Burns: Types, Treatments, and Prevention
Also known as: Burn injuries, Scalds
Burns: definition and how common they are
Burns are tissue injuries caused by exposure to heat, chemicals, electricity, or radiation. In the United States, about 450,000 people are treated for burns each year, and roughly 30,000 need admission to a specialized burn center. Burns are the fourth leading cause of trauma deaths in the country, and the second leading cause of accidental death in children ages 1 to 4. The size and depth of a burn determine its severity and guide treatment. Acting quickly helps limit long-term damage.
Causes and risk factors
Burns result from several different mechanisms. Thermal burns (flames, boiling liquids, steam, hot surfaces) are the most common. Chemical burns happen on contact with strong acids or bases. Electrical burns can cause deep injury that is not visible on the surface. Radiation burns come from sun exposure or radiation therapy. Risk is higher for young children, older adults, workers exposed to industrial hazards, and anyone whose alertness is reduced by alcohol or certain psychoactive medications.
Symptoms
Signs vary by how deep the burn goes:
- First-degree burns: redness, pain, and local warmth, with no blisters, such as a mild sunburn
- Superficial second-degree burns: painful blisters with pink, moist skin
- Deep second-degree burns: blisters, whitish or pink skin, and reduced sensation
- Third-degree burns: charred or white, leathery skin that feels numb because the nerve endings are destroyed
Pain is, paradoxically, often absent in the deepest burns because the nerves have been destroyed.
Diagnosis
A doctor assesses a burn by its depth (first, second, or third degree) and its extent, estimated with the Rule of Nines (the percentage of total body surface area affected). The clinical exam is the foundation of diagnosis. Additional tests may be needed, such as blood work (complete blood count, electrolytes), an EKG for electrical burns, and referral to a specialized burn center for severe cases.
Treatments
Treatment depends on severity:
- Immediate cooling: hold the burn under cool (not iced) running water for at least 5 to 30 minutes. Do not put ice on a burn. This is the top priority.
- Minor burns (first degree): moisturizers, sun protection, and oral pain relievers such as acetaminophen or ibuprofen
- Superficial second-degree burns: antiseptic cleaning, hydrocolloid or non-stick dressings changed regularly, and pain relievers
- Deep second-degree and third-degree burns: hospital care, skin grafts, and rehabilitation
- Infection prevention: watching for signs of infection, with targeted antibiotics only if an infection is confirmed
- Pain management: matched to the intensity of the pain, from mild to strong pain relievers
Prevention
Most burns at home are preventable:
- Keep children away from stovetops, ovens, and hot liquids
- Set your water heater no higher than 120°F (49°C), and always test bathwater before a child gets in
- Install smoke detectors and anti-scald devices on faucets
- Wear personal protective equipment (PPE) in higher-risk work settings
- Apply a high-SPF sunscreen (SPF 30 or higher) and reapply at least every 2 hours, and after swimming or sweating
- Store chemical products out of children’s reach, in their original containers
When should you see a doctor?
Seek emergency care if a burn covers more than 10% of the body surface; involves the face, hands, feet, joints, or genitals; or is a third-degree burn. In children and older adults, any significant burn deserves medical evaluation. Signs of infection, such as fever, spreading redness, or pus, need prompt care.
Sources
- StatPearls: Thermal Burns (NCBI Bookshelf), U.S. burn incidence (about 450,000 treated and roughly 30,000 burn-center admissions each year), thermal burns as ~86% of cases, and burns as a leading cause of accidental death
- MedlinePlus: Burns, U.S. National Library of Medicine first aid (cool, not ice, water for 5 to 30 minutes), burn degrees, and when to seek emergency care
- StatPearls: Burn Evaluation and Management (NCBI Bookshelf), American Burn Association criteria for burn-center referral (>10% TBSA, full-thickness burns, and burns of the face, hands, feet, genitalia, or major joints) and the Rule of Nines
- HealthyChildren.org (American Academy of Pediatrics): First Aid for Burns, when a burn needs emergency care (burns on the hand, foot, face, genitals, or over a joint) and not putting ice on a burn
- MedlinePlus: Sunscreen, sun protection and sunscreen use
- MedlinePlus: Bathing an infant, safe water heater temperature to prevent scalds