Damage to the skin caused by fire, sunlight, hot surfaces, chemicals, electricity, or radiation is called a burn. Burns caused by hot liquid or steam are called scalds. Children are more likely to be seriously burned or scalded than adults because the skin of children is thinner than that of adults. The seriousness of a burn or a scald depends on how many layers of skin are damaged.

Symptoms

First-degree burns, including sunburns, are the mildest type of burn. The outer skin becomes red and sore. Second-degree burns are also red and very painful. They damage the outer skin and some of the underlying skin. Blisters usually appear on the burned skin.

Third- and fourth-degree burns are very serious. Third-degree burns damage all the layers of skin. The skin turns leathery and hard. It loses its normal color and feels numb. Fourth-degree burns destroy every layer of skin and also damage the muscles, tendons, or bone beneath. The skin looks charred, or blackened. Both third- and fourth-degree burns can threaten a person's life.

Causes

Burns and scalds result from several causes. Scalding occurs when hot steam or hot liquid—for example, bathwater, coffee, or grease—touches the skin. Contact burns commonly happen when the skin touches a hot object, such as a radiator, an iron, or a cooking pan. Fires, especially house fires, can cause serious burns. The sun, tanning lamps, X-rays, and some cancer treatments give off radiation that can cause burns. Certain dangerous chemicals, lightning, and electricity can also cause burns.

Prevention

Firefighters and people who work with dangerous chemicals wear special clothing to protect their skin from burns. Smoke detectors and fire alarms help to prevent burns by warning people to leave buildings that catch fire. Sunblocks and sunscreens can prevent sunburns.

Families can prevent many burns and scalds by making their homes safe for young children. Safety experts have a number of recommendations for parents: They should turn the handles of hot cooking pots out of the reach of children. They should set their water heater at a temperature that will not scald the skin. They should make sure to extinguish candles and cigarettes before leaving the room or falling asleep. They should keep matches, lighters, and dangerous chemicals locked away. They should also cover electrical outlets.

Treatment

Lotions to cool the skin and to prevent it from drying out help to treat minor sunburns. Other minor burns and scalds should immediately be held under cool water. The patient should wash the wound carefully and leave it uncovered to heal.

Patients with moderate burns should see a doctor. Treatment includes applying gauze bandages to keep the wound clean and antibiotics to prevent infection. The doctor may also prescribe drugs for pain.

Patients with major burns must be treated immediately. Doctors first give the patient extra oxygen if smoke or fire damaged the lungs. They then provide fluids intravenously (through the patient's veins) to treat shock and to replace fluids lost through the burns. Next they wash the burned areas and give antibiotics. If the burns cover much of the body, the patient must remain in the hospital for weeks or months while the skin heals. In the most serious cases doctors cut away the burned skin. Surgeons then use skin grafts—skin taken from other parts of the patient's body—to cover the burned areas.