Health Tips

Life is full of surprises, and sometimes they come in the form of accidental hot drinks spillage. 

Burns and scalds are damage to the skin usually caused by heat. A burn is caused by dry heat – by an iron or fire, for example. On the other hand, a scald is caused by something wet, such as hot water or steam. Both are treated in the same way. Burns can also be caused by chemicals, electricity or sun rays (i.e. sunburn). 

Types of burns

Before we discuss the types of burns, let’s look at our skin.

Madhero88 and M.Komorniczak, CC BY-SA 3.0, via Wikimedia Commons

As you can see, the skin comprises of 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

• the subcutaneous fat, or subcutis – the deeper layer of fat and tissue

Burns are assessed by how seriously your skin is damaged and which layers of skin are affected. In general, there are 4 main types of burn, which tend to have a different appearance and different symptoms:

• superficial epidermal burn – where the epidermis is damaged; your skin will be red, slightly swollen and painful, but not blistered. This is known as the first degree burns.

• superficial dermal burn – where the epidermis and part of the dermis are damaged; your skin will be pale pink and painful, and there may be small blisters.

• deep dermal or partial thickness burn – where the epidermis and the dermis are damaged; this type of burn makes your skin turn red and blotchy; your skin may be dry or moist and become swollen and blistered with clear or yellow-coloured fluid leaking from the skin, and it may be very painful or painless. This is known as second degree burns.

• full thickness burn – where all 3 layers of skin (the epidermis, dermis and subcutis) are damaged; this is known as the third degree burns. The skin is often burnt away and the tissue underneath may appear pale or blackened, while the remaining skin will be dry and white, brown or black with no blisters, and the texture of the skin may also be leathery or waxy. As the nerves in skin are probably destroyed, third degree burn is not as painful as the others.

Burns from a hot water bottle. Image credit to ^©DermNet New Zealand via Creative Commons Attribution-NonCommercial-NoDerivs 3.0 (New Zealand)

10 days after fluoride burn (chemical burn). Image credit to ^©DermNet New Zealand via Creative Commons Attribution-NonCommercial-NoDerivs 3.0 (New Zealand)

Real life tragedies

On 27 June 2015, there was a large fire incident that happened during a party at Taiwan Formosa Water Park. Staff of the outdoor "color powder party" sprayed clouds of cornstarch towards the participants, which ignited. The fire lasted 40 seconds and burned 508 people, killing 15 and leaving 199 in critical condition. It turns out that the colored cornstarch powder used during the party was combustible and caused the dust explosion that ended up injuring hundreds of people.

Image credit to: https://www.asiaone.com/asia/when-powders-turn-deadly

First aid for burns

Now, let’s get down to business: how to handle burn or scald asap.

1. Firstly, if you are the one who is about to help someone else who is experiencing burn, make sure you are safe.

2. If on fire:

   1. Stop, Drop to the ground, Cover face & Roll so fire is smothered.

   2. Smother flames with a fire blanket

   3. Move away from heat source

3. Remove clothing and jewellery (including nappies in the case of a baby)

   1. Clothing can hold heat on the burnt area.

   2. If swelling occurs, jewellery can stop blood flow to the burnt area.

   3. But do not try to remove anything that's stuck to the burnt skin, as this could cause more damage.

4. If it’s a chemical burn:

   1. take off any contaminated clothing;

   2. for dry chemicals, brush off the chemicals before putting the burnt area under water.

5. Apply cool running water

   1. For at least 20 minutes

   2. If running water is not available, wet 2 cloths and alternate them onto burn every 2 minutes.

   3. Never use ice, iced water, or any creams or greasy substances like butter. This is true for sunburn as well.

6. After first aid, cover the burns with clean cloth and keep the person warm.

   1. You can also put a layer of cling film on the surface of the burn rather than wrapping it around a limb. 

   2. A clean clear plastic bag can be used for burns on your hand.

7. Get pain relief (if required) with paracetamol (Panadol) or ibuprofen.

8. If the burn is to your arm or leg:

   1. raise it whenever possible to reduce swelling

9. If the burn is to your face or eyes:

   1. Avoid lying down for as long as possible, as this will help reduce swelling.

10. Seek medical attention if needed

Image courtesy of https://www.stjohnvic.com.au/news/how-to-treat-and-recognise-a-burn-effective-first-aid-for-burns/

When to seek medical attention

Go to a hospital accident and emergency (A&E) department for:

• The burn is deep, even if the person does not feel any pain

• Large or deep burns bigger than the affected person's hand

• The burn is larger than 3 cm or has blisters

• The burn is of any size that causes white or charred skin

• The burn is on the face, hands or genitals that causes blisters

• The burn is to the throat or airway

• All chemical and electrical burn

• You are concerned or unsure about the injury

Also get medical help straight away if the person with the burn:

• Progressive reddening, swelling and pain in the uninjured skin around the burn wound in the first few days after burning. This may indicate wound infection and must be treated immediately.

• Has other injuries that need treating

• The person is going into shock – signs include cold, clammy skin, sweating, rapid, shallow breathing, and weakness or dizziness

• Person is pregnant

• Person is over the age of 60

• Person is under the age of 5

• The person has a medical condition, such as heart, lung or liver disease, or diabetes

• The person 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. Burns may expose such a person to greater infection risk, thus in need of immediate medical attention.

Call 999 for an ambulance immediately if the person has a severe burn injury.

Breathe in smoke or fumes?

After a fire, if someone has breathed in smoke or fumes, they should also seek medical attention.

Some symptoms may be delayed, and can include:

• coughing

• a sore throat

• difficulty breathing

• singed nasal hair

• facial burns

A word from Doc2Us

If you have any questions related to burn and scald, you can consult our professional doctors and healthcare professionals on Doc2Us. Doc2Us is a mobile application that allows you to talk to a doctor or any healthcare professionals via text chat at any time and from anywhere. For better communication, you can even send our online doctor images or voice messages related to your medical inquiry.

Download Doc2Us app on Apple App Store, Google Play Store and Huawei App Gallery; or use our web chat at https://web.doc2us.com/

Till then, stay at home and take care!

Note: Doc2Us is not for medical emergencies. In the event of severe medical conditions, please call 999.

Disclaimer: As a service to our users and general public, Doc2Us provides health education contents. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

References

1. NHS UK - Burns and Scalds

2. The Royal Children's Hospital Melbourne - Burns – prevention and first aid

3. BeyondBurns - Burn First Aid

Cover image credit: Themidget17, CC BY-SA 4.0, via Wikimedia Commons

Written By

Ms Joyce Toh

Reviewed By

Doc2us Medical Board