Treatment Of Burns
Burns send nearly half a million people in the United States to the hospital every year. This doesn’t account for the countless burns treated in smaller clinics or at home. Learning to identify burns, treating them quickly, and keeping infection at bay are key factors in expediting the healing process.
What Are The Causes Of Burns?
Most burns to the skin are caused by heat from fire, hot liquids, or steam. Burns caused by caustic chemicals are similar to burns due to heat, while other types of burns – from radiation, too much sun and electricity – have different characteristics. Severe burns can penetrate below the skin’s epidermal layers into fat, muscle, or bone.
Following the trauma of the burn, fluid leaks into the area from blood vessels, causing swelling and pain. Burned skin is easily infected because it can no longer effectively maintain a barrier against invading organisms. This is why physicians might recommend a tetanus shot following a more serious burn.
Severity Of Burns
Burns are distinguished by their degree of severity:
- First-degree: These are the least serious burns. They are marked by redness, and extend only into the outermost layer of skin, known as the epidermis. This is a typical sunburn or a brief exposure to hot water.
- Second-degree: These extend into skin tissue directly below the epidermis (known as the superficial or papillary dermis) and can involve superficial blistering.
- Third-degree: These damage all layers of skin. They can be life or limb threatening.
What Are The Symptoms Of Burns?
First-degree burns are red and painful and may cause some skin swelling. The affected skin may peel off after a day or two, and they typically heal in three to six days.
Second-degree burns have blisters and are painful and very swollen. The skin typically appears red, white, or splotchy and may look moist. These burns usually take two to three weeks to heal and may cause some scarring.
Third-degree burns are the most severe but are sometimes the least painful because the burn has damaged nerves in the skin. The skin appears white or charred and can have a waxy or leathery appearance. Healing is a prolonged process.
Electrical burns widely vary depending upon the voltage and exposure. External burns can result from contact with the electrical arc, while others are caused from the current passing through the body. Some electrical burns can cause internal injuries, with no obvious external damage, and should be treated as a medical emergency with transport to a hospital as soon as possible.
Chemical burns from toxins such as car battery acid, bleach, ammonia, or pool cleaning products can also widely vary. If ingested or absorbed through open cuts in the skin it can create internal injury difficult to detect, while direct skin contact can result in skin that appears dead or blackened.
What Are The Conventional Treatments?
Perform first aid for first-degree burns by immediately placing the burned area under cool running water (don’t use butter, oil, ice, or ice water, all of which can worsen the damage). If no running water is available, immersing the burn in clean, cool water is the next best option. Cover the burn with an antibiotic ointment or a pure aloe vera gel or cream without additives. If you have pain, take an over-the-counter pain reliever such as ibuprofen, Motrin, Advil, or naproxen (Aleve).
Place second degree burns under cool running water for 15 minutes. Apply an antibiotic cream to the burn and cover it with a nonstick dressing held in place with gauze or tape. Change the dressing daily (after making sure your hands are clean). Watch for signs of infection (redness, swelling, pus, worse pain) and don’t break any blisters that form. As the burn heals, it may itch. Don’t scratch. Keeping the wound clean is imperative. Deeper second-degree burns, which appear dark red and have a lot of blistering or which cover a larger skin surface should receive immediate medical attention.
There is inherent danger in treating electrical burns and you should proceed with caution. Immediately turn off the source of electricity if possible, if not, move the source away from the injured person with a dry, non-conducting object such as cardboard, plastic or wood. Don’t move the person with the burn injury and call 911. Cover any burned areas with sterile gauze and try to prevent the person from becoming chilled. However, don’t use a blanket or towel to cover them, since loose fibers can stick to the burn.
For chemical burn treatment, wash burns with large amounts of water and remove any clothing that has been splashed by the chemical. Don’t put anything other than water on the burn (you could set off a chemical reaction that will make matters worse). Call your doctor or 911.
If there is any chance of smoke or chemical inhalation, seek immediate medical care or call 911.
Go to the hospital immediately for more severe burns. Emergency treatment is essential to prevent dehydration and shock. Gauging the depth of the burn using specialized imaging is an important step to determining the most effective course of treatment.
What Treatments Does Dr. Weil Recommend?
Immediately place the affected part in cold running water, or immerse it in clean, cool water, for at least 10 minutes with a brief break if necessary. (There is a critical 20-minute window following the trauma in which treatment will prove most effective.) Then apply one of the following natural treatments of burns:
- Aloe vera gel: The clear gel that fills the thick leaves of the succulent aloe vera plant from Africa is a superior home remedy for burns. Keep a potted aloe plant in your kitchen to have available in case of an accident. To use the fresh plant, cut off a lower leaf near the central stalk, cut off any spines along the edge, split the leaf lengthwise, score the gel-filled interior with the point of your knife, and apply the liquid directly to the burn. It will soon soak into the skin and provide immediate soothing relief. Use it on sunburn, thermal burns, and any areas of skin irritation or inflammation. You can buy aloe products in drugstores and health food stores, but some have too little aloe to do your skin much good. Avoid products that have additives, especially colors and perfumes. Read labels to determine the percentage of aloe gel in the formula and choose products with the most.
- Calendula tincture: This comes from a popular ornamental plant called a pot marigold (it is not a true marigold). You can buy ready to use calendula products in health food stores.
- Honey: Honey can be spectacularly effective for severe burns and is the basis of a therapy in China that has attracted much attention from doctors in the West. It is soothing, antiseptic, and healing. However, I wouldn’t depend on the honey from the supermarket – or even the health food store – to treat your next burn. Instead, try one of the medicinal honeys. The type used in New Zealand research on honey for wound healing is known as manuka honey, and is now available commercially. While manuka is used in many products, for burns, I recommend using only medical-grade products such as MEDIHONEY.
Again, be sure to get medical help for any burn that covers a large area, results in charring of skin, or becomes infected.
Reviewed by Ben Gonzalez, M.D., September 2016
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