FAQs: Treating burns

Posted on 20 May 2019

When treating burns Dr Philip Nel says it’s vital to ‘ensure that the environment is safe for you and the patient before attending to the wound.

Remove any affected clothing or jewellery and cool the area down with running water – if the clothing has melted into the wound, don’t try to remove it. Don’t apply ice directly to the burn, as it will jeopardise the blood supply to the area and can worsen the injury.’

‘I’ve just burnt my hand on the stove. What do I do?’
For a long time, it was thought that putting butter, grease or oil onto burn wounds would seal them from air and infection – this remedy dates back to 19th-century battlefields but that’s not the case now. ‘There’s no evidence that putting butter on a burn is beneficial at all,’ says Dr Nel. ‘The rule of burn treatment is to cool the area under clean, running water for 20 minutes. Applying an oily substance like butter may actually influence the severity grading assessment and treatment of the wound negatively.’ The only time it may be useful to apply butter or oil to a burn wound is in the case of a tar burn – the grease content will help to remove the hot tar from the skin to allow for further treatment.

‘Does the steam from a kettle burn? How do I treat it?’
Water boils at 100°C, which means that the steam produced is at roughly at the same temperature. Steam becomes superheated – over 500°C – under extreme pressure. ‘Steam can cause severe burns as it’s hotter than boiling water!’ says Dr Nel. Treat steam burns as you would any burn. ‘Remove the cause of the burn safely, cool the area down immediately and seek medical advice.’

‘Sunburn is only bad when my skin is blistered.’
Any degree of sunburn – from superficial redness to severe blistering – damages your DNA at a cellular level, experts warn. By the time you’ve sunburnt to blister stage, it’s considered a second-degree burn. ‘This is “partial thickness” burn, which means it’s gone deeper into the tissues and damaged nerve endings,’ says Dr Nel. Blistered sunburn is very painful; the skin radiates heat and becomes swollen, and the blisters may weep fluid, which can quickly dehydrate you. Dr Nel recommends leaving the blisters alone, keeping your skin clean to avoid infection, drinking lots of water to avoid dehydration, and taking painkillers until you can see a doctor. If any symptoms like fever or vomiting occur, seek medical assistance immediately.

Types of burns

First degree Superficial burns only affect the outer layer of your skin – the epidermis. The area will be red, slightly swollen and painful, but without any blisters.
Second degree This burn affects the epidermis and the underlying dermis layer. The area will be red, blistered and very swollen. Scalds or flames typically cause this type of burn.
Third degree This is the most serious burn and may even damage the underlying subcutaneous tissue, bones, muscles and tendons. The area will appear white or charred with no feeling because the nerve endings have been severely damaged.

When should I go to the hospital?

Most burns don’t require hospital treatment, but here’s when you should go to your nearest emergency centre:
1. If it’s a third-degree burn, seek medical attention immediately;
2. If the burn is large (larger than your hand) and deep, and shows sings of infection (redness, heat, swelling or pain);
3. If the burn has caused white or charred skin;
4. If the burn has caused blisters; or
5. If it’s a chemical or electrical burn.