What Are Burns?

Burns are a very common type of injury that causes severe skin damage that kills off skin cells on the body. Your body can heal from even the most severe types of burns, but how they are treated depends on the severity of the injury.

Dr. Schnell says, “Burns are categorized into three classifications: First degree, second degree, and third degree; and each degree is based on how severely your skin is damaged.”

First Degree Burns

First degree burns are characterized by non blistered, reddened skin. Dr. Schnell says, “First degree burns are where the skin is damaged but not broken.” 

First degree burns often don’t require a physician’s intervention unless the injury is severely painful or there are complications associated with the burn. 

If you have a first degree burn you would experience:

• Dry, peeling skin as the burn heals
• Minor inflammation and swelling
• Pain
• Redness

Dr. Schnell says, “A bad sunburn would be a first degree burn.” If you spill hot coffee on your hand or accidentally grab a hot pan, you could receive a first degree burn. 

These types of injuries affect only the top layer of skin, so the symptoms of a first degree burn will dissipate after the skin cells shed in about seven to 10 days. Most of the time, these injuries will not leave a scar. 

Second Degree Burns

In a second degree burn, the skin is blistered. This is the most common type of burn that is treated by the team at Rapha Wound Care. 

Dr. Schnell says, “A second degree burn generally starts with blisters and then becomes an open wound where the skin is broken and it goes no deeper than the subcutaneous or fat layer.” 

Excessive sun exposure could cause the skin to blister, but a scalding from boiling liquids, fires, electrical, or chemical burns can also elevate the injury to a second degree burn.

A second or first degree burn has some commonalities in the symptoms you will experience. Dr. Schnell says, “The first two types of burns are painful. The third type of burn is painless.” 

Third Degree Burns

Third degree burns are more serious. Dr. Schnell says these types of burn injury “Goes through the skin, subcutaneous tissue, and muscle and it destroys the nerve supply in that area.” These patients generally have physiologic anesthesia; that is, they feel no pain, because they’ve destroyed the nerve supply to that part of the body. 

The larger and more complex third degree burns are usually referred to a burn center.

How Are Burns Treated?

Treating First Degree Burns

First degree burns can usually be treated with home care. The sooner you treat the wound the faster it will heal. Treatment should include:

• Soaking the burn in cool water for five minutes or more
• Taking ibuprofen or acetaminophen for pain relief
• Coating the burn in an aloe vera gel with or without lidocaine to numb the pain and soothe the skin
• Using an antibiotic ointment to heal the skin and cover it with a clean sterile gauze wrap.

Do not ice the burn; this causes more tissue to break down. Also, do not use a cotton ball to apply the ointments, because little fibers from the cotton can get stuck in the wound, increasing the risk of infection. 

Dr. Schnell says, “I recommend aloe or an aloe substitute. Motrin or Tylenol around the clock. Definitely Motrin the first 24-hours if you can handle it and have no contraindications.”

Treating Second Degree Burns

A second degree burn is typically treated by a doctor because the damage goes below the outer layer of skin. 

Dr. Schnell says these burns are often, “Treated with an ointment called Silvadene, which is a preparation that has silver in it.” Silvadene cream works to stop the growth of bacteria that could infect the open burn wound. The medication has antibiotic properties for the types of organisms that tend to infect burns. Dr. Schnell says, “Unlike other antibiotics it doesn’t cause antibiotic resistance with long term use.” 

Since the second degree burn extends below the epidermis, or outer layer of skin, it’s important to keep the area clean and bandaged to prevent infection and help the area heal more quickly. 

Second degree burns can take up to three weeks to heal. You may not experience scarring but you may notice pigment changes in the affected area.

If the blisters are extensive, more extensive repair work in the form of a skin graft may be required to fix the damage. In the skin grafting procedure, the doctor removes healthy tissue from another area on the body and transplants it to the burned skin area. Treatment for a second degree burn is similar to the first degree burn, including cool water, over-the-counter pain medication, and applying antibiotic cream on the blisters. 

Again, if your face or some of the hard-to-treat areas are affected, see your doctor.

Treating Third Degree Burns

Third degree burns can be life-threatening. For these deeper wounds, pain control is important. In a third degree burn, the burned area doesn’t hurt because the nerves are damaged. It’s the skin around the burn that is severely painful. 

Dr. Schnell says, “Often overlooked are the non steroidal anti inflammatory drugs such as Motrin. Motrin blocks the pain pathways. So, if you give Motrin in the first 24-hours, the pain down the road will be much less.” More serious painkillers are used in severe cases. 

Third degree burns are typically treated with:

• A warm, humid, sterile environment
• Antibiotic creams or ointments
• Cosmetic reconstruction surgery
• IV fluids with electrolytes and antibiotics
• Nutritional supplements
• Pain medications
• Skin grafts
• Tetanus shot