Burns: First Degree
What is it?
A burn is an injury to the tissues of the body.
Burns are classified according to the amount of
tissue they affect and how deep they are. A
first-degree burn is the least serious type of
burn because it injures only the top layers of
skin, called the epidermis.
Who gets it?
Anyone can get a first-degree burn. It is
difficult to say how many people are affected each
year because most do not need to seek medical
treatment. Children are especially at risk for
first-degree burns from hot water that is greater
than 120 degrees Fahrenheit (49 degrees Celsius).
Children and the elderly are more likely to
experience complications from burns.
What causes it?
First-degree burns are most often caused by
brief contact with either dry or moist heat
(called a thermal burn) or chemicals; spending too
much time in the sun (sunburn); or friction (such
as by rubbing the skin against a rug or rope).
When a burn is caused by hot water or steam, it is
called a scald. The most common sources of heat
that cause first-degree burns are hot water,
cigarettes, hot grease, and hot beverages.
What are the symptoms?
Skin with a first-degree burn is red, sore, and
sensitive to the touch. It may also be moist,
slightly swollen, or itchy. Sunburns are often
accompanied by headache and low fever. When
lightly pressed, the reddened skin whitens, which
is called blanching. First-degree burns do not
blister and do not leave a scar. See a doctor
immediately if a burn is on the face, hands, feet,
or genitals; is caused by an electrical source; or
covers a very large area.
How is it diagnosed?
Your doctor will examine the burned area and
classify it according to the amount of tissue
affected and the depth of the burn. He or she will
ask how the burn occurred. If the patient is a
child, the doctor will ask further questions to
ensure the patient is not a victim of child abuse.
Doctors assess the severity of a burn by
determining what percentage of the total body
surface area (BSA) is affected. In patients older
than nine years, they apply what’s called the
“rule of nines” to determine the percentage of
BSA.
For example, the genital area is considered 1% of
BSA. The head and neck are 9%. Burns on each arm,
including the hand, is also 9% of BSA. Each leg,
including the foot, is 18%. The front of the torso
is 18%, as is the back of the torso, including the
buttocks. In children younger than nine, the palm
of the child’s hand is used as a measure of 1% of
BSA. First-degree burns that cover less than 15%
of an adult's body or less than 10% of a child's
body are considered minor. First-degree burns that
cover 15 to 25% of an adult's body, or 10 to 20%
of a child's body, are moderate burns. Those that
cover more than 25% of an adult's body or more
than 20% of a child's body, as well as those on
the face, hands, feet, or genitals, are critical.
What is the treatment?
Minor burns can be treated at home. First,
remove any clothing or jewelry from the injured
area. Then, hold the burned area under cool
running water for around 10 minutes to stop the
burning process. You can also use a clean towel or
wash cloth moistened with cold water. However,
don’t use ice or ice water because they will
further damage the tissue. You can place a dry,
sterile gauze pad over the burn, but do not use
any bandages with adhesive. It is important for
the bandage to be loose so the burn gets air.
Never apply butter or oils. They make it more
difficult for the burn to heal and can actually
make the burn worse because the heat can’t escape.
You can, however, gently wash the area with an
antiseptic cleanser and apply an aloe-based cream
to relieve pain. Pain relievers such as
acetaminophen, ibuprofen, or aspirin can help with
inflammation and pain, and should be used
according to directions. Never give aspirin to a
child under the age of 18 because of the risk of a
serious illness called Reye’s syndrome. Chemical
burns are treated a little differently. For liquid
chemicals, first remove any clothing or other
items that the chemicals have spilled on. Then,
thoroughly wash any chemicals off the skin under
running water for 15 to 30 minutes. For dry
chemicals, use large amounts of water to flush the
chemicals from the skin. Never use small amounts
of water because they may actually activate the
chemicals. If no water is available, use a clean
cloth to brush any dry chemicals off the skin.
Loosely cover the burn with a dry, sterile
bandage. Different chemicals have different
effects, so you should always check the chemical
label, if possible, for additional directions.
Always see a doctor if the chemicals have gotten
into the eyes or mouth. First-degree burns usually
heal very quickly. The burned skin may peel after
a few days, but should not scar. Vitamins C and E,
and zinc may help the burn to heal, but should be
taken only in safe amounts. Call your doctor
immediately if redness and pain do not decrease
within a few days; if the redness, pain, swelling,
or fever increase; or if there are signs of
infection, such as red streaks radiating outward
from the burn. Moderate and critical burns should
be treated at a hospital. Use the above guidelines
for emergency first aid.
Self-care tips
Many burns occur at home and could have been
prevented. You can avoid first-degree burns by
handling hot liquids and objects carefully. Make
sure electrical cords are in good condition,
household chemicals are safely stored and labeled,
and hot beverages and objects are out of reach of
small children. When handling chemicals, wear
protective gloves and eyewear, and follow label
directions for safe handling. Never wear clothing
with long, loose sleeves while cooking or around
any type of open fire. Never put a child into a
tub unless you have first tested the water
temperature. You can guard against burns from hot
water by keeping your hot water heater set lower
than 120 degrees Fahrenheit (49 degrees Celsius).
Children should also sleep in flame-resistant
pajamas or nightgowns. Do not smoke, or make sure
discarded cigarettes are completely extinguished.
Teach your children fire safety and make sure they
do not have access to matches or lighters. You can
also protect you and your family from burns by
making sure you have operating smoke detectors on
every floor of your house. Also check the
temperature of a child’s car seat or seat belt
before buckling the child in. Even these objects
can cause burns after a period of time in direct
sunlight. Never allow children to handle fireworks
without adult supervision. Fireworks are a leading
cause of burns and other injuries. You can avoid
sunburns by using a sunscreen of at least a 15 SPF
rating. Apply sunscreen liberally at least 20
minutes before sun exposure and reapply after
swimming or sweating. Avoid spending time in the
sun from 10 a.m. to 3 p.m., when the rays are
strongest.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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