Burns are different from scalds but both damage the skin. Burns are caused by dry heat whereas a scald is caused by something wet, such as hot water or steam. Depending on the severity, all three layers of your skin can be permanently damaged. Here are seven first aid tips for burns and what the NHS says about when to go to hospital.
To treat a minor burn, the NHS advice recommends following these seven steps of first aid advice:
- immediately get the person away from the heat source to stop the burning
- cool the burn with cool or lukewarm running water for 20 minutes – do not use ice, iced water, or any creams or greasy substances like butter
- remove any clothing or jewellery that’s near the burnt area of skin, including babies’ nappies, but do not move anything that’s stuck to the skin
- make sure the person keeps warm by using a blanket, for example, but take care not to rub it against the burnt area
- cover the burn by placing a layer of cling film over it – a clean plastic bag could also be used for burns on your hand
- use painkillers such as paracetamol or ibuprofen to treat any pain
- if the face or eyes are burnt, sit up as much as possible, rather than lying down – this helps to reduce swelling
- if it’s an acid or chemical burn, dial 999, carefully try to remove the chemical and any contaminated clothing, and rinse the affected area using as much clean water as possible
People at greater risk from the effects of burns should also get medical attention after a burn or scald. This includes anyone who:
- has other injuries that need treating
- is going into shock – signs include cold, clammy skin, sweating, rapid, shallow breathing, and weakness or dizziness
- is pregnant
- is over the age of 60
- is under the age of five
- 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
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The size and depth of the burn will be assessed and the affected area cleaned before a dressing is applied.
Burns are assessed by how seriously your skin is damaged and which layers of skin are affected.
Your skin has three layers – the epidermis (the outer layer of skin), the dermis (the layer of tissue just beneath, which contains blood capillaries, nerve endings, sweat glands and hair follicles) and the subcutaneous fat, or subcutis (the deeper layer of fat and tissue).
Superficial epidermal burns are where the epidermis is damaged, superficial dermal burns are where the epidermis and part of the dermis are damaged, and deep dermal or partial thickness burns are where the epidermis and dermis are damaged.
If all three layers of skin are damaged it is a full-thickness burn.
If your skin is just red, slightly swollen and painful but not blistered, it’s probably a superficial epidermal burn, but if there are small blisters and the skin is pink it’s a superficial dermal burn.
Minor burns normally heal in about 14 days and leave minimal scarring.
When the skin is red, blotchy, dry or moist, swollen and blistered, it could be a deep dermal or partial thickness burn.
In this case, the burn could be either very painful or painless – the severity doesn’t determine how painful it is.
If your skin is burnt away and the tissue underneath is pale or blackened while the remaining skin is dry and white, brown or black with no blisters and the texture is leathery or waxy, you may be suffering from a full-thickness burn.
If you have a more serious burn that requires medical treatment, it’ll be assessed to determine the level of care required.
The healthcare professional will assess the size and depth of the burn by examining the area and then clean the burn for you and cover it with a sterile dressing.
You’ll also be offered pain relief if necessary such as paracetamol or ibuprofen.
Sometimes it is necessary to have an injection to prevent tetanus, a condition caused by bacteria entering a wound.
If the burn’s moderate or severe, you may be referred to a specialist burn care service.
According to the NHS site, in some cases, it may be necessary to have surgery to remove the burnt area of skin and replace it with a skin graft taken from another part of your body.
More severe and deeper burns can take months or even years to fully heal, and usually leave some visible scarring.