastic surgeons use specialist treatment to try and minimise such scars.
Other types of treatment or support are sometimes needed as part of rehabilitation after burns. Physiotherapy can help restore movement to burnt areas, especially the hands. Volunteers in some dermatology departments can offer advice on how to apply specialist products for camouflaging scars - contact your local Red Cross branch for details.
Psychological treatments such as counselling can help people, who have been burnt, come to terms with having been in an accident or with any serious changes to their appearance. |
| Fire prevention |
For most people, the greatest threat of injury or death from fire is in the home. In the UK, firemen are called to approximately 60,000 home fires every year; 10,000 people are injured and 500 people die in these fires. The most common causes of fire are:
smoking related fires (eg cigarette ends or matches)
cooking related (eg chip pans)
heaters and electric fires
A simple bedtime routine can prevent fires.
Make sure all cigarettes are extinguished. Do not smoke in bed.
Turn off all electrical appliances that don't need to be on (eg hairdryers).
Turn off portable heaters.
Make sure open fires have a suitable fireguard and are safe to leave.
Close all doors to prevent any fire spreading.
Fitting a smoke alarm, and ensuring it has a fresh battery, can save lives where these safety measures fail.
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This factsheet is written for people who have been burnt, or who want to know more about burns.