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Burns

Published by Bupa's health information team, May 2009.

This factsheet is for people who have been burned, or who would like information about burns.

A burn is an injury to the skin tissue, usually caused by contact with intense heat, electricity or chemicals. Recognising different types of burns and having a basic knowledge of how to treat them can minimise scarring and even save lives.

• About burns
• Symptoms of burns
• Causes of burns
• Diagnosis of burns
• Treatment of burns
• Questions and answers
• Related topics
• Further information
• Sources

About burns

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

Types of burn

The severity of your burn depends on how deeply it has affected the skin tissue (see illustration). There are three types of burn: superficial, partial-thickness and full-thickness.

The layers of skin

Superficial burns

Superficial burns only affect the surface of the 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 can be painful or painless and may blister.

Full-thickness burns

All layers of your skin are damaged by full-thickness burns. Your skin will be 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

If you're burned, you may have symptoms such as:

• changes in skin colour - burns can cause pink, red, white, brown and black skin
• blisters
• pain in the burned area - but pain from burns isn't related to severity

Symptoms of an airway burn include:

• burned nose hairs
• soot in your mouth or nose
• change in your voice
• sore throat
• wheezing

If you have been burned and have any of these symptoms, you should seek advice from your GP.

Causes of burns

Burns are caused by:

• dry heat (fire)
• wet heat (steam or hot fluids)
• radiation (sun)
• heated objects
• extreme cold
• inhaling smoke or toxic fumes, particularly from chemical explosions or house fires
• electricity
• chemicals

Diagnosis of burns

Most burns are easily diagnosed - you will know when you have burned yourself. Determining the cause, size and thickness of your burn, and whether you have inhaled smoke or chemical fumes, will be your doctor's main concern.

Your doctor will ask you about your symptoms and examine you. He or she may also ask you about your medical history.

Treatment of burns

Treatment for burns depends on their severity. You can treat superficial and minor partial-thickness burns caused by heat at home. However, seek medical help:

• all deep partial-thickness and full-thickness burns
• all chemical and electrical burns
• superficial and partial-thickness burns covering an area larger than the palm of your hand
• burns that cover a joint or are on the face, hands, feet or groin
• all airway or suspected smoke inhalation burns
• advice if you're not sure about the extent of the burn or how to deal with it

For full-thickness burns or burns caused by chemicals or electricity, call for emergency help. While waiting, valuable treatment can be given.

• For burns caused by heat, carefully remove any restricting clothing or jewellery that isn't stuck to the burn. Flood the burn with cool (not cold) water until medical help is available.
• For burns caused by chemicals, remove any affected clothing. Brush the chemical off your skin if it's a dry powder and flood the burn with cool (not cold) water. Don't try to neutralise the chemical with another chemical.

Home treatment

Superficial and minor partial-thickness burns can be treated at home. Begin by flooding your burn with cool (not cold) water for 10 to 30 minutes or until the pain is relieved.

Ointments or creams may help superficial burns like sunburn, but don't apply them to any deeper burns that have caused a change in your skin colour or blisters. Always ask your pharmacist for advice before applying ointments or creams.

Don't burst any blisters that form on your burn. Covering a partial-thickness burn with kitchen clingfilm may reduce pain and speed healing. Ask for advice as soon as you can from your practice nurse or local accident and emergency department.

Over-the-counter painkillers, such as paracetamol or ibuprofen, may also help. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Superficial and shallow partial-thickness burns usually heal within three weeks, with minimal scarring.

Hospital treatment

If you're severely injured over large areas of your body with partial- and full-thickness burns, you will 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.

Healthy skin prevents loss of fluid from the tissues underneath and is a very effective barrier to infection. These functions are lost after your skin is severely burned. If infection is suspected, you will be given antibiotics. If large quantities of fluid are lost through your burned skin, this can seriously affect your heart and circulation. You will be closely monitored and may need to have fluids through a drip to help your circulation.

You may be referred 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 need counselling to help deal with the effects of burn scars or physical therapy to regain movement in your burned areas.

Related topics

• Sun care

Further information

• British Burn Association
  0161 291 6321
  www.britishburnassociation.co.uk
• British Red Cross
  0844 871 1111
  www.redcross.org.uk
• Changing Faces
  0845 450 0275
  www.changingfaces.org.uk
• Children's Fire and Burn Trust
  020 7233 8333
  www.childrensfireandburntrust.org.uk

Sources

• Standards and strategy for burn care: a review of burn care in the British Isles. British Burns Association (National Burn Care Review Committee). 2005. www.bapras.org.uk
• Burns and scalds. Clinical Knowledge Summaries. http://cks.library.nhs.uk, accessed 1 September 2008
• Longmore M, Wilkinson IB, Rajagopalan S. Oxford handbook of clinical medicine. 6th ed. Oxford: Oxford University Press, 2005:834-835
• Simon C, Everitt H, Kendrick T. Oxford handbook of general practice. 2nd ed. Oxford: Oxford University Press, 2007:1076-1077
• Wasiak J, Cleland H. Burns (minor thermal). BMJ Clinical Evidence. www.clinicalevidence.com, accessed 1 September 2008
• McLatchie GR, Leaper DJ. Oxford handbook of clinical surgery. 2nd ed. Oxford: Oxford University Press, 2002:497-502
• Rehabilitation overview. British Burn Association. www.britishburnassociation.co.uk, accessed 1 September 2008

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: May 2009