Ouch, That Burns!

In treating a burn, your goal, should you survive it (some burns can be really serious, you know), is getting rid of its aftermath with the least damage to your dermis, scarification of your skin, impairment to your pelt, or harm to your hide. In other words, you first want to live through the experience, contain the pain, and then, to the greatest extent possible, get rid of the evidence (unless you want to wear your injuries forevermore as red badges of courage).

We Homo sapiens folk – that’s you and I – have found many, many ways to raise our external body temperature to dangerous and painful levels, i.e., ways to burn ourselves. A burn can result from:

• Thermal contact with an open flame
• Getting splattered with scalding water or steam
• Making physical contact with a really, really hot object (and by that we mean something like a frying pan, not someone you’ve met at Hooter’s; the latter is a subject for another, very different, lesson in “how-to-get-rid-of”).

It can also be produced by:

• Spending too much time in the sun with too few body coverings
• Using your body to complete an electrical circuit
• Getting frostbitten (which should really be called “frostburned”) while tramping about in the North Woods barefoot
• Deluding yourself into thinking a can of sulfuric acid you’ve just dumped into your bathtub is really a container of bath oil, thereby giving yourself a radical chemical peel when you lower yourself into it.

Types of Burns

Chemical burns, electrical burns, radiation burns, or cold burns obtained from obsessively seeking the perfect tan, messing with the North American power grid, spending too much time inside the reactor core at your local atomic power plant, or insisting on body surfing on glaciers, are also subjects for separate lessons in “how-to-get-rid-of,” lessons which we may or may not cover another day. Here we’re concentrating on getting rid of the ravages of garden variety thermal burns.

The severity of a thermal burn is a factor of how many layers of skin you have injured. If only the top layer (epidermis) is affected, it’s a superficial burn which, while it may be somewhat painful, generally cures itself in a matter of days. These are familiar to you if you have ever picked up, without benefit of a pot holder, what you thought was a cold frying pan – and wasn’t. You also know it from biting into a hot pizza. We used to call these first degree burns, but the medical fraternity (and, one assumes, sorority) has dropped that term, along with first degree and second degree burns. This change may or may not be the result of people getting confused at having to keep track of which was worse – a third degree or a first degree burn. Nowadays the three classifications are called superficial, partial thickness, or full thickness burns – much easier to figure out than having to count.

The superficial partial thickness burn reaches the second layer of skin (dermis), typically producing a blister; it’s much less serious than a deep partial thickness burn which may go deep enough to destroy nerve endings and sweat glands. The worst kind is the full thickness burn, which may go all the way through two layers of skin and down to muscle and bone.

Treating Burns

By now, you should have gotten the point that the deeper the burn, the more serious it is, and the seriousness is amplified with the growth of the burn coverage. Serious burns can kill. They require medical treatment, possibly even hospitalization. Getting rid of them is up to a doctor, not you. Extensive full thickness burns are difficult to treat, the prognosis generally is not good, and they may represent the most painful long-term trauma a body can suffer. And you will never get rid of the scarring. So, by all means, try to avoid them.

Minor superficial burns are another story. These are so commonplace that chances are you will apply treatment yourself. Keep in mind that how you treat the burn will play a large part in whether it is going to leave something of itself behind on your body long past the time it has healed:

1. You do not want to create burn scars from minor wounds. So, the first thing to remember is to NEVER put ice on a burn. Apply cold running water to it as soon as possible, as this will probably limit the damage and ease the pain. Try to get it under cold water within 30 seconds. But icing the wound will result in permanent scarring. (A note of caution here: even applying cold water to a major full thickness burn must be avoided, for it can cause shock. Call 911.)
2. Keep a cold, but not icy, compress on the wound to keep the pain down, and take a pain relief medication. The compress should keep the wound’s swelling to a minimum. If the compress and pain relievers do not control pain sufficiently, you may have to visit a doctor to obtain an application of local anesthetic.
3. After the immediate pain settles, apply a topical antibiotic. Then keep air away from the wound by loosely wrapping it with non-stick gauze bandages, never using cotton on the wound. Change the dressing twice a day, washing the wound with soap and water each time, patting dry, then applying more antibiotic and again wrapping with a sterile gauze bandage.
4. Partial thickness burns may also be treated in this way if the area affected is no more than a couple of inches in diameter. In the case of this type of burn, should blisters appear, leave them alone. Don’t open them. They are nature’s way of keeping the wound moist.
5. Increase protein in your diet. It helps in healing wounds.
6. Wounds may take up to two years to heal fully. For at least a year, avoid injuring the area again and don’t expose it to radiation from the sun. Instead, use a sun block, for further exposure may lead to further change in pigmentation. Applying sun block and moistener to it regularly should limit the scarification and discoloration. But when the wound heals, there will still probably be some change in pigmentation of the skin.

Should burns leave you with disfigurements, there are a couple of things you can do. One is to claim you obtained them dueling when you were a student at Old Heidelberg University and that they are an emblem of honor. This story is unlikely to fly if you are a young female bookkeeper at a Midwest trucking company. Your best bet would be to obtain and use something called cosmetic camouflage which can correct irregular contours, correct discolored skin, and conceal scars. Or you can try cosmetic surgery.

But the best route to happiness would be to find a partner and friends who love you for who you are, not for what you used to look like before you stuck your head in that campfire to retrieve a lost marshmallow.