What is a Burn?
A burn is damage or injury to the skin or tissue, usually caused by direct contact with heat. This can lead to death of skin cells in the area and may result in scarring.
People can acquire a burn from various elements, such as: chemicals, electricity, vapors and steam. A burn can also develop internally, due to inhalation of smoke or very hot air, for example. (1)
Additionally, skin and tissue can become burnt from radiation. This is often caused by ultraviolet (UV) emissions from the sun, otherwise known as sunburn. This type of burn can take several days or weeks to heal and may cause severe damage and complications in the future. (2)
Burn injuries are very common, although they are completely preventable in most cases. In the US alone, an estimated half a million people seek burn treatment each year. (3)
The skin is the largest and heaviest organ. It serves as a protective layer between the body and the outside environment, while helping to regulate core temperature.
Each layer of the skin has a different set of tasks to protect the body. Water and fat are stored in small chambers of the deepest layer, to keep tissues and muscles safe.
The outer layer of skin is constantly renewing as the surrounding environment causes skin cells to fall off. A burn to the outer layer is generally quick to heal.
However, if a burn penetrates through to the deepest layer, damage might be permanent and sometimes even fatal. (4)
The thickness of the skin changes with age. The skin is usually very thin in young children and elderly people, which is why burns are especially harmful for these two age groups. Some diseases also affect the skin’s thickness, again creating a higher chance of burn damage.
Symptoms depend on the severity of the burn. When a severe burn occurs, the body will launch an explosive inflammatory response which triggers a variety of symptoms that can, in some circumstances, cause further damage. (5)
Some of the most common symptoms are described below:
Pain is the initial sign of a burn, however it does not predict precisely how deep or severe the burn is. Pain can often be worsened by fear or anxiety. (6)
When a body part is injured, the nerves react by initiating pain. This works as a sort of emergency call to the brain, indicating that the body is in need of help.
Burns can cause different degrees of pain; mild burns can be sensitive to the touch, whereas deep damage can be excruciatingly painful.
Redness usually occurs when the skin becomes irritated or suffers damage.
This is a typical sign of a burn to the first or second layer of the skin. (7)
Change in Skin Color
The skin can continue to change its color over a period of time following a burn, particularly in cases of sun damage.
The color of the skin may at first look blistering red. However, as it settles, it can appear pink or even purple. These changes can develop up to three days after exposure to the sun. (8)
If a burn is very severe and affects the deeper layer, the skin color might change to become leathery white or charcoal black. This can be seen in burns caused by high voltage or chemicals, for example. (9)
As the cells work to contain damage within the affected area, this can lead to a buildup of fluids as the body prevents the moisture from escaping.
The trapped fluid can lead to swelling (edema). In severe cases, this could cut off circulation to different parts of the body, resulting in organ damage or even failure. (10)
A blister, sometimes called a vesicle or bulla, is a typical sign of a burn injury. Blisters differ in size and contain body fluid which will leak out once ruptured; a yellow crust usually forms afterwards.
Blisters can appear in both mild and severe burns; they can develop as a secondary event following the injury.
Doctors have found evidence that suggests blisters may be a tool to help the healing process of burns.They appear to contain growth material which can help form new blood vessels. Therefore, even though it can be painful and annoying, a blister might be of more benefit than harm. (11)
A burn is categorized by its type, severity and depth. (12)
Doctors will calculate the percentage of total body surface area (%TBSA), using a rule of nines. Each part of the body (head, chest, arms, genitalia) is given a percentage of nine, dependent on the size of the area. This will determine how much of the body is burnt. (13, 14)
For example, if an adult patient has sustained burns to the chest and left arm, doctors will say that 13.5 percent of the body is burnt and thereby determine the severity.
If the patient is a child, this method will be adjusted, depending on the child’s age and size (e.g. large head, smaller arms/legs).
A first-degree burn is categorized as a superficial or partial thickness burn. Such a burn has only affected the outer layer of the skin. It will generally take up to two weeks for the wound to heal, but usually won’t leave a scar.
This type of burn is still considered as a partial thickness burn. The injury has gone through to the second layer of skin and, in some cases, the patient may need a skin graft to cover and protect the wound.
A second-degree burn can be very painful, with redness and swelling; it is also likely to leave a scar.
A third-degree burn is classified as a “full thickness” burn. It has penetrated both layers of the skin. The area may look leathery white around the edges and black within the center.
The level of pain is often severe, although, as nerve endings are usually destroyed, this pain is not from the area of the third-degree burn. The pain actually comes from the surrounding partial thickness burn. This type of burn will almost certainly leave a scar.
The patient will need intensive care to recover and prevent possible complications.
Treatment depends on the type of burn sustained and its severity. In serious cases, doctors will work fast to prevent life-threatening secondary complications, such as shock.
Shock is caused by the body’s response to the burn. The body seals off the affected area, which can accidentally restrict the blood flow to various organs. This condition can progress quickly and could be fatal in extreme cases. (15)
As a burn is almost always caused by accident, it occurs without warning; therefore, it is important to know what to do, in order to quickly help the person in need. (16)
Doctors recommend to “drop and roll” if the body or clothing is alight.
In cases of an electrical burn, the power should be shut off before assisting the person.
It is important to cool down the burnt area with lukewarm water for at least 20 minutes. Do not use cold water or ice as this reduces blood flow.
Doctors will clean the wound before applying a protective dressing. A close eye should be kept on the burn as it heals; burn wounds have a tendency to become infected.
The patient is likely to be given pain relief if open blisters are present; any dead skin surrounding a blister might be removed. (17)
Patients with severe burns will typically be transferred to a specialized burn unit, where intensive care is provided.
Doctors will start by making sure the airway is clear or checking if the patient needs assistance in breathing.
Skin that has been severely burnt loses its ability to stretch; this can prevent the person from breathing correctly or can cut off vital blood flow to an area of the body.
To fix this, a surgeon will perform an escharotomy, an incision made in the affected area which releases pressure on some of the deeper tissues and restores circulation. (18)
When the body has been severely burnt, fluid loss is highly likely.
Depending on the patient’s response, doctors will administer fluids through an IV (intravenous) in a vein. This will prevent further damage caused by restricted blood flow. (19)
Surgery is not the immediate response from doctors when it comes to burn injuries.
However, if the patient is fit for surgery, procedures can be used to replace damaged skin, using either healthy skin from an unaffected area, or artificial skin. Surgery may also be beneficial to reduce scarring. (20)
What is a burn? A burn is an injury or damage to the skin or tissue, usually caused by a source of heat.
What are the signs of a burn? Signs can include: pain, redness, change in skin color, swelling and blisters. If the burn has affected the airway, symptoms can be: coughing, wheezing and difficulty breathing. (21)
How do you develop a burn? Burns can be caused by a number of situations: heat, chemicals, electricity, water, lightning or even extreme cold. (22)
How is a burn diagnosed? Doctors can generally tell by sight if you have a burn. Thereafter, an estimation of the severity will be carried out in order to implement the correct treatment.
What is the best treatment for a burn? If the burn is minor, first aid treatment can usually be administered at home, as mentioned above. But if the burn is severe, intensive care is needed. Rehabilitation and psychological help may be required. (23)
What are the long term complications of a burn? Mild burns, such as sun damage, can lead to skin cancer or other skin diseases. Major burns can cause loss of functional ability. Some people may also need psychological support to help them recover fully from the injury. (24)
Is a burn considered a disability? A severe burn injury can lead to physical disabilities. However, there are professionals available in many countries to help prevent this as much as possible. (25, 26)
Is there a cure for a burn? There is no cure, but many burns can be prevented by: installing fire alarms, teaching children about the dangers of fire and heat, or taking precautions before handling chemicals or anything electrical.
Is a burn life threatening? Yes, it can be. Even after the source is removed, the person is still at high risk. Organ failure can take place due to shock or excessive swelling.
A burn is an injury or damage sustained to the body; this can be as a result of exposure to one of many elements, such as heat, chemicals or electricity.
Burn injuries are very common but mostly preventable. For example, many people have experienced a minor burn when sitting too long in the sun.
However, burns can also be severely debilitating and require intensive care. Patients may take several years to recover.
It is important to know about first aid and how to help a person afflicted by burns. Even a small amount of knowledge can change the outcome of a burn injury.