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Burns

Dr Roger Henderson
Reviewed by Roger HendersonReviewed on 29.04.2024 | 5 minutes read
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Burns can happen in a second, and it’s important to act fast to prevent further injury and reduce the risk of scarring. Minor burns and scalds are fairly common, with hot water from pans, kettles or the bath as top of the list, and fireworks when celebrations come around.

Burns typically affect the hands, forearms and face, or the lower legs or bottom when young children get in a very hot bath. Sunburn also counts as a burn.

Take burns seriously, even if there isn’t much to see initially – it can take some time for the skin to react and deep pain to set in, but the skin has been traumatised, and the process of injury continues unless it is cooled and treated.

What different types of burn are there?

Burns are classified according to the depth and extent of the skin damage, and their treatment depends on how severe they are. There are three main types;

  • First-degree (superficial) burns - the skin is red, painful and very sensitive to touch. The damaged skin may be slightly moist from leakage of the fluid in the deeper layers of the skin, and sunburn is a good example of such a burn.
  • Second-degree (partial thickness) burns. Here, the damage is deeper, and blisters usually appear on the skin, which is still painful and sensitive.
  • Third-degree (full thickness) burns. The most severe type of burn, and here the tissues in all layers of the skin are dead, so there are typically no blisters on the skin. The burned surface can have several types of appearance, from white to black (charred) or bright red from blood in the bottom of the wound. Because the skin nerves are damaged, these burns can be surprisingly painless and lack sensation when touched. Specialist treatment with skin grafts are often required for severely damaged areas, and these types of burns are often life-threatening if enough of the body is burnt.

What should I do immediately after a burn?

Taking care of your own safety first, you need to remove the person from the source of heat immediately. If there are flames, extinguish these using the ‘drop and roll’ technique or cover them with a blanket. Chemical or electrical burns will require protective equipment, so dial 999 and do not approach until you have specialist advice.

After this, the immediate thing to do is to try to limit the extent of the damage if possible, and so prevent the burn from becoming worse. Cool any burnt area by placing it under cool (not freezing) running water. Try to do this for as long as possible until the pain eases – this may take over an hour. (First-degree burns such as mild sunburn usually do not require this treatment and can be treated with aftersun preparations and calamine lotion.) Burns that should be assessed medically include;

  • Burns bigger than the palm of the hand.
  • Burns on the face, neck, hands, and in the groin.
  • All third-degree burns.
  • Most second-degree burns.

If you have to travel to see a doctor or nurse then a good tip is to either keep pouring water over the burn, or wrap the area with clean, soaking wet cold towels. Never try to lance any blisters yourself and don’t follow folk remedies - water is the only thing that should be used – so never be tempted to put butter or lard on burns. Someone with a burn should also have a tetanus injection if they have not had a booster within the last 10 years.

Anything I should avoid?

You should avoid the following to promote healing:

  • Avoid a whole body shower, as this can induce hypothermia.

  • Avoid pulling clothes stuck to the burn off, as this may cause more skin damage.

  • Avoid delaying the cooling process – you can cool the area while calling 999 if necessary, or cool first then attend hospital – this is to reduce pain and prevent long-term scarring.

  • Avoid putting household products – butter, toothpaste or cream – on the burn, as these can cause further harm.

  • Avoid using ice to cool the burn, as this can deepen the burn.

  • Avoid plasters or adhesive bandages on the burn, as this can cause further damage to the skin on removal.

Healthwords pharmacists' top tips

Treatment at home or with pharmacy products is generally limited only to first-degree (superficial) burns that just affect the outer layer of skin. Anything deeper than this, or which covers the size of skin surface larger than the affected person’s hand, will need medical attention.

Mild burns are damage to the skin typically caused by dry heat such as a hot iron, hot oven or a fire. Scalds are caused by a hot wet substance such as contact with hot water or steam. They are both treated in the same way and in most cases, mild burns or scalds can be treated at home, and normally heal without the need for further treatment.

When should I see my doctor?

Any burn worse than a first-degree burn should be assessed in the Emergency Department. If the burn covers an area larger than the injured person’s hand, it’s blistering, white or charred, or it affects the face, hands, arms, feet, legs or genitals, these should be immediately assessed.

Other reasons for urgent medical attention include if the injured person has long-term medical conditions that make them more vulnerable, if they are over 60 or less than 5 years old, or if they are pregnant, they should seek urgent medical attention.

Any electrical or chemical burns require a 999 call, even if you can’t see an injury, as this can affect the heart or cause delayed damage. You must call 999 immediately if the injured person is having difficulty breathing or responding, if they feel unwell, or they're sweaty and clammy.

What are the best tips to reduce the risk of getting burnt?

Prevention is better than cure here, and the majority of burns are preventable. The kitchen is the most dangerous room in the house, and the most likely place for burns and scalds to occur, especially where small children are concerned. When cooking, keep them away from hot drinks, pans and kettles, barbecues and other open flames, and turn pan handles away from the front of the cooker so children cannot reach up to grab them.

Never throw water over oil fires, such as in a chip pan, because this will cause an explosion. Instead, smother the fire by covering the pan with a damp cloth. Buy a proper fire-smothering blanket and keep it somewhere in the kitchen where it is easily accessible.

When running a bath for a small child, fill it with cold water first to prevent the risk of them climbing into a half-run bath full of hot water.

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Dr Roger Henderson
Reviewed by Roger Henderson
Reviewed on 29.04.2024
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