Summer’s finally here! And along with summer come burns — sunburns, burns from barbeques, campfires and hot marshmallows, fireworks, scalds, motorcycle exhaust pipes, campfires, ropes, lightning, fuels, and numerous others.
Besides immediate tissue damage from the burn itself, the biggest risk of the injury may be infection. Damaged tissue is a ready entry point for bacteria that normally reside on the skin (e.g. Staph and Strep), as well as a multitude of others in our surrounding environment.
Burns can be classified into four main types: Thermal, electrical, chemical, and radiological (x-rays). Thermal burns of the skin are probably the most common during the summer, and these can be of four main types – first, second, third, and fourth degree according to the amount of tissue damage.
First degree burns (includes sunburns) affect only the first layer of skin, the epidermis. The skin is red, but there are no blisters. Second degree burns affect the next layer, the dermis, and are called partial thickness burns. These include burns with blisters. The more superficial partial thickness burns are infection risks but usually heal without scarring. The deeper partial thickness burns can lead to contractures, scarring, and possibly require skin grafting. Third degree, full thickness burns penetrate both the epidermis and dermis. These result in scarring, contractures, and often require surgery to remove tissue and can result in amputation. Fourth degree burns extend even further beneath the skin into fat and muscle tissue. The burned tissue must be removed, and amputations and even death can result.
Do you know how to care for common burns? Where would you turn if you were to sustain a burn this summer? Burn creams? Butter? Go to the emergency room? Should you “pop” a blister? Of course the answer is “it depends.”
First degree burns are usually treated with local measures of cool, cleansing water, and soothing over-the-counter emollient creams with local anesthetics to help ease the suffering. Keep any burned area clean! Second degree burns have the concern for risk of infection, so do NOT purposely pop a blister. However, if the blister pops spontaneously, clean with soap and cool water and apply silver sulfadiazine cream (e.g. Silvadene) per label instructions, usually twice a day. If you sustain a burn that is deeper than a blister or is over more than a small area of the body, it is best to seek immediate medical attention. If it’s more than a blister but only on a very small area of the body, you should see your primary care physician right away. For anything more, seek help in your hospital’s emergency room.
Of course, the best treatment is prevention! Wear sunscreen with at least SPF15. Repeated skin damage from sunburns can lead to various skin cancers that can even be fatal. Wear proper clothing when riding motorcycles and avoid those unfortunately common exhaust pipe burns that are often second degree and more. Be careful with campfires — don’t use gasoline to start them! Always use smoke alarms at home. Use extreme caution when using fireworks as even legal fireworks carry a huge risk for burns. Don’t smoke, but if you do, dispose of cigarettes properly to avoid risk of fire. Have a fun and safe summer and 4th of July holiday!
Dr. Fleming is the Medical Director of The Jane Pauley Community Health Center (part of Community Health Network). Ideas for this column can be e-mailed to Dr. Fleming at AskDrFleming@gmail.com