What are burns?

A burn is an injury caused by exposure to heat or flame, chemicals, electricity, sunlight or radiation. They can cause skin damage and in severe burns, the affected cells actually die.

The most common causes of burns are scalds from hot liquids and steam, building fires and flammable liquids and gases. Sometimes there can also be inhalation injury, caused by breathing smoke.

Most people can recover from burns, especially if treatment is given early. However, children and some people are more vulnerable. Any signs of infection have to be monitored closely.

There are four levels to burns:

1st-degree burn

This is the least serious type, involving only the outer layer of skin. It may cause redness, swelling and pain. But even though it is a minor burn, if it involves much of the hands, feet, face, groin, buttocks or a major joint, seek emergency medical attention.

2nd-degree burn

This is more serious as it may cause red, white or splotchy skin, swelling, pain and blisters.

If the burn is no larger than 3 inches (7.6 centimeters) in diameter, treat it as you would a minor burn. But if the burned area is larger or covers the hands, feet, face, groin, buttocks or a major joint, seek medical help immediately.

3rd-degree burns

This is the most serious burn, as it involves all layers of the skin and underlying fat. The burned areas may appear as charred black or white. The affected skin can feel numb. The person may experience difficulty breathing, carbon monoxide poisoning and other toxic effects (e.g. if smoke inhalation has also occurred). They will always require urgent medical treatment.

4th-degree burns

These burns extend through the skin to injure muscle, ligaments, tendons, nerves, blood vessels, and bones. They will always require urgent medical treatment.

The immediate steps to take in case of burns

For heat / thermal burns: Smother any flames by covering them with a blanket or water. If your clothing catches fire, do not run. Instead stop and roll on the ground to smother the flames.

Note: Never use ice on a burn, as it can restrict blood flow to the skin, and further damage tissue. It is far better to immediately run cool water over the burn to stop it from spreading. Keep doing this for 10 to 20 minutes if possible.

For burns due to exposure to the cold: See http://www.webmd.com/first-aid/home-treatment-first-aid-for-cold-exposure for the steps to take. For example, you shouldn’t rub frozen skin.

For chemical burns: Work out what caused it, and in the USA call the Poison Control Center or the National Poison Control Hotline (1-800-222-1222) for more information about how to treat the burn.

For tar or hot plastic burns: Immediately run cold water over it and do not try to remove the tar or plastic. Later on you can try to remove it by loosening it first with mineral oil or ointments such as Vaseline or Polysporin. Often tar will peel off by itself after a few days as the skin cells below it will flake off. After the tar or plastic is removed, you can then wash and treat the burned skin. If you have any trouble removing tar or plastic from the skin, seek medical help.

In case of a burn caused by electricity: If appropriate, turn off the electricity and do not approach the person until they have been separated from the source of the electricity. Check for breathing and a heartbeat. If necessary, call emergency services.

At major accident scenes: After you have treated the burn, look for other injuries, as the burn may not be the only injury. Carefully remove any jewelry or clothing at the site of the burn. But, if clothing is stuck to the burn, do not remove it. Instead, carefully cut around the stuck fabric to remove loose fabric. If you don’t remove the jewelry, it may be hard to remove it later if swelling occurs.

If you do feel medical help is needed, do not apply anything to the burn. Just cover it with a clean, dry cloth to reduce the risk of infection.

What are conventional treatments for burns?

The treatment required depends on the degree of burn.

Usually, first-degree burns only need home treatment such as applying an aloe vera cream and an over-the-counter pain medication. Use cool cloths on the burn and take frequent cool showers or baths. However, a doctor may prescribe other creams if the burned area covers the hands, feet, face, groin, buttocks or a major joint.

Small second-degree burns may be treated in the same way. However, a doctor may prescribe other creams for larger burns or if the burned area covers the hands, feet, face, groin, buttocks or a major joint.

Treating third-degree burns is more complex, and sometimes skin grafting or the use of synthetic skin are required. If large parts of the body are burned, more intensive treatments such as intravenous (IV) antibiotics may be used to prevent infection, and IV fluids may also be required to replace fluids lost when the skin was burned.

Burn pain can be intense and prolonged. Also, additional pain can be caused, as the wounds have to be cleansed and the dressings changed in order for the burns to heal. Sometimes, aggressive pain management is required. The medications used can cause side effects and become addictive.

What are alternative treatments for burns?

Although there is no evidence-based research to support the effectiveness of the following measures, some people find they help relieve burn symptoms:

• Soak a cloth in water to make a cool compress.
• Add half a cup of oatmeal or baking soda to a cool water bath.
• Use a moisturizer or light powder to help stop the burned skin from chafing due to the friction of having your clothes rub against it.
• Use calamine lotion or paw paw ointment to help with the itching.
• Cut a raw potato and spread the juice on the burned skin.
• Use chamomile diluted in warm water or brewed into a tea to sponge on the burned skin.
• Aloe vera lotion. Aloe vera is said to help stop pain and inflammation, reduce swelling and stimulate skin growth and repair.

Avoid breaking open any blisters. Consult your doctor if infection occurs.

Moist exposed burn ointment (MEBO) is an oil-based ointment containing sesame oil, beta-sitosterol, berberine, and other small quantities of plant ingredients that was developed at the China National Science and Technology Center in Beijing in 1989.

A 2001 study(1) concluded that MEBO is as effective as the conventional approach in the management of second-degree burns, though it is not the panacea for all burn wounds as claimed. It may be a useful alternative in burn injuries involving the face, neck, and hands. It is less expensive than conventional treatment and provides better pain relief in the first 5 days after burns. As it can be applied by semiskilled personnel, its use may be advantageous in mass casualty situations before evacuation to definitive burn care facilities.

Sources:

1 http://www.medscape.com/viewarticle/408107_4

Of course, essential oils traditionally have also been used for burns. For more information, see the Useful Essential Oils tab.