Clive Anderson - AT THE DERMATOLOGISTA BURN is tissue damage caused by a variety of agents such as heat, chemicals, electricity, sunlight or nuclear radiation. Burns often lead to infection due to damage to the skin's protective layer. There are three degrees of burn injury, depending on the severity of the burn:-
Superficial burns or first degree burns. These burns affect only the outer layer or epidermis of the skin. In most cases a superficial burn is caused by mild sunburn or a sudden brief burst of heat. The skin becomes red and dry. It is painful to touch. The pain usually lasts 48 - 72 hours and then subsides. The skin may peel off in one to two days. Superficial burns will heal in three to six days. To treat superficial burns, soak the area in cool water. Apply cool compresses. Treat the area with Aloe Vera cream or an antibiotic ointment.
Second-degree burns involve the epidermis and part of the dermis or lower layer of the skin. Most commonly, hot liquids, flames or brief contact with a hot object, cause second-degree burns. The burnt skin is red and may appear shiny. A blister develops rapidly and the area is painful to touch. Second -degree burns may be superficial or deep, depending on the depth of the injury. Superficial second-degree burns heal in about three weeks while the deeper burns take a longer time to heal.
Soak the burn area for 15 minutes in cool water. Cover with a cool compress and seek medical attention. Do not burst blisters but if they become very tense prick them with a sterile needle to allow the fluid to drain out. The doctor may prescribe antibiotic ointments. Cleanse the wound daily with a mild soap and change dressings one to two times daily.
A third degree burn is often referred to as a full thickness burn as it affects the outer layer of the skin or epidermis and the entire lower layer or dermis. Third degree burns are caused by scalding liquids, extended contact to a hot objects, fires, an electrical source or a chemical. The burnt skin appears dry, leathery and swollen. Because of damage to the nerve endings there is no pain. This burn does not heal, as there is no epidermis or hair follicles left to generate new skin. Scar formation usually occurs. This burn is usually treated in hospital and the type of treatment will depend on the amount of body surface affected. The area is cleaned thoroughly to remove dead skin and tissue. Intravenous fluids may be necessary to replace the fluids lost from drainage through the damaged skin. Oral antibiotics may be necessary along with topical antibiotic creams. Skin grafting may be necessary to achieve healing.
Burns often happen unexpectedly, but certain precautions will help prevent them:
put smoke alarms in each room. Check them weekly and put in new batteries every six months
wear gloves and protective clothing to prevent chemical burns
don't smoke in bed. Put cigarettes out carefully
cover electrical outlets
test the water temperature carefully before you or the children get in
turn the handles of pots and pans towards the side of the stove or use back burners only. Do not let small children play near the stove or help you cook. Do not wear clothing with long loose sleeves when cooking
touch the car seat and belt buckles before putting children in them. It is a good idea to cover the car seat with a towel when the car is parked in the sun.
In black skin especially, burn injuries heal leaving a dark or sometimes a light spot. These changes in skin colour usually normalise without any treatment. Keloid or hypertropic scarring may result from a burn injury, especially if healing is disrupted by infection.
Dr. Clive Anderson is a Dermatologist and Venereologist.
