A burn occurs when hot substances destroy some or all skin layers. It is the 15th leading cause of death. According to WHO, it’s a global public health problem with over 96000 deaths annually from fire-related burns. Smoking and scalding are the leading causes of burns in adults and children. This article will discuss mainly first and second-degree burns and the best way to treat them.
What is a Burn?
Burn is an injury to the skin which causes damage to the tissues primarily caused by excessive heat, radioactivity, friction, electricity, or chemicals. Burns can be minor medical issues or life-threatening emergencies. The burns’ severity depends on the burning substance’s temperature or surface’s duration.
Degrees of Burn
There are three primary degrees of burns: first-degree, second-degree, and third-degree. Each degree depends on the severity of the damage to the tissues. First-degree burns are minor burns, whereas third-degree is the most severe.
Burns of the first degree are also known as superficial burns. The epidermis is the outermost layer of the skin. The skin consists of three layers, and the epidermis is the thinnest. Hence, a first-degree burn is the mildest form of skin injury and usually doesn’t require medical help. Moreover, long-term tissue damage is rare in first-degree burns. However, some superficial burns can be significant or painful and may require medical treatment.
Symptoms of first-degree burns include the following:
- Minor inflammation
- Redness and peeling skin
Causes of First-Degree Burns
Intensive ultraviolet rays produced by the sun can penetrate the outer layer of skin, causing sunburn. Sunburn can cause redness and blisters on the skin. Additionally, a sunburn usually heals by itself within a few days; therefore, no extensive medical care is necessary.
One of the most common causes of first-degree sunburn in children younger than 5 is scalds. It causes damage to the skin through heat and hot objects. For example, consuming hot food or hot drinks can scald the roof of your mouth, which can cause superficial burns or first-degree burns. It can also occur if you shower in boiling water. Furthermore, higher temperatures can lead to more severe skin issues, especially in children.
An electric burn is a skin burn that occurs when electricity comes in contact with your skin. Electricity can travel through your body which can damage the tissues and organs. The electric burn damage can be mild or severe. A person can also get burned or electrocuted from exposure to electricity by playing with an electric appliance or by sticking any object into the openings of a socket.
Thermal burns may occur from any external heat source, such as hot liquids, flame, hot solid objects, or occasionally steam. Fire may also cause first-degree burns sometimes.
First-degree burns usually require at-home care. It includes the following:
- Taking ibuprofen or acetaminophen for pain relief.
- Applying lidocaine.
- Using antibiotic ointment and loose gauze to protect the affected area.
- Cold compresses
A second-degree burn is also known as a partial-thickness burn. It affects the epidermis and part of the dermis layer of the skin. It can cause blisters, swelling, and redness, white or splotchy skin. It can also cause severe pain, but it can be relatively minor. Burns that affect large areas can cause severe complications and may be prone to infection. Cancer patients undergoing chemotherapy are also at risk, as are those with a weakened immune system. It takes longer for 2nd-degree burns to heal than first-degree burns. Large areas of the body or face, joints, genitals, or buttocks are more susceptible to 2nd-degree burns.
Second-degree burns are divided into two categories
- Superficial second-degree burn:
It typically heals with conservative care, which requires no surgery at all. It usually takes two to three weeks for healing. In order to treat burn wounds, topical medications are applied. The new epidermis grows in three to four weeks with proper care.
- Deep second-degree burns:
It appears more pale than pink. The skin is drier, and the sensation of the skin can be diminished. These burns may need surgical treatment, depending on the severity.
Causes of Second-Degree Burn
Physical sources of heat such as sun, stove, and kettle can cause second-degree burns. Certain chemicals, including bleach and other cleaning products, can also cause burns.
Some common causes of second-degree burns include the following:
- Direct contact with boiling water
- Accidents with stoves, kettles, or ovens
- Severe sunburn
- Exposure to fire
- Certain chemicals
Intentional abuse, such as acid attacks, can also cause a second-degree burn. Such chemical burns are also known as caustic burns.
Third-Degree Burns or Full-Thickness Burns
A third-degree burn is also known as full thickness burn. This type of burn damages the epidermis (outer layer of the skin) and the entire layer beneath. In some cases, it can also damage the hypodermis, which is the innermost layer of the skin. A third-degree burn is more severe than a first and second-degree burn and always requires skin grafts. These burns have very diminished pain. It can cause serious injury requiring immediate medical help because it can damage the nerve endings in the skin responsible for sensing pain.
The burn site may appear white, grey, brown, waxy, or leathery. A person with a third-degree burn may require hospitalization. The treatment will vary depending on the location and severity of the burn.
Symptoms of Third Degree Burn
Symptoms of third-degree burns include the following:
- Whitish color
- Blisters that do not develop
- Waxy or leathery
Causes of Third-Degree Burn
Following are some commonly observed causes of 2nd-degree burns.
Steam can cause third-degree burns as it penetrates the epidermis to the lower layers of the skin and tissue. It may also cause infection.
When the skin comes in contact with hot objects for an extended period, such as flames from a fire, it damages the epidermis and the lower layers of skin, causing a third-degree burn.
Flash burns are the most severe consequences of a nuclear explosion. It results from the absorption of radiant energy by the skin. A 1-megaton explosion can cause third-degree burns at distances up to 5 miles. It burns over 25 percent of the body.
Chemicals can cause third-degree burns if a person comes in contact with a harsh substance such as bleach, disinfectants, or acid. It damages the tissues of your body due to rough or corrosive substances. Swallowing household chemicals can also cause third-degree burns, which may result in serious complications. Mild chemical burns usually heal quickly, but severe chemical burns can be life-threatening and can cause permanent tissue damage.
These wounds recover with severe scarring and spotting without surgery. Other treatments include the following:
- Antibiotic ointments or creams
- Intravenous fluids that contain electrolytes
- Early cleaning and debriding
Difference between First and Second-Degree Burn
Burns are usually classified according to the depth of the injury caused to the layers of the skin. First-degree burns are less severe than second-degree burns. First-degree burns damage the outer layer of the skin, whereas second-degree burns affect the epidermis and the next layer (dermis). The burn site appears red, swollen, blistered, and painful in a 2nd-degree burn. Whereas in first-degree burns, the burn site appears red, dry, and painful with no blisters. For example, mild sunburn.
Symptoms of First-Degree Burns
First-degree burns usually have only minor symptoms for a week or two after they occur.
- Skin redness
Symptoms of Second-Degree Burn
Following are the common symptoms of partial thickness burn.
- Severe pain
If you experience any of these symptoms, then consult your healthcare provider for testing and treatment.
Infections Associated with Burns
Staphylococcus is an infection caused by severe skin burns. People with eczema are more likely to get staphylococcus. It lives harmlessly on skin surfaces, especially around the nose, genital area, and mouth. Staph infection spreads through a contaminated surface or from person to person.
Pseudomonas is among the leading causes of infections in people suffering from severe skin burns. This infection can cause significant delays in a patient’s recovery, leading to fatal issues. It can also spread to people through contaminated surfaces, hands, and equipment.
Patients with severe skin burns are more prone to infections such as acinetobacter. It can spread directly to a person or environment with bacteria. It is highly contagious. It may lead to delays in wound healing, graft losses, and the development of sepsis.
Anaerobic bacteria cause anaerobic infection. These bacteria occur naturally in the body. Conditions with anaerobes are rare and typically occur due to electrical burns.
A patient with a burn injury is at a higher risk for sodium and potassium imbalances in both the resuscitation and acute phase, which can cause hypokalemia. The body releases extra potassium in your blood in response to severe burns.
Anything that can leave a scar can cause a keloid. This includes being burned, cut, or having severe acne. Keloids can also develop after you get your body pierced. Keloids sometimes show up for four months or more after your skin is injured. Keloid scars are thick, itchy, and painful.
An infected burn can cause sepsis (blood poisoning) or toxic shock syndrome. This condition can be life-threatening if not treated on time. Signs of sepsis include the following:
- A high temperature
Sepsis can be treated by topical or systemic antimicrobial therapy, debridement, or wound cleansing.
Treatment of Burns
Burns are generally preventable, and the treatment depends on the severity of the burn. If the patient is immediately transferred to a burn center, burns are covered with clean and dry dressings. The doctors apply antibiotics at the burn center. Major burns may require prolonged treatment.
For minor burns, doctors recommend the following ointments
- Silver sulfadiazine
- Mupirocin (it’s only available with a prescription)
Antibiotics are a popular option to apply to burns as they are relatively inexpensive and easy to find. Also, consider s tetanus shot for recovery.
Full-thickness burns are treated with skin grafting. The purpose of this surgery is to remove dead skin and replace it with healthy skin. It is often treated with an antibiotic ointment or a non-sticky dressing. There are three types of skin grafts.
- Sheer graft
It is usually applied to the face or hands for a better cosmetic effect. It uses the whole piece of skin without holes. Newly healed grafts are fragile and sensitive. It would be best if you took special care to protect them. Do not rub or scratch them.
- Meshed grafts
A meshed graft is used for more significant wounds. During the procedure, a piece of skin is taken from another part of the donor’s skin to close the open area. The donor skin shrinks when it is taken off the body. It is then put through a machine to stretch it. This stretched skin covers a large area of your body but leaves a permanent mesh pattern. A new layer of skin fills in the areas between the holes to heal the wound.
Advanced dressings are pads and strips that have wound-healing products in them. You don’t have to apply ointments with these dressings. Special dressing keeps the skin safe from damage. These dressings also speed up the healing process. But it has one disadvantage, these dressings are relatively more expensive than ointments. Special wound dressings include
- Hydrocolloids (DuoDerm)
- Hydrogels (Aqua clear)
- Silver-impregnated drugs
- Non-adherent gauze
What should you avoid?
Prevention is the key. There are a number of recommendations to reduce the burn risk.
- Avoid smoking in bed
- Limit the height of open flames
- Lower the temperature of hot water taps
- Avoid hot spills
- Always check that electrical cords are not frayed.
- Smoke alarms
There are a few things that you shouldn’t put on a burn
- Steroid creams like hydrocortisone
- Dressings that can shed fibers
Recovery of First and Second-Degree Burn
A first-degree skin burn usually heals within a week, leaving minimal scarring. These burns don’t need any medical attention. The burn may require medical attention and proper treatment if it is severe. Whereas severe burns may take a long time to heal, after appropriate first aid and wound assessment, the procedure may involve medications, wound dressings, therapy and surgeries. It usually takes more than nine weeks to recover.
When to Consult a Doctor?
It is suggested to consult a doctor in case of a burn, depending upon the degree of the burns.
In case of first-degree burns, patients must get first aid and get treated by using OTC tubes.
When it comes to second-degree burns, it is recommended to talk to your doctor for better treatment.
If you are seeking the proper treatment for burns, then your doctors online team has a professional doctors team that can treat your wound in the most efficient way!
FAQs About First and Second-Degree Burn Answered By your Doctor Online Team
A superficial burn can be treated at home with a clean, non-stick, and sterile bandage. If blisters occur, let them heal on their own.
No burns do not need air to heal. Air can further damage the tissues as burns are considered open wounds. They heal better in a moist environment.
You can treat a second-degree burn at home. Use antibiotic ointments and special dressings to treat a second-degree burn at home.