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Burns

Burns can be minor medical problems or life-threatening emergencies. Some of the most severe burns are caused by electricity or chemicals. Scalding liquids are the most common cause of burns in children.

Sunburns and small scalds can usually be treated at home, but deep or widespread burns need immediate medical attention. People with severe burns often require treatment at specialized burn units. Skin grafts may be necessary to cover large wounds.

For most burns, the very first thing to do is to flood the injury with cool tap water. Ice is not recommended because it can cause additional damage to the burned tissue.

Symptoms Causes Complications Prevention

Burns don't affect the skin uniformly, so a single injury can reach varying depths. Distinguishing a minor burn from a more serious burn involves determining the degree of damage to the tissues of the body. The following are four classifications of burns:

  • First-degree burn. This minor burn affects only the outer layer of the skin (epidermis). It causes redness and pain and usually resolves with first-aid measures within several days to a week. Sunburn is a classic example.
  • Second-degree burn. These burns affect both the epidermis and the second layer of skin (dermis), causing redness, pain and swelling. A second-degree burn often looks wet or moist. Blisters may develop and pain can be severe. Deep second-degree burns can cause scarring.
  • Third-degree burn. Burns that reach into the fat layer beneath the dermis are called third-degree burns. The skin may appear stiff, waxy white, leathery or tan. Third-degree burns can destroy nerves, causing numbness.
  • Fourth-degree burn. The most severe form of burn affects structures well beyond the skin, such as muscle and bones. The skin may appear blackened or charred. If nerve damage is substantial, you may feel no pain at all.

When to see a doctor

While minor burns can be cared for at home, call your doctor if you experience:

  • Increased pain, swelling, redness or discharge in the burned area
  • A burn that doesn't heal in several weeks
  • New, unexplained symptoms

Seek emergency medical assistance for:

  • Burns that cover the hands, feet, face, groin, buttocks or a major joint
  • Chemical or electrical burns
  • Third- or fourth-degree burns
  • Difficulty breathing or burns to the airway

Many substances can cause burns, including:

  • Fire
  • Hot liquid or steam
  • Hot metal, glass or other objects
  • Electrical currents
  • Radiation from X-rays or radiation therapy to treat cancer
  • Sunlight or ultraviolet light from a sunlamp or tanning bed
  • Chemicals such as strong acids, lye, paint thinner or gasoline

Deep or widespread burns can lead to many complications, including:

  • Infection. Burns can leave skin vulnerable to bacterial infection and increase your risk of sepsis, a life-threatening infection that travels through your bloodstream and affects your whole body. Sepsis is a rapidly progressing, life-threatening condition that can cause shock and organ failure.
  • Low blood volume (hypovolemia). Burns can damage blood vessels and cause fluid loss. This may result in low blood volume (hypovolemia). Severe blood and fluid loss prevents the heart from pumping enough blood to the body.
  • Dangerously low body temperature (hypothermia). The skin helps control the body's temperature, so when a large portion of the skin is injured, you lose body heat. This increases your risk of hypothermia — when the body loses heat faster than it can produce heat, causing a dangerously low body temperature.
  • Breathing (respiratory) problems. Breathing hot air or smoke can burn airways and cause breathing difficulties. Smoke inhalation damages the lungs and can cause respiratory failure.
  • Scarring. Burns can cause scars and keloids — ridged areas caused by an overgrowth of scar tissue.
  • Bone and joint problems. Deep burns can limit movement of the bones and joints. Scar tissue can form and cause contractures, when skin, muscles or tendons shorten and tighten, permanently pulling joints out of position.

To reduce your risk of common household burns:

  • Never leave items cooking on the stove unattended.
  • Turn pot handles toward the rear of the stove.
  • Use sturdy oven mitts that cover hands and wrists.
  • Keep hot liquids out of the reach of children and pets.
  • Never cook while wearing loosefitting clothes that could catch fire over the stove.
  • Keep space heaters away from combustible materials.
  • If you must smoke, avoid smoking in the house and especially never smoke in bed.
  • Check your smoke detectors and change their batteries regularly.
  • Keep chemicals, lighters and matches out of the reach of children.
  • Set your water heater's thermostat between 120 and 130 F (49 to 54 C) to prevent scalding.
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