Burns

About burns

In the UK, around 175,000 people visit the accident and emergency department of a hospital each year for burn injuries, and 16,100 are admitted to hospital. Burns usually affect your skin, but other parts of your body can be injured, such as your airways and lungs, from inhaling hot fumes and gases.

Types of burn

The severity of your burn will depend on how deeply it has affected your skin tissue. There are three types of burn: superficial, partial-thickness and full-thickness.

Superficial burns

Superficial burns only affect the surface of your skin (epidermis). Your skin will be red and painful, but not blistered. Mild sunburn is an example of a superficial burn.

Partial-thickness burns

Partial-thickness burns are deeper burns that damage your epidermis and dermis to varying degrees. If the damage to your dermis is shallow, your skin may be pale pink and painful, with blisters. Deeper burns to your dermis will cause your skin to become dry or moist, blotchy and red. Deep partial-thickness burns may or may not be painful and they may blister.

Full-thickness burns

All layers of your skin are damaged by full-thickness burns. Your skin will look white, brown or black and dry, leathery or waxy. Because the nerves in your skin are destroyed with full-thickness burns, you won't feel any pain or have blisters.

Symptoms of burns

Symptoms vary depending on the severity of your burn. They include:

  • changes in your skin colour – burns can cause your skin to look pink, red, white, brown or black
  • blisters
  • pain in the burnt area

Symptoms of a burn to your airway include:

  • burned nostril hairs
  • a change in your voice (it may sound hoarse)
  • a sore throat
  • wheezing

Complications of burns

There are a number of complications of burns. These are listed below.

  • Serious breathing problems if you have an airway burn and have inhaled smoke (it can take up to 24 hours for these problems to develop).
  • Dehydration and circulation problems if you have a severe burn. If you lose large quantities of fluid through your burned skin, it can seriously affect your heart and circulation.
  • Infection and possible septicaemia – healthy skin is a very effective barrier to infection, but this function is lost if your skin is severely burned.
  • Damage to your muscles if you have an electrical burn. Large muscle damage may also lead to kidney failure.
  • Scarring, which can disfigure your skin or affect movement if your burn is around a joint.

Severe extensive burns can be fatal.

Causes of burns

Burns are caused by:

  • dry heat (such as from a fire)
  • wet heat, often called a scald (steam or hot fluids, for example)
  • radiation (from the sun or a sun bed, for example)
  • extreme cold
  • inhaling smoke or toxic fumes, particularly from chemical explosions or house fires
  • electricity
  • chemicals

Diagnosis of burns

Most burns are easily diagnosed and you will know yourself if you have a burn.

Your doctor will ask about your symptoms and examine you. He or she may also ask you about your medical history. Your doctor will want to determine the cause, size and thickness of your burn, and whether you have inhaled smoke or chemical fumes.

Treatment of burns

Treatment for burns depends on their severity. You can treat superficial and minor partial-thickness burns that are caused by heat yourself at home. However, seek urgent medical help from your GP or an accident and emergency department in a hospital for:

  • all deep partial-thickness and full-thickness burns
  • all chemical and electrical burns
  • superficial and partial-thickness burns that cover an area larger than the palm of your hand
  • burns that cover a joint or are on your face, hands, feet or groin
  • all burns that extend completely around a limb
  • all burns where you may have inhaled smoke

Also seek medical help for advice if you're not sure about the extent of a burn or how to deal with it.

For burns caused by chemicals, if possible look at the advice on the label of the chemical product. For full-thickness burns or burns that are caused by chemicals or electricity, it's important that you start cooling the burn immediately under cool or tepid water (unless instructed otherwise on the chemical product) and then call for emergency help. While you're waiting, there are a number of important things you can do.

  • For burns caused by heat, keep cooling the burn with cool or tepid water for between 10 and 30 minutes or until medical help is available. Don't use iced water. Carefully remove any restrictive clothing or jewellery that isn't stuck to the burn. Next, cover the burn using cling film – layer this on to the burn rather than wrapping it around a limb, for example. If you have a burn on your hand, use a clean, clear plastic bag. Don't use wet dressings or creams.
  • For burns caused by chemicals, keep cooling the burn with cool or tepid water for at least 20 minutes and remove any affected clothing (wear gloves if possible). Don't try to neutralise the chemical with another chemical.

Self-help

You can treat superficial and minor partial-thickness burns yourself at home. Begin by cooling your burn with cool or tepid water for 10 to 30 minutes or until the pain is relieved. Don't use iced water.

Only apply ointments or creams to very mild sunburn and if in doubt, don't use creams and ointments. Don't apply them to any deeper burns that have caused a change in your skin colour or blisters. Always read the patient information leaflet that comes with the ointment or cream and if you have any questions, ask your pharmacist for advice.

Don't burst any blisters that form on your burn because this makes them more likely to become infected. If you cover the burn with cling film, it may reduce pain and speed healing.

There are a range of dressings available, such as hydrocolloid, silicon nylon, polyurethane film and biosynthetic dressings as well as antimicrobial dressings that contain silver, but there isn't any strong scientific evidence to support their use. If you feel you need to use a dressing, ask your pharmacist or doctor for advice.

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Superficial burns will usually heal within two weeks and you shouldn't have much of a scar.

If you're unsure how to treat a burn or have any questions, ask your doctor for advice.

Hospital treatment

If you're severely injured over large areas of your body with partial and full-thickness burns, you will need to be admitted to hospital. Your doctors will continue first aid measures and protect your damaged skin with dressings. They will also give you medicines for any pain you might have.

If your doctor suspects that your skin is infected, you will be given antibiotics.

If you have lost large amounts of fluid through your burned skin, you will be closely monitored and may need to have fluids through a drip to help your circulation.

Your doctor may refer you to a specialist burn unit. Full-thickness burns tend to result in scars that can be difficult to treat and you may require skin grafts to minimise scars. Skin grafts are performed by plastic surgeons. Skin from an unaffected part of your body will be used to repair any of your burned skin that can't heal itself.

You may find it useful to have counselling to help you deal with the effects of scars from your burn. Physiotherapy can help you to regain movement in your burned areas.

What is the best way to protect my children from being accidentally burned?

Answer

It's estimated that nine out of 10 burn injuries are preventable. By following a few safety precautions, you can greatly reduce the chance of burns occurring in your home.

Explanation

Most burns are caused by accidents around the home. Children are particularly at risk for burns. Approximately 1,000 people are admitted to hospital every year for severe burns and half of them are children.

Children have thinner skin than adults and so are burned much more easily. Hot drinks are the number one cause of scalds in children under five, although burn injuries from hot bath water, chip pans and hair straighteners are also common.

If you have children, the following tips may help prevent accidental burns in your home.

  • Don't leave hot drinks within reach of your children and don't pass hot drinks while holding a baby.
  • Never leave your children alone in the kitchen when you're cooking. Use the back burners on your stove and keep the pan handles turned inwards.
  • Put hot kettles at the back of your kitchen work surface.
  • Don't overfill a chip pan with oil. If your chip pan catches fire, don't throw water on it. Turn off the heat if it's safe to do so, get out of your house and call for emergency help.
  • If possible, replace your chip pan with a temperature-controlled deep-fat fryer or use oven chips.
  • Keep hot hair straighteners out of reach of your children.
  • Babies' milk should be lukewarm, not hot. Always shake the bottle well and check the temperature by testing a few drops on the inside of your wrist.
  • If you're running a bath, run the cold water first and then the hot water.
  • Bath water for babies or toddlers shouldn't feel hot or cold. Always test it first with your elbow before bathing your child.
  • Keep matches and lighters where young children can't see or reach them.
  • Use fireguards to stop babies and young children falling on to fires or heaters and don't let your children play or leave toys near fires and heaters.
  • Put plug guards into sockets so your children can't stick anything into the holes.
  • Make sure electrical appliances in your children's bedrooms are switched off at night.

What are the potential complications of a severe burn?

Answer

Complications from severe burns are common and can be life-threatening. All deep burns of any size should be examined by a doctor.

Explanation

If you're severely burned by heat, chemicals or high-voltage electricity, you probably won’t feel any pain as your nerve endings will also have also been destroyed by the burn. However, you should go immediately to your nearest accident and emergency department in a hospital or call for emergency help. Severe burns can cause serious complications as a result of extensive fluid loss and tissue damage. Although you may feel fine, complications can still develop hours after a burn and your condition may deteriorate rapidly.

Common complications from severe burns include the following.

  • Serious breathing problems from smoke inhalation, which can take up to 24 hours to develop.
  • Poisoning if you have inhaled toxic gases released by burning materials such as plastic.
  • Dehydration and shock as a result of massive fluid loss.
  • Infection caused by poor cleaning and dressing of your injuries, which can lead to a serious bacterial infection of your blood (septicaemia).
  • Thick, crusty surfaces produced by deep burns, which can become too tight and cut off the blood supply to your healthy skin and tissues.
  • Widespread muscle damage, which can lead to kidney failure.
  • Extensive scarring, which can cause disfigurement or immobility if you're burned around your joints.

Older people and young children are particularly vulnerable to complications from burns, so it's important to see a doctor as soon as possible if you're not sure about the extent of a burn or how to deal with it.

What are burn clubs and camps?

Answer

Burn clubs and camps are places for young people who have been severely burned to meet, share stories and improve their self-esteem.

Explanatio

Children who have scars from severe burns may not feel good about how they look. Burn clubs and camps offer children and young people the chance to improve how they feel about themselves through a variety of challenging and fun activities. The idea behind the camps is that although children may not be able to change their appearance, they can feel good about what their bodies can do. This in turn improves how they feel about themselves.

All burn clubs and camps in the UK are currently funded through private donations. Volunteers from both the public and the NHS help to run the camps. Burn clubs and camps are gradually gaining recognition for their contribution towards the physical, social and psychological rehabilitation of burn-injured young people and their families.

Ask your doctor if you would like more information about burn clubs and camps.