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Burns

Key points

  • There are three types of burn: superficial, partial-thickness and full-thickness.
  • Symptoms of burns vary depending on their severity but can include changes in your skin colour, blisters and pain.
  • If you're not sure about the extent of a burn or how to deal with it, seek medical help for advice.
  • If you have a severe burn, you will need to go to hospital.

A burn is an injury to your skin tissue, usually caused by contact with intense heat or cold, electricity or chemicals.

About burns

In the UK, around 175,000 people visit the accident and emergency department each year for burn injuries, and 16,100 are admitted to hospital. Burns usually affect your skin, but other parts of your body can be injured. For example, inhaling hot fumes and gases can damage your airways and lungs.

Types of burn

The severity of your burn will depend on how deeply it has affected your skin tissue. There are three types of burn: superficial, partial-thickness and full-thickness.

Illustration showing the layers of skin

Superficial burns

Superficial burns only affect the surface of your skin (epidermis). Your skin will be red and painful, but not blistered. Mild sunburn is an example of a superficial burn.

Partial-thickness burns

Partial-thickness burns are deeper burns that damage your epidermis and dermis (inner layer of your skin) to varying degrees. If the damage to your dermis is shallow, your skin may be pale pink and painful, with blisters. Deeper burns to your dermis will cause your skin to become dry or moist, blotchy and red. Deep partial-thickness burns may or may not be painful and they may blister.

Full-thickness burns

All layers of your skin are damaged by full-thickness burns. Your skin will look white or brown and will be dry and leathery. Because the nerves in your skin are destroyed with full-thickness burns, you probably won't feel any pain or have blisters.

Symptoms of burns

Symptoms of burns vary depending on their severity. They include:

  • changes in your skin colour – burns can cause your skin to look pink, red, white, brown or black
  • blisters
  • pain in the burnt area

Symptoms of a burn to your airway include:

  • burned nostril hairs
  • a change in your voice (it may sound hoarse)
  • a sore throat
  • wheezing
  • swelling

Complications of burns

There are a number of possible complications of burns, which include the following.

  • Serious breathing problems if you have an airway burn and have inhaled smoke. It can take up to 24 hours for these problems to develop.
  • Dehydration and circulation problems if you have a severe burn. If you lose large quantities of fluid through your burned skin, it can seriously affect your heart and circulation.
  • Infection and possible septicaemia. Healthy skin is a very effective barrier to infection but this function is lost if your skin is severely burned.
  • Damage to your muscles if you have an electrical burn. If a large amount of muscle tissue is damaged, it may lead to kidney failure.
  • Scarring. This can disfigure your skin or affect movement if your burn is around a joint.

Severe extensive burns can be fatal.

Causes of burns

Burns are caused by:

  • dry heat (such as from a fire)
  • wet heat, often called a scald (from steam or hot fluids, for example)
  • radiation (from the sun or a sun bed, for example)
  • extreme cold
  • inhaling smoke or hot fumes, particularly from chemical explosions or house fires
  • electricity
  • chemicals

Diagnosis of burns

Most burns are easily diagnosed and you will know yourself if you have a burn.

Your doctor will ask about your symptoms and examine you. Your doctor will want to determine the cause, size and thickness of your burn, and whether you have inhaled smoke or chemical fumes.

Treatment of burns

Treatment for burns depends on how severe they are. You can treat superficial and minor partial-thickness burns caused by heat yourself at home. However, seek urgent medical help from your GP or an accident and emergency department in a hospital for:

  • all deep partial-thickness and full-thickness burns
  • all chemical and electrical burns
  • burns that cover an area larger than the palm of your hand
  • burns that cover a joint or are on your face, hands, feet or groin
  • all burns that extend completely around your arm or leg
  • all burns where you may have inhaled smoke

If you're not sure about the extent of a burn or how to deal with it, seek medical help for advice.

First aid

There are a number of important things you can do to immediately help relieve your symptoms.

  • For burns caused by heat, keep cooling the burn with cool water for between 10 and 30 minutes or until medical help is available. Don't use iced water. Carefully remove any restrictive clothing or jewellery that isn't stuck to the burn. Next, cover the burn using cling film. However, don't wrap it around the area, just put one layer on. If you have a burn on your hand, use a clean, clear plastic bag.
  • For burns caused by chemicals, look at the advice on the label of the chemical product. Start cooling the burn immediately under cool or tepid water (unless instructed otherwise on the chemical product). Keep cooling the burn for at least 30 minutes and remove any affected clothing. Wear gloves if possible. Don't try to neutralise the chemical with another chemical.
  • For any type of burn, don't use butter or fats on it as this can cause an infection.

Self-help

After following the first aid advice above, you can continue to treat superficial and minor partial-thickness burns yourself at home.

Don't apply any ointments or creams to a burn. It's also important not to burst any blisters that form on your burn because this makes them more likely to become infected. If you cover the burn with cling film, it may reduce pain and prevent an infection.

There are a range of dressings available, such as hydrocolloid, silicon nylon, polyurethane film and biosynthetic dressings as well as antimicrobial dressings that contain silver. However, there isn't any strong scientific evidence to support their use for superficial and partial thickness burns. If you feel you need to use a dressing, ask your pharmacist for advice.

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Superficial burns will usually heal within two weeks and you shouldn't have much of a scar. If you're unsure how to treat a burn or have any questions, ask your doctor for advice.

Hospital treatment

If you have a severe burn, you will need to go to hospital. Your doctors will continue first aid measures and protect your damaged skin with dressings. They will also give you medicines for any pain you might have. Your doctor may refer you to a specialist burn unit.

The first stages of treatment at hospital are to evaluate your burn, treat fluid-loss and prevent infection.

  • If your doctor suspects that your skin is infected, he or she will give you antibiotics.
  • If you have lost large amounts of fluid through your burned skin, you will be closely monitored. You may need to have fluids through a drip to help your circulation.

After these initial stages of treatment, you may then need to have skin grafts, which are performed by plastic surgeons. Full-thickness burns tend to result in scars that can be difficult to treat and skin grafts can help to minimise scars. Skin from an unaffected part of your body will be used to repair any of your burned skin that can't heal itself. You may later find it useful to have counselling to help you deal with the effects of scars from your burn. Physiotherapy can help you to regain movement in your burned areas.

 

Reviewed by Rachael Mayfield-Blake, Bupa Health Information Team, September 2013.

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For sources and links to further information, see Resources.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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