September 19, 2017

The right way to treat burns

Water from a boiling pot splashes onto your arm. In search of cool relief, you reach for an ice pack. But that’s the last thing you should do, says Angela Gibson, MD, PhD, who specializes in the surgical treatment of burns and trauma at UW Health’s Burn Center.

“It makes you feel better, but the ice could lead to a deepening of the burn because it causes constriction of the blood vessels,” Gibson explains.

Nearly a half million people seek treatment for burns every year, and many more deal with mild burns at home. Burn injuries are classified with degrees: first-degree burns affect just the top layer of skin (epidermis), second-degree burns reach the dermis layer in the middle, and third-degree burns affect the full thickness of skin, down to the layer of fat underneath the dermis.

Tips for treating burn injuries

Without proper treatment, even superficial burns can deepen, making healing more difficult. Gibson shares the following tips for treating burn injuries:

Know when to see a doctor. How do you know if a burn is bad enough to warrant a trip to the nearest clinic or hospital? “If the pain is out of control and you’re not able to clean it thoroughly, or if the burn is on your face/neck, hands, feet, or over a joint, you should see a doctor,” Gibson says. If you’re not sure, call your doctor, who can easily reach the nearest burn center for advice. “We’re just a phone call away,” Gibson notes.

At the same time, no pain at all can also be a bad sign. “A deep burn will have no sensation; it will be pale, white or yellow, and it will be leathery and drier than a less severe burn, which is moist or pink,” she explains. Severe burns may require skin grafting (transplanting skin from another part of your body).

Forget the ice and reach for the plastic wrap. While ice is a no-no, “running it under cool water is fine,” Gibson says. But if you’re seeking professional medical care, you want to keep the wound clean and dry. She recommends loosely wrapping the injury with plastic cling wrap, which can keep the wound clean without sticking and can ease the pain until you can get to the clinic or hospital. “If nerves are exposed to air, it hurts a lot more,” she explains.

Keep it clean. A simple washing with water and soap will do. “The wound needs to be cleaned properly to avoid infection, and cleaning a burn injury can be incredibly painful. That’s why we admit some patients even with smaller wounds,” she says. If you can’t clean it on your own, you’ll need to see a professional and follow their instructions to keep the wound bacteria-free at home.

Yes to blisters, no to scabs. “Scabs are not good because they lead to scarred wound healing,” Gibson says. But a blister can be a natural protective barrier as a burn injury heals. If the blister is impeding motion, it may need to be opened up, and if it pops on its own, “it needs to be unroofed because otherwise you’re trapping bacteria,” she says.

Monitor your healing. It may be difficult to tell when a burn has healed because it will have a different coloration from your regular skin, but healed skin will look dry. The exception is full-thickness burns, which will appear dry from the start. “If you’ve had a burn you’ve been treating for more than a week and it isn’t healing, you should be seen by a doctor,” Gibson says. “Wounds that still haven’t healed after two weeks may need to be skin grafted.”

Prevent future burns. Of course, the best approach is to avoid a burn in the first place. “Most patients are surprised by how short a contact with heat can be to give them a burn,” Gibson says. Both infants and the elderly are more susceptible to burns because they have thinner skin. Gibson has seen infants and toddlers burn their feet after walking over coals still smoldering the day after a campfire, and elderly patients who’ve burned themselves simply by using water that’s too hot. Some safety tips to keep in mind:

  • Water heaters should be kept to 120 degrees. “Burns are all about temperature and contact time,” Gibson says. “So the longer the contact time and the higher the temperature, the deeper the burn. At 140 degrees, it takes only five seconds to get a full thickness burn.”

  • If a grease fire erupts on your stove, don’t try to put it out with water and never try to move the pan before it’s cooled . “Water makes it go out of control,” she explains. “You want to cover it with something to smother the oxygen.”

  • Avoid using gasoline and other accelerants to start fires. “Even the vapors from gasoline can ignite and cause a huge combustion,” she says.