Superficial burns occur from accidents in and around the home mostly the kitchen. Warm fluids, gas, fire, electricity or sunlight are the major culprits. Once this makes contact with the skin, the epidermis or dermis can be affected. In the event that the epidermis is affected this is known as first-degree skin burn. The sign is redness (erythema). If some of the dermis is affected this is called non-deep second-degree skin burn and signs will be a blister and reddish/pinkish (in light coloured skin) or red/brown/purple (in dark coloured skin) appearance. If the burn crosses the dermis into the layer called the subcutis then the appearance is white/yellow or even black/brown (in light coloured skin). This is called second-degree full thickness burn and many times there is loss of pain because the nerves have also been burned.
Superficial burns usually resolve after 1 week and second-degree skin burns that are superficial will resolve within 3 weeks.
GP’s see about 5 to 10 patients each year with superficial burns and the majority are children or those aged 75 years and older.
Let the GP know about when the burn occurred, the cause and if you have applied cool/water to the burn.
Your GP can perform 2 types of tests to assess the depth of the burn.
- Pinprick – with a sterile needle the GP will prik the burn wound and assess for bleeding and/or pain. Superficial burns will be very painful and bleed easily whilst deeper burns (second-degree or tertiary degree) will not bleed nor be painful
- Capillary refill – while wearing sterile gloves, the GP will press gently on the burn wound to assess how quickly blood circulates back to this region. In superficial burns this test is normal compared to deeper burns where this test will be affected.
The GP will assess the following 3 conditions
- The percentage burns of your body ; this is needed to determine the risks of complications such as sepsis, shock or multiple organ failure. The GP uses a rule: This indicates 9% burn to the head or (one) arm; 18% to the front of the chest, back, (one) leg and 1% for the genitalia area.
- The location of burns on your body; if you are burnt near your eyes, ears, mouth, hands, genital area then complications can be very severe. These types of burns are referred to specialist care for further treatment
- The cause of the burn; hot water scalds can be more severe than for instance hot oil scalds.
Management of burns consist of
- Cool, Cool and more Cool; it is important to keep the burn under flowing tap water at room temperature for a minimum of 15 minutes. This procedure not only serves as pain relief, it also stops further damage of the burn and prevents the release of toxic substance from burnt cells. Cooling the burnt area is effective for circulation of blood to the area to allow for better healing
- Analgesia in the form of Paracetamol
- Soothing creams in the form of vaseline or hydrogel
- Dressing in the form of hydrocolloid to be changed once every two days. It is a semi-permeable dressing and protects from bacterial infection. The inner layer is a gelatinous membrane that protects the wound and the outer layer seals the rest of skin firmly. This type of dressing heals superficial wounds faster. Do not worry when you change the bandage you smell a pungent odour from the dressing, this is normal to allow for better results.
- Tetanus vaccination is optional and depends on the circumstances of the burn
- Do not use silver sulphadiazine cream; this should only be used in specialist care due to the complications of skin discolouration. Furthermore application of this cream makes it difficult to assess deeper burns that have whitened as a result.
Your GP should refer you to specialist care in case of
- Deep second-degree or third-degree burns
- More than 5% of your body is affected
- Burns that are located on or near your eyes, nose, mouth, ears, hands, joints or genital region
- Infected burn
- Poor healing of a burn
- Loss of function of limbs
- Scar formation