Burn Injury

Burns are categorized by severity in one of three major types: first, second, or third degree. The category a burn falls in depends on how deeply the burn has reached and which layers of skin have been touched by the burn. First degree burns are superficial and affect only the outermost layer of skin, the epidermis. Second degree burns go through the epidermis to the second layer of skin, the dermis. Third degree burns affect not only the epidermis and dermis, but also the third layer of skin, called the hypodermis or subcutaneous tissue. Third degree burns can also affect deeper tissues of the body beyond the skin.

First Degree Burns

For the most part, first degree burns cause little damage and no lasting harm. Examples of first degree burns include a mild sunburn, brief contact with a hot pan, or a drop of hot water.

Symptoms: A first degree burn will leave some sort of small blemish, either red or pink in color. The burn is so slight that no blistering occurs. Pain may be intense at first and continue later as a dull throb. This is because the epidermis is filled with nerve endings. Mild swelling may occur at the burn sight, and the pain is often accompanied by a sensation of itching. Recovery is usually swift, leaving no marks behind.

Treatment: First degree burns should be immediately washed with a mild soap in clean, luke-warm water to help avoid infection. Chances of infection with first degree burns are very low, but washing is a simple method to ensure that one doesn’t set in. Cold water is not recommended as it can cause complications in select circumstances. An aloe vera lotion or Mycitracin ointment can be used to help swelling and promote comfort. Aspirin or ibuprofen can be taken for the pain. Professional treatment should only be necessary if the burn covers large portions of the body.

Second Degree Burns

Second degree burns are more severe than first degree burns. A second degree burn will often break the skin from the damage to the epidermis as it affects the dermis. A second degree burn will most likely cause blistering, bubbling, or oozing at the site of the burn.

Symptoms: Second degree burns cause the skin to turn red as the dermis is exposed. Blistering occurs soon after. White pus and/or sticky, clear plasma from the blood may build on the burn. Pain is more intense than with first degree burns, since nerves are being affected from both layers of skin.

Treatment: Second degree burns must be handled very delicately. Warm water and a very mild soap should be used to clean the burn. Do not scrub. Simply apply a small dab of liquid soap and run the water over the burn for a couple of minutes. This will temporarily relieve some of the swelling and pain. Never use cold water or ice to treat burns. Ice will only make the burn worse and could cause a secondary condition, frostbite. After cleaning the burn, the body part should be wrapped loosely in sterile gauze. Blisters should remain intact for as long as possible. Topical ointments should not be used for second degree burns. Any second degree burn larger than three inches in diameter should be taken to a medical professional for further treatment.

Third Degree Burns

Third degree burns are the most severe types of burns. Third degree burns affect all three layers of skin and can go into deeper tissues such as muscle, bone, ligaments, tendons, and even internal organs. Some doctors use a fourth degree in the case of damage beyond the skin but this is not universally recognized. Third degree burns are extremely serious and immediate medical attention is required.

Symptoms: The skin will be white in color, depending on how deep the burn goes. Most of the nerves will have been burned away, so pain will only be felt on the fringes. Because no pain is felt, further damage can easily occur, leading to shock and death. Permanent scarring is a certainty.

Treatment: Emergency personnel should be called immediately. The patient will need a sterile environment as risk of infection is very high. Doctor care is required for several days to several months, and skin grafts may be required.