Advanced Pathophysiology

Burns: Classification and Treatment

Burns are skin injuries caused by heat, chemicals, electricity or radiation. Your doctor will recommend treatment based on the size of your burn and the layers of skin the burn effects. Your skin has three main layers. The epidermis, the dermis, and the hypodermis or subcutaneous layer containing fat, blood vessels and nerves. Beneath the skin are tissues such as muscle, fascia and bone.

First-degree or superficial burns affect only your epidermis. The burn site appears red and dry with no blisters and is mildly painful. Second-degree or partial-thickness burns involve your epidermis and portions of your upper dermis and lower dermis. The burn site is red and moist and may be blistered, swollen and very painful. Third-degree or full-thickness burns extend through your dermis and into the hypodermis. The burn site appears patchy in color ranging from white to brown, with a dry leathery texture. Because the burn is so deep, it causes little or no pain. Fourth-degree burns involve the destruction of all layers of your skin, sometimes extending into the underlying muscle or bone. These burns are brown, dry, charred, and almost always painless.

You can treat your first-degree burn by soaking it in cool water for a few minutes. To soothe and protect the tissue, apply an antibiotic ointment and cover with a clean dry bandage. You can take acetaminophen or ibuprofen for pain. Care for a second-degree burn by soaking in cool water for several minutes, apply an antibiotic ointment to prevent infection and cover with a clean, dry, non-stick bandage. Change your bandage every day and make sure your hands are clean. Acetaminophen or ibuprofen may help with pain and swelling. If you have a third or fourth-degree burn, go immediately to an emergency department. If you can, elevate the burned body part higher than your heart. You will also need to seek medical attention if your burn is larger than three inches in diameter, or if it is located on your face, hands, feet, groin, buttocks, or over a major joint.