First-Degree Burns

A burn is damage to body’s tissues of an individual, which may be caused either by heat, electricity, chemicals, radiation or sunlight. Another kind of burn is an inhalation injury, which is caused by breathing smoke.

Basically there are three forms of burns:

First-Degree Burns: These are superficial burns, as they damage just the skin’s outer layer.⁽¹⁾ First-Degree Burns vary from other degree burns in that they do not penetrate deep into inner layers of the skin and tissues.

Second-Degree Burns: They damage both the skin’s outer layer and the layer beneath it.⁽²⁾ Second-Degree Burns go through the epidermis and reach the dermis, which is the top of the second layer of skin.⁽²⁾ Second-Degree Burns tend to form blisters and are more painful and swollen than first degree burns.

Third-Degree Burns: They destroy or damage the deepest layer of skin and tissues underneath.⁽²⁾ They tend to reach the third and lowest level of the skin, the hypodermis. The affected area from the Third-Degree Burns appears white.

Fourth-Degree Burns: These burns penetrate through all the three layers of the skin and damage the muscle, bones, nerves and fat lying underneath them.⁽³⁾ There is no pain in fourth-degree burns, as the nerves get damaged preventing the individual from feeling the pain.⁽³⁾

Fifth-Degree Burns: These are very fatal burns where all of the skin and majority of the muscle is destroyed. Patient loses his/her ability to function in 5th degree burns.

Sixth-Degree Burns: These type of burns are the most fatal of all where there is destruction of all the skin, muscles, ligaments; and the 6th degree burns even penetrates the bones where the charred bone is visible and there is complete loss of function of the affected area.

The various effects of burns are swelling, blistering, scarring and in serious cases they cause shock leading to death sometimes.⁽¹⁰⁾ They sometimes lead to infections, as they damage an individual skin’s protective barrier. Treatment for burns depends on three factors i.e. the cause of the burn, how much deep it is, and how much of the body area the burns have covered. Antibiotic creams when applied on burnt surface can prevent or treat infections. For more serious burns, cleaning the wound, replacing the skin is required, and it is to be ensured that the patient has enough nutrition and fluids.

First-degree burns are one of the mildest types of skin injuries, which are sometimes referred to as superficial burn or wounds and they usually don’t require medical treatment. The pain from the first-degree burns is usually well tolerated by young adults, but children and older adults find it difficult to handle it. First-degree burns are an injury that affects the outer layer of our skin. However, some superficial burns can cover larger areas on the body or they may be painful enough requiring a trip to our family doctor. While in one’s house they often happen when anybody touches something hot, such as a hot stove, hot iron, or hair straightener; whereas, other than house, it may cause due to mild electric shock while handling electric appliances. Staying out long in the sun without sunscreen or other forms of sun protection can sometimes lead to first-degree burns.

Some of the common causes of First-Degree Burns are:

Scalds: First-degree burns in children are commonly caused by scalding.⁽¹¹⁾ Scalding are the burns which result from hot steam. Showering in extremely hot water also causes scalds or first degree burns.

Sunburns: Staying out in the sun for prolonged periods of time without sunscreen causes first degree burns ⁽¹⁾. The intense ultraviolet (UV) rays from the sun tend to penetrate the outer skin layer resulting in a sunburn, which is characterized by redness of the skin, peeling and blistering.

Electricity Burns: First degree burns can also result from electricity burns especially in children if they stick their finger or any other object into the opening of a socket, or if the child chews of an electrical cord etc., then there is a high risk of suffering from electrical burns.

First-degree burns that are caused by electricity may affect more of the skin than you can see in the top layer. It’s a good idea to seek medical treatment immediately after any type of electrical burn occurs.

Usually the first degree burns are not that serious and they tend to heal quickly without having the need to see a doctor. The most common symptoms observed with first degree burns are: skin redness, swelling and pain. First degree burns do not break the skin or cause blisters on skin.⁽¹²⁾ The pain and swelling from first degree burns will be mild and the skin may start to peel after few days. For first degree burns, which occur in larger extents on body, an increased level of pain and swelling may be experienced. In such scenario, it is advisable to see a doctor rather than seeking a home remedy. Larger first degree burns need more time to heal than the smaller ones. In contrast, the second-degree burns and blisters are more painful as they penetrate deeper layers of skin. Other than redness and pain, soreness in the burned area is noticed, a temporary change in skin colour may occur caused by peeling of skin in first degree burns.

First degree burns generally do not require a doctor’s visit and can be treated at home most of the times. Should the first degree burns be to the children, then it is advisable to call the child’s paediatrician. The doctor will first examine the burn and then assess its severity and the degree of penetration in the skin and then will decide on the course of treatment. Adults suffering from first degree burns too should see a doctor if the burn becomes swollen, infected or extremely painful. First degree burns on certain areas like face, groin, hands and feet may compulsorily require you to see a doctor.

If a decision is made to treat the first degree burn wound at home, then immediately remove the clothing, watches, rings and any jewellery near or covering the surrounding burnt area. Soak the burned area in cool water right away, and keep it there for about 10 minutes; or apply wet and cold compresses to the burnt area until the pain decreases.⁽²⁾ The process can be done from five to 15 minutes and the compress can then be removed until the pain subsides. Never apply ice directly to any type of burn.

The American Academy of Dermatology recommends applying of petroleum jelly every 8 t 12 hours on the burns. Cover the burned area with a non-stick bandage. Be sure to change the dressing at least four times a week, as long as there is no infection. Change the bandage everyday if the burn seems infected.

Do not pop any blisters, as this can lead to increase in the risk of infection and scarring. Over-the-counter medications, such as acetaminophen or ibuprofen can be taken to reduce pain, swelling and inflammation. Drinking plenty of fluids is advisable. If the burn does not show signs of healing within 48 hours, then immediately seek medical attention.

• Avoid applying any type of oil to your burns. These oils prevent healing in the burnt site.
• Avoid using extremely cold compresses or ice, because they can worsen the burn.⁽⁶⁾ However, over the counter available products containing lidocaine along with aloe vera help a lot with pain relief.
• Other than Aloe vera, calamine lotion, antibiotic ointments and honey.⁽⁷⁾ can be applied to the burn to propagate the healing of the wound and to reduce drying of the burnt skin.⁽⁶⁾

Different sources suggest different times of healing for first-degree burns. The National Institute of General Medical Sciences says it may take about a week for a first-degree burn to heal; while other experts say it usually takes 5 to 10 days for an individual to recover from a first-degree burn. While some are of the opinion that there may be peeling of the skin as it heals, and may take four to 20 days for a first-degree burn to heal adequately.⁽⁴⁾ Healing time of the first-degree burns often depends on the area affected. It is imperative to consult your doctor if the burn shows any signs of infection or becomes worse.

Most of the first-degree burns are preventable if the right precautions are taken.

• A broad-spectrum sunscreen  with a sun protection factor (SPF) of 30 or higher will help prevent sunburn.⁽⁵⁾
• Keep the hot cooking pots with its handles in the center of the stove top. Ensure that they are on the back burners to prevent accidents.
• Most water heaters have a maximum setting of 140˚F, which can be manually reset to have a maximum of 120˚F to avoid burns due to hot water.
• Covering all the exposed electrical sockets in the home with childproof will be helpful in preventing burns.⁽⁸⁾ Unplug appliances, which are not in use. Place the electrical cords where the children cannot reach.⁽⁸⁾

Scarring is not usually a problem with a first-degree burn.⁽⁹⁾ They are only formed when the lower layer of the skin gets damaged, and first-degree burns do not usually penetrate that deeper into the skin. First-degree burns also tend to heal in less than 10 days. However, always it is advisable to take extra care with sensitive and damaged skin. If the skin in the affected area begins to peel, allow natural healing and do not pull it off, as it might be painful leading to scar formation.

First-degree burns do not require medical attention; however, seek medical care immediately if:

• When the burned area is larger than the palm of that individual’s hand and completely encircles ankle, wrist, finger, toe or other body part.
• See a doctor when the burn is accompanied by a fever or pain and redness that don’t respond to over the counter medications.
• Always pay close attention to first-degree burns and watch for signs of possible infection, such as red streak leaving the burnt area, increased tenderness and swelling, when yellow or green liquid oozes from the burns.

References:

Also Read:

• Chemical Burns: Types, Causes, Symptoms, First Aid, Treatment, Prognosis, Complications
• What are Electrical Burns: Signs, Symptoms, First Aid, Treatment, Types, Healing Time, Pathophysiology, Causes
• Hot Water Burn: First Aid, Treatment, Healing Time, Causes, Symptoms, Classification, Prevention
• Do’s and Don’ts for Cases of Burns In Children
• What Should You do After Getting a Turf Burn?
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• 10 Home Remedies To Soothe Burnt Finger
• Burn Blister – Should You Pop It?