Burns are common skin injuries that are caused from exposure to heat, sunlight, friction, chemicals, electricity, and radiation. They are divided into different degrees based on the depth of injury the cause to the skin layers.
First degree burns are the simplest type, because they only affect the outermost layer of our skin known as the Epidermis. They usually present as redness with little pain depending on the degree of exposure. A good example of this type of burn is a non blistering sunburn or a friction burn.
Second degree burns are more severe than first degree burns because the injury penetrates deeper into the second layer of skin known as the dermis. They present with redness, heat, pain, and blistering which is an important differentiating factor from first degree burns. Even though these burns blister, they rarely leave any scarring.
Third Degree burns are very severe because injury penetrates deeper into the dermis and subcutaneous tissue where hair follicles are embedded. This type of burn presents with complete loss of the outer layer of skin, damage to the full thickness of the dermis, loss of hair, and are painless due to nerve damage. This type of burn requires professional medical attention. It usually leaves scarring and may require a skin graft.
Fourth Degree burns are even more complicated and involve deeper tissues like tendons, ligaments, and muscles.
The proper management of treating burns is aimed at preventing infection, reducing pain, and promoting quick healing. As long as the skin is intact like in first degree burns, the chance of infection is rare. While in the case of second degree burns, the first thing to do is not pop the blister. Inside the blister is a sterile environment, and the skin that is under the blister is not ready to be exposed yet. So the longer you can maintain the blister the quicker that area will heal with less complication. In the case where a blister may get punctured and seep out its contents, do not peel off the flap of skin because is serves as a protective layer for the maturing skin under it. As an additional precaution to a punctured blister, you can apply a topical antibiotic (Neosporin, Polysporin) and a band aid on top to prevent exposure and contamination.
Reducing pain is another important factor in the management of burns. The approach varies depending on the size of the burn. In the case of sunburn, an oatmeal bath is recommended to soothe the skin. Then topical agents containing aloe and lidocaine (ex. Solarcaine) may be applied afterwards to keep the skin hydrated and numb the pain. An uncommon method to reducing burning pain in as fast as 15 minutes is the topical application of three colored toothpaste (ex. Aquafresh). This should only be tried at the time of the burn, if the burn has intact skin on it, and if it isn’t infected.
It usually takes about a week for the skin to heal and keeping the new skin moist will quicken it maturation and reduce scarring. Applying vitamin E oil on healing new skin is a good way, as long as one is not allergic to it. Another moisturizing agent that can be used is aloe.
