Thermal Burns

Overview

Thermal burns are injuries to the skin and underlying tissue caused by heat. They can result from flames, scalding liquids, steam, or contact with a hot object such as a stove, iron, or hot pan. Thermal burns are among the most common types of burns and range from minor injuries that heal on their own to severe, life-threatening wounds.

Burns are described by how deep they go. A first-degree burn affects only the top layer of skin, a second-degree burn reaches the layer beneath and usually blisters, and a third-degree burn destroys the full thickness of skin and may damage deeper tissue. The deeper and larger the burn, and the more sensitive the location, the more serious it is. Knowing basic first aid and recognizing when a burn is an emergency can make a major difference.

Symptoms

The appearance and symptoms of a thermal burn depend on its depth.

• First-degree: Red, dry, painful skin without blisters, like a typical sunburn
• Second-degree: Red, swollen, very painful skin with blisters and a moist appearance
• Third-degree: Skin that looks white, leathery, charred, or waxy; it may feel numb because nerve endings are damaged

Warning signs of a serious burn include large burned areas, burns on the face, hands, feet, joints, or genitals, signs of breathing difficulty after a fire, and any deep or third-degree burn. These need emergency care.

Causes

Thermal burns happen when heat transfers to the skin faster than the body can cope with. Common causes include:

• Scalds: Hot water, coffee, tea, soup, or other hot liquids and steam, a leading cause in young children
• Flames: House fires, cooking fires, campfires, and burning clothing
• Contact burns: Touching hot objects such as stoves, ovens, irons, curling tools, or hot metal
• Steam: From boiling water, kettles, or appliances

Risk Factors

• Young children and older adults, who have thinner or more delicate skin
• Cooking and use of hot liquids without caution
• Smoking, especially near oxygen or in bed
• Working with fire, hot equipment, or industrial heat sources
• Reduced sensation or mobility that delays moving away from heat

Diagnosis

Burns are assessed mainly by examination:

• Depth assessment: The clinician determines whether the burn is first, second, or third degree based on its appearance and sensation.
• Size estimation: The percentage of body surface burned is estimated, which guides treatment and fluid needs for larger burns.
• Location and cause review: Burns to the face, airway, hands, feet, joints, or genitals, and burns from fire in enclosed spaces, are flagged as higher risk.
• Further evaluation: For serious burns, additional tests check for smoke inhalation, dehydration, and other injuries.

Treatment

First aid for a minor burn: Cool the burn under cool (not ice-cold) running water for about 20 minutes, remove jewelry or tight items near the area before swelling, cover loosely with a clean, non-stick dressing, and use over-the-counter pain relief. Do not apply ice, butter, or ointments to a fresh burn, and do not break blisters.

Medical treatment depends on severity:

• Minor burns: Cleaning, dressing, pain control, and monitoring for infection.
• Larger or deeper burns: Specialized wound care, fluids to prevent dehydration, infection prevention, and pain management.
• Severe burns: Hospital or burn-center care, which may include surgery and skin grafting, and rehabilitation.

Call emergency services right away for large burns, third-degree burns, burns to the face or airway, burns with breathing difficulty, or burns in young children or older adults.

Prevention

• Set water heaters to a safe temperature and test bathwater before use
• Turn pot handles inward and keep hot liquids away from table edges
• Keep children away from stoves, ovens, irons, and hot drinks
• Install and maintain smoke alarms and have a fire escape plan
• Never smoke in bed or near oxygen
• Use oven mitts and caution with hot surfaces and appliances

When to See a Doctor

Call emergency services immediately for burns that are large, deep, or third-degree; burns to the face, hands, feet, joints, or genitals; burns that encircle a limb; any burn with trouble breathing, coughing, or hoarseness after a fire; and burns in infants or older adults. See a doctor promptly for blistering second-degree burns, burns that show signs of infection (increasing pain, redness, swelling, pus, or fever), or any burn that is not healing.

Related Topics

Frequently Asked Questions

References

1. American Burn Association. Burn Prevention and First Aid.
2. Mayo Clinic. Burns - First aid.
3. MedlinePlus, U.S. National Library of Medicine. Burns.
4. Centers for Disease Control and Prevention (CDC). Burn Prevention.