Thermal burns occur when the skin comes into contact with a heat source, and their treatment depends on the location and severity of the injury.
What are thermal burns?
Thermal burns are caused by heat sources that increase the temperature of the skin and tissues and cause cell death or carbonization. Hot metals, hot liquids, steam and flames, when they come into contact with the skin, can cause such thermal burns.
Types of thermal burns
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First degree thermal burn (superficial)
First degree burns only affect the epidermis or the outer layer of the skin. The burn site is red, painful, dry and blister-free. Long-term tissue sequelae are rare and usually involve an increase or decrease in skin color.
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Third degree thermal burn
Third degree burns destroy the epidermis and dermis. Third-degree burns can also affect the underlying bones, muscles, and tendons. When bones, muscles, or tendons are also burned, it is a fourth-degree burn. The burn site appears white or charred. There is no sensation in the area because the nerve endings are destroyed.
How do thermal burns manifest?
The doctor will examine the burn to determine its degree or severity. The process involves estimating the percentage of the body affected by the burn and its depth.
Minor burns: first and second degree burns that cover less than 10% of the body are considered minor and rarely require hospitalization.
Moderate burns: Second degree burns covering about 10% of the body are classified as moderate. Burns on the hands, feet, face or genitals can range from moderate to severe.
Severe burns: Third degree burns covering more than 1% of the body are considered serious.
What are the causes of thermal burns?
Dry and moist heat sources can cause thermal burns. Dry heat sources are: flames, hot metal, glass or other hot objects. Moist heat sources include: hot water, oil or other boiling liquids, hot steam. The airways can also burn if a person inhales smoke, steam or superheated air.
First aid for thermal burns
Minor burns can be treated at home and usually go away within a few weeks. In the case of first-degree burns, let cold water flow over the burn (not ice!). A simple fatty repair/healing cream can be applied and carefully bandaged with gauze, or the lesion can be left uncovered, depending on the area. Over-the-counter pain relievers can also be taken. Treatment for second and first degree burns is similar. The doctor may prescribe an antibiotic cream to control the local skin flora (bacteria) and prevent over-infection of the burn. Blisters (larger blisters) caused by the burn can be gently punctured with a sterile needle to gently release the tense serum (clear fluid of the blister) without removing the blister/blister ‘cap’. Burns with blisters (the smallest blisters) will be treated by applying simple mixtures (with zinc oxide) with a quick-drying effect on the blisters. The injured areas are covered with sterile compresses, which are changed periodically.
How are thermal burns treated?
First degree burns can be treated at home. For second degree burns or worse, a specialist doctor should see the patient. People with severe burns may need treatment in specialized centers. They may need skin grafts to cover large wounds. They may also need emotional support and months of aftercare, such as physical therapy. If the burned area is large, especially if it covers joints, physiotherapy exercises may be needed. These can help stretch the skin so that the joints can remain flexible. Other types of exercise can improve muscle strength and coordination.
One or more of the following procedures may be needed for severe burns:
- breathing assistance (if the burn is on the face or neck);
- feeding tube. People with extensive burns or who are malnourished may need nutritional support;
- facilitating blood flow around the wound. If a burn scab extends completely around a limb, it can constrict and impede blood circulation;
- skin grafts. A skin graft is a surgical procedure in which sections of your own healthy skin are used to replace scar tissue caused by deep burns. Donated skin from deceased donors or pigs can be used as a temporary solution;
- plastic surgery. Plastic (reconstructive) surgery can improve the appearance of burn scars and increase the flexibility of scarred joints.
What complications can occur with burns?
For third-degree burns, which are the most serious and life-threatening, potential burn complications include:
- dehydration;
- disfiguring scars and contracts;
- edema (excess fluid and swelling in tissues);
- organ failure;
- pneumonia;
- very low blood pressure (hypotension) which can lead to shock;
- severe infection that can lead to amputation or septicemia.
Some people develop post-traumatic stress disorder (PTSD) or depression after a third-degree burn. Thanks to medical advances, many people who have burns covering even up to 90% of the body survive.
Rehabilitation is designed to meet the specific needs of each patient, so every program is different. The goals of a burn rehabilitation program include helping the patient return to the highest possible level of function and independence while improving the overall quality of life—physically, emotionally, and socially.
Bibliography:
- “Burns: Types, Symptoms & Treatment.” Cleveland Clinic, 2020,
- “Burns and Wounds.” Hopkinsmedicine.org, 2023, www.hopkinsmedicine.org
- “Burns – Diagnosis and Treatment – Mayo Clinic.” Mayoclinic.org, 2022, www.mayoclinic.org
