Ahna Patterson, PA-C
Burns are a leading cause of accidental injury and death in the United States. Approximately one million people annually seek care for burns and one-third of those patients present to the emergency room for care. Smaller, non-life-threatening burns comprise the majority of burns, but some burns can cause death if individuals do not seek immediate treatment.
Types of Burns
When you think of burns, you may first think of fire and burns caused by open flames. But burns can also be caused by scalding liquids (e.g., spilling hot coffee), hot vapors or gases (e.g., steam issuing from a boiling pot), contact with hot surfaces (e.g., asphalt on a hot summer day), electricity (e.g., arc flash incidents), radiation (e.g., sunburns), and chemicals (e.g., exposure to industrial cleaners).
The severity of a burn is assessed by how deeply the burn penetrates the skin, the size of the burn, the location of the burn on the body, the age of the burn victim, and whether the victim has any preexisting conditions or has sustained other injuries in addition to the burn (such as smoke inhalation). Burn assessment can be challenging for healthcare providers who are not specially trained in burn care. Consultation with a Burn Specialist and care in a specialized burn unit may be warranted for certain burns.
Historically, burns were classified as first degree, second degree, and third degree burns; while these designations are still around, presently, the preference is to classify burns as superficial, partial-thickness, and full-thickness.
- Involve only the outer layer of skin
- Skin can appear dry and red
- Healing time can be 3 – 6 days
Superficial Partial-Thickness Burns
- Skin can appear red, moist or weeping, often with blisters
- Healing time can be 7 – 20 days
Deep Partial-Thickness Burns
- Skin can appear wet or waxy dry, with open blisters, and can be a variety of colors
- Healing time is more than 21 days
- Skin can appear waxy white, leathery gray, charred, or black; dry and not elastic
- If more than 2% total body surface area is affected, the skin never heals
- Only deep pressure can be felt by individual and they generally have no pain sensation
- These burns require specialized care and have prolonged healing time or may never heal
Superficial burns can be treated by running cool water over the affected area and loosely covering the burn with a sterile, non-adhesive bandage. Because burns impact the body’s ability to regulate heat, never use ice or cold water on a burn—doing so can increase risk of shock or hypothermia. Be careful not to peel away dead skin from a burn; this can cause scarring and/or infection. Use over-the-counter pain relievers if needed for pain.
Always consult your healthcare provider if you have any concerns about the severity, size, depth, or location of a burn. Even minor burns may require treatment in a burn unit, and burns that are more severe may require skin grafting and surgery. Every burn should be monitored closely for signs of infection (increased pain, fever, oozing blisters, swelling). People with burns are vulnerable to contracting tetanus; tetanus boosters are usually recommended if not up-to-date.
Call 911 and seek emergency medical care if you or someone you are with experience a burn that is deep; is larger than three inches; is located on the face, groin, buttocks, feet, or hands; and/or causes the skin to appear charred, leathery, black, brown, or white.
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Mayo Clinic, “Burns: First aid,” https://www.mayoclinic.org/first-aid/first-aid-burns/basics/art-20056649
Michel H. E. Hermans, “An Introduction to Burn Care,” Advances in Skin & Wound Care, January 2019, https://journals.lww.com/aswcjournal/fulltext/2019/01000/An_Introduction_to_Burn_Care.3.aspx
Phillip L. Rice, Dennis P. Orgill, “Emergency care of moderate and severe thermal burns in adults,” UpToDate, updated October 1, 2019.
WebMD, “Thermal Burns Treatment,” https://www.webmd.com/first-aid/thermal-heat-or-fire-burns-treatment#1
Wound Source, “Burns, Superficial (First-Degree),” https://www.woundsource.com/patientcondition/burns-superficial-first-degree