Burn

Thermal burns are one of the most common household injuries, especially in children.1 . In children, burns occur mainly in the kitchen, for example after contact with boiling water.

Guide to thermal burns: I got burned, what should I do?

First, it is important to know whether or not you need to see a doctor urgently. Choose point A. or B.:

–  A. It is necessary to urgently consult a doctor or a professional from the emergency services if the burn is of first or second degree and if it extends to a skin surface greater than the area of ​​the hand (the surface of the victim’s palm is approx. 1% of the body surface); if it is located at the level of the joints; if it affects a child of suckling age or a child up to three years old; if the eyes, intimate areas and/or mouth are affected; or even if the burn is of the third degree, that is, if all layers of the skin are affected (also read the section Symptoms, below).
Practical advice while waiting for help:
– Avoid removing clothes that have burned while waiting for help (emergencies), i.e. leave clothes that are stuck to the skin and remove the rest. Of course, any fabric or clothing still on fire must be put out of the fire and away from the affected individual.
– Avoid overcooling the body (no more than 5% of the body surface, equivalent to about 5 palms), as a drop in temperature known in medical language as hypothermia can lead to a serious shock to the body.
– Try to cover the burned parts with a fabric that is as sterile as possible, cold and slightly damp, such as a sheet, towel, coat, etc.
– After cooling down (cooling) for 10 to 15 minutes under cold running water, avoid stagnant water if possible.
– You should never give drink or administer medication to a person affected by severe burns.
– It is necessary to position the injured person on the side that is not affected by the burns, resort to emergency procedures if necessary.

–  B.  If the burn is first or second degree, without the limitations listed in point A., it is possible to treat yourself (self-medication).
It is necessary to cool the burn as quickly as possible with cold to lukewarm water at a temperature of approximately 15°C for 10 to 15 minutes2 . In the past, scientists believed that cold water would allow the inner tissues to cool. However, this “internal burn” theory has been questioned by several studies, such as one carried out in 2015 by the University of Oxford (see this study inPubMed), the researchers said that the effect of cold water is mainly to relieve pain. The use of cold water or ice should be avoided, which aggravate tissue damage.
If you don’t have tap water, you can soak the burned area in cold water or apply wet compresses.3 , but still be as hygienic as possible.

Finally, medicines and curative products should be used:
– Clean the burn with saline soap or antiseptic or disinfect with, for example, sodium hypochlorite or diluted chlorhexidine. Dry the burn well by tapping the wound well. Read further under Treatments for more details
– Next, apply a protective and healing agent such as silver sulfadiazine cream or chlorocresol to the burn and cover with a sterile dressing (gauze) that does not adhere to the wound. It is advisable to renew the bandage every day or every other day, depending on the product.
– In case of pain caused by the burn, it is possible to administer an antalgic, such as acetylsalicylic acid (aspirin), paracetamol or even ibuprofen.

Definition

Burns are skin injuries, usually caused by exposure to intense heat or by contact with a chemical agent, the other two etiologies of burns are electrical and radiation .

– First degree burn : this is when only the epidermis is affected. For example: sunburn . The skin is red, reddened, and without blisters (i.e., no skin detachment).

– Second-degree burns : they can be superficial, when the epidermis and a part of the dermis are affected, and deep, when the entire epidermis and dermis are destroyed. A deep burn needs a doctor’s care. In cases of deep second-degree burns, scarring may appear.

– Third-degree burn : this is the charring of the skin, where the epidermis, dermis, and hypodermis are destroyed. In other words, all layers of the skin are affected. At this stage, medical follow-up becomes indispensable.

Note
A burn can be a minor health problem treatable by self-medication, or it can be a major life-threatening medical emergency.

Causes

The causes are varied, but burns are usually caused by:

– An exposure or contact with a source of heat (eg boiling water) or on the contrary with a source of cold. Heat sources include very hot liquids or vapors (scalds), flames or very hot materials. In a French study published in June 2018 by Santé Publique France , which examined burn cases in mainland France from 2014 onwards, hot liquids were responsible for 51% of burn cases, fire and flames or smoke for 27% of cases and hot objects (eg iron) for 8.1% of cases.

– UV radiation can also cause burns, particularly sunburn. It should be noted that sunburn is a radiation burn, not a thermal burn.

– Intense friction, this is known as a thermal contact burn.

– Contact with a chemical substance

– Exposure to any radioactive agent (eg X-ray)

– Electric shock. Lightning can also lead to burns, sometimes severe.

– Exposure to jellyfish and other marine animals and microorganisms.

Symptoms

Symptoms vary, depending on the degree of the burn:

– First-degree burns cause reddening of the skin (which turns white under pressure), sometimes there is inflammation and mild dehydration. In some cases, a first-degree burn can cause a little fever and pain. It is not possible to observe the presence of blisters or wounds.

In the case of first-degree burns, only the epidermis is affected, i.e. the top layer of the skin.

Sunburn is a classic example of a first-degree burn.

Second degree burnsthey are characterized by the appearance of blisters or sores containing a clear yellow or transparent liquid (if there is anything else, consult quickly) and redness of the skin. The skin is often inflamed. When the burn is deep, it can cause cardiovascular shock and a drop in blood pressure (in this case, quickly consult a doctor). In case of second-degree burns, the dermis and epidermis are affected. A second-degree burn often results in moderate to severe pain. These burns are usually caused by contact with boiling water (pan drop) or iron. Healing takes longer than in the case of first-degree burns, the normal healing time is 10 to 15 days (if this time is exceeded, please consult a doctor).

– Third-degree burns are very deep, so they can destroy muscle, fat, and tendons, as well as damage bone. The color of third-degree burns is usually white and does not change color under pressure. The burn may also be black or brown in some cases with a cardboard effect when touched (also called 4th degree in France).
In extreme cases, these burns can result in loss of limbs or death, especially if they are children or the elderly (for third-degree burns, see a doctor immediately, it’s a real medical emergency).
In cases of third-degree burns, there can be very severe pain, but sometimes the contraction also occurs, some people do not feel any pain due to the destruction of nerve endings, which are responsible for the pain.

Attention: Be careful with third-degree burns, never apply solutions or medications while waiting for help, in addition, direct the unburned side of the body to lie down, use emergency measures if necessary.

Treatments

Treatments for 1st and 2nd degree burns (also read the guide at the beginning of this article):
The thing to do in case of 1st or 2nd degree burns is to cool the burn as quickly as possible with cold or cool water at a temperature around 15 °C for 10 to 15 minutes.
Important to know: avoid cooling a very large area of ​​the body (no more than 5% of the body area, equivalent to about 5 palms of the victim’s hand), because a reduction in temperature, called hypothermia in medical parlance, can lead to severe shock in the body.
In fact, it is the contact with the air of the burn that hurts the most, hence the interest in cooling down underwater and immediately applying protection such as a bandage.

Bandage:
After cooling under water, apply a clean cloth (towel) if you have to go to the emergency room4 . It is possible to bandage yourself if the burn is characterized by simple redness or an unperforated blister less than 1 cm in diameter. Below we show you how to prepare a dressing.

Sunburn:
For only first-degree burns, such as sunburn , it is recommended to take a bath or shower with cold water and then dry with a towel “caressing” the skin, avoiding excessive contact with the skin as much as possible ( usually very painful).

Chemical products:
Attention, in case of 1st degree burns caused by chemical products, it is advisable to consult a doctor.

Blisters:
In the case of second-degree burns, the blisters must not be punctured under any circumstances, as they can become infected. If the blister is burst, especially in children, consult a doctor.

Preparing the dressing for non-perforated (2nd degree) blisters:
In 2nd degree burns with one or more non-perforating blisters, it is advisable to follow this procedure for dressing:
– Early on, use antiseptic soap to clean the burn or apply saline solution and then diluted sodium hypochlorite or chlorhexidine to disinfect the burn. Alcohol and other colored products should not be used for disinfection.
– Then apply silver sulfadiazine cream (Flammazine® or Ialugen Plus® which also contains sodium hyaluronate) or chlorocresol to heal and protect the burn. Apply a thick layer over the burn.
– Then apply a cream based on silver sulfadiazine or chlorocresol to heal and protect the burn. Apply a thick layer to the burn. You can also use a greasy cream.
– Then place a sterile gauze and a bandage around it to close the burn. But before the gauze, put a greasy tulle (Jelonet) to prevent the wound from sticking together when the dressing is removed.
Grades:
– It is important to avoid any infection, which can mainly favor the appearance of scars. In addition, infections result in a deepening of the lesions. Remind people of the signs of infection and encourage them to seek medical attention if they develop symptoms (foul smell, purulent discharge, pain, severe redness, delayed healing, chills, fever, rapid heartbeat, low blood pressure). Do not stick anything on burned or scarred skin.
– Caution, do not apply any product containing silver sulfadiazine on the face as well as open areas and on children younger than 3 months (all over the body). Silver sulfadiazine, which contains silver, can cause dark skin discoloration5 .
– Remember that 2nd degree domestic burns are usually caused by contact with boiling water (falling pan) or an iron.

Notes on first-degree burns:
In the case of a first-degree burn (superficial burn), where blisters do not form, just simple redness, it is advisable to apply a healing cream or ointment such as Bepantol®.

Analgesic medicines based on acetylsalicylic acid (aspirin) , paracetamol (for example, Tylenol®), naproxen or ibuprofen to improve pain after burns. It must be taken in pill form. Avoid the use of aspirin in children under 12 years of age (or according to medical advice for children under 12 years of age).

Itching: Itching
is a common problem during the healing process. The itching usually gradually subsides and eventually stops after the sore is completely healed. Systemic antihistamines are usually used for persistent itching, with diphenhydramine being most commonly used. Local measures include baking soda baths, ideal for children, and moisturizing lotions. L’h ydratation ou la prize demedicaments tranquillisants sont aussi utilisés. Many patients prefer to wear loose, soft cotton clothing.6.

Treatments for deep 3rd and 2nd degree
burns In case of 3rd degree burns or in some cases of 2nd degree (read more about this at the beginning of this file), you should always consult a doctor as soon as possible (emergency) .

3rd Degree Treatment
A skin graft is usually required for 3rd degree burns.

Herbal medicine

– In cases of superficial 1st and 2nd degree burns (with just one exception, read the good advice), after running water over the wound, cleaning and applying a disinfectant, the use of an ointment based on aloe vera can be quite useful as a wound healer and especially as a moisturizer.

– It is also possible to use calendula for its healing properties.

– Curcumin gel. In fact, a study published in February 2017 in the open access journal BioDiscovery showed that curcumin gel, an active ingredient in turmeric ( Curcuma aromatica or Curcuma longa ), after burns or scalding can reduce the severity of injuries, decreasing the pain, inflammation and improved healing, leading to fewer or no scars in the affected area. Curcumin acts by inhibiting the enzyme phosphorylase kinase, involved in inflammation. This study was conducted by Prof. Madalene Heng of the David Geffen School of Medicine at the renowned University of California at Los Angeles (UCLA).

Tips

Attention, the following advice only applies to first degree burns and only to some second degree cases, especially when the burn is located in a small area (read below for more details). Do not use these tips in cases of third-degree burns. In the latter case, which is a medical emergency, call for help as soon as possible (fire, ambulance, doctor, police).

– Cool the burn, as soon as possible, with water at about 15°C for 10 to 15 minutes. If the source is thermal (e.g. boiling water), cooling must be done within the first hour, after which it is no longer useful or necessary. Cold water has an anti-pollution and anti-inflammatory effect. It is also possible to apply cold compresses to combat pain.

– Protect yourself from the sun (sunscreen, wear caps or hats) to avoid sunburn. See also our complete file on sun and skin .

– Do not smoke near flammable substances (gas station, etc.).

– Never pierce a blister, which protects the lower part of the burn. If it bursts, disinfect it immediately. Wash the blister with soap or water and then apply a disinfectant cream or ointment, usually with antibiotics . It is advisable that the flectenes (bubbles) are cut by a qualified professional, depending on the area. In fact, hairy areas are more likely to become infected.

– Remove all adornments (eg rings, wedding rings, piercings, etc.), as swelling of the affected area may occur.

– Never try to remove tissue stuck to burned skin.

– Avoid the use of some home remedies, such as: butter, toothpaste, clay and ice (putting ice on a burn can cause burns). These tips are often more dangerous than effective.

– When cooking, try to put the handle of the pan inwards to prevent children from pulling it. Also pay attention to the open oven and dishes that are hot (or that burn if they use gas). Summary: Keep kids out of the kitchen while you cook.

– Place the iron out of reach of the child.

– Protect your child well from bonfires and barbecues.

– Keep lighters and matches out of reach of children.

– Pay attention to the temperature of the bottle, it should not be too hot. Test the temperature, for example by putting a little liquid on your arm.

– Test the children’s bath water (it shouldn’t be too hot or scalding).

– Do not use an electrical device in the bath (cell phone).

– Be up to date with your tetanus vaccinations.

– In the case of a scar, for example after a deep 2nd degree burn, a sunscreen with a sun protection factor of 50 or more can be applied directly to the scar. Avoid sun exposure of children under two years old. It is known that scars from sunburn, as well as malignant skin changes, increase significantly.

– Install smoke detectors in your home and test them regularly (preferably once a month). Replace smoke detectors every ten years.

– If possible, place a fire extinguisher in or near the kitchen. Store household products in such a way as to prevent access by children and the risk of spillage on them. Wear protective caps.

Jeanne Kenney
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I’m a stylist trainer, a content creator, and an entrepreneur passion. Virgo sign and Pisces ascendant, I move easily between my dreams, the crazy world I want, and my feet on the ground to carry out my projects.

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