Health Tips

Did you know that burns are the fourth most common type of trauma worldwide, after traffic injuries, falls, and interpersonal violence? The definition of burn is damage to the skin or other body parts caused by extreme heat, flame, contact with heated liquids/objects, sunlight, electricity or chemicals.

It is something so common that most of us have heard of various ways to treat burn from medications to natural remedies like aloe vera to products like toothpaste. But are they all helpful?

If it is not confusing enough, burn is further classified into 4 degrees (based on the burn depth) with each degree requiring a different method of management respectively.

Categories of Burn

1st degree - Superficial, local inflammation of the skin. Symptoms include pain, redness, and mild swelling. Eg. Sunburns.

2nd degree - Deeper (symptoms of 1stdegree + blistering of the skin.)

3rd degree - Involves all layers of the skin, rendering damage to the nerves and blood vessels. This burns normally appear white and leathery and tend to be relatively painless.

4th degree - Most severe form as it penetrates through fats, muscles, bones and joints.

First of all, if you or your child obtained a burn wound. The first thing to do is assess which level of burn it is. As mentioned, burn is classified into 4 degrees based on the depth of the skin affected.

Burns that can be treated at home are Grade I and II (only if it is less than 20% of your body and you are NOT a child), which are of course the milder versions. A burn grade of III & IV would require immediate medical attention.

How to manage burn immediately at home (for 1st and 2nd degree burns only)?

1. Stop the burning process, move away from the burning process or remove the person from the area. Remove any clothing or injury near the burn area including a baby’s diapers. If the clothing is stuck to the skin, do not try to remove it on your own but seek emergency medical care.

2. Run cool water over it for 20 minutes (not ice) to cool the skin down, reduce pain and prevent the burn from worsening (burning through deeper layers of the skin).

3. After cooling the burn area, it is essential to debride (removal of damaged tissue and foreign objects) and clean the burn area gently with any mild antibacterial soap or any soap for the matter and then apply an antibacterial cream on top of it. This will help to prevent infection which could worsen the burn and prolong the healing process. Not removing the damaged tissue could invite infection as it is a good place for bacteria to thrive. If you have blisters, they will usually break open and drain on its own, do not break it open yourself as it may increase the risk of infection. If you have not had a tetanus shot in the past five years and your burn is superficial partial-thickness or deeper, you need a tetanus booster vaccine. 

4. Covering the wound helps to prevent dirt from entering the wound whose skin barrier is no longer intact anymore. One need not cover the wound too tightly and the usage of a sterile transparent plastic wrap placed over the burn has been proven to be helpful to prevent infection.

5. Antibiotic cream or ointments may help to prevent infection, therefore, speeding up the healing process.

6. Over-The-Counter pain medications. Pain is somewhat inevitable when one suffers from a first or second-degree burn as your receptors are exposed or damaged but not dead. Pain medication may help to reduce pain, inflammation, and swelling. NSAIDs such as Paracetamol and Ibuprofen may provide the relief needed. 

7. Aloe vera. Aloe vera has a reputation with many skin products and it is not in vain as it is a proven age-old natural remedy. It has anti-inflammatory and anti-bacterial properties which are mother nature’s way of helping us with burns.

When to see a doctor or go to the hospital?

• large or deep burns bigger than the affected person's hand

• burns of any size that cause white or charred skin

• burns on the face, hands, arms, feet, legs or genitals that cause blisters

• all chemical and electrical burns

• has other injuries that need treating

• is going into shock – signs include cold, clammy skin, sweating, rapid, shallow breathing, and weakness or dizziness

• pregnant

• > 60 years old OR < 5 years old

• has a medical condition, such as heart, lung or liver disease, or diabetes

• has a weakened immune system (the body's defence system) – for example, because of HIV or AIDS, or because they're having chemotherapy for cancer

• If someone has breathed in smoke or fumes, they should also seek medical attention.

Unproven remedies that may worsen burn

• Oils & Butter - they trap heat which may worsen the burn process and increase skin damage
   
• Toothpaste & Eggwhites - Both are non-sterile and may help bacteria to spread in the burn area
   
• Ice - Ice is not the same as cool water. As running cool water helps in stopping the burn process, ice may further cause skin irritation. One may even experience a cold burn

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Reference:

1. https://www.nejm.org/doi/full/10.1056/NEJMra1807442

2. https://www.uptodate.com/contents/skin-burns-beyond-the-basics#H10

3. https://www.medicalnewstoday.com/articles/319768.php

4. https://www.nhs.uk/conditions/burns-and-scalds/treatment/

Picture reference:

1.https://slideplayer.es/slide/9067205/27/images/11/Fluidoterapia+en+los+pacientes+quemados.+Sanch%C3%A9z+Sanch%C3%A9z+M.jpg

2. http://healthcentral.nz/wp-content/uploads/2014/10/burn.jpg

3. http://www.fiegerlaw.com/images/blog/shutterstock_247151131.3)-min.jpg

4. https://www.legaldefenders.com/wp-content/uploads/2016/09/burn-injuries-806x449.jpg

5. https://www.rcemlearning.co.uk/reference/major-trauma-burns/

Written by

Dr. Jessamine Chong Sze Lynn