Burns are injuries to the skin and underlying tissues that can lead to pain, blister, swelling and loss of skin. They are usually caused by heat from fire, steam, or hot liquids. However, they may also result from chemicals (acids), ultraviolet radiation (sun exposure), radiation and electricity.

Q: How are burns classified?

A: Burns are classified as minor, moderate or severe. This classification is based on two factors: depth of the burn and total area burned.

  • Burn depth. The depth of injury from a burn is described as first, second or third degree:

First-degree burns affect only the top layer of skin, the epidermis. These are described as “superficial” burns. First-degree burns are red, swollen, and painful. The burned area whitens when lightly touched but does not develop blisters.

Second-degree burns extend into the middle layer of skin, the dermis. These may be referred to as “partial-thickness” burns. Second-degree burns are pink or red, swollen, and painful, and they develop blisters that may ooze a clear fluid. The burned area may whiten when touched.

Third-degree burns extend through all three layers of skin, the epidermis, dermis, fat and muscle). These burns also harm the sweat glands, hair follicles and nerves. These are called “full-thickness” burns. Third-degree burns usually are not painful because the nerves have been destroyed. The skin becomes leathery and might be white, black or bright red. The burned area does not whiten when touched, and hairs can easily be pulled from their roots without pain.

  • Burn area

Minor burns: All first-degree burns as well as second-degree burns that involve less than 10 percent of the body surface usually are classified as minor.

Moderate and severe burns: Burns involving the hands, feet, face, or genitals, second-degree burns involving more than 10 percent of the body surface area, and all third-degree burns involving more than 1 percent of the body are classified as moderate or severe.

Q: What is the best treatment for burns?

A: First-aid measures at home may be all that is necessary to treat small, shallow burns that are clean. Running cold water over the burn can help relieve pain.

If the burn has the following traits you should consult a physician for immediate treatment:

  • The burn is larger than the size of the person’s open hand.
  • Blisters appear at the site of the burn.
  • The burn involves the face, hand, foot, genitals or skin folds.
  • The wound is not entirely clean.
  • Pain persists longer that one day after the burn.

A serious burn might require admission to a hospital or frequent re-examination at a doctor’s office, possibly as often as daily for the first few days.

Q: What are the complications of a burn?

A: Minor burns are usually superficial and do not cause significant complications. Severe burns and some moderate burns can cause serious complications that might take hours or days to develop.

Dr. Oswald Lightsey Mikell, certified by the American Board of Cosmetic Surgery, is the owner of Dermatology Associates of the Lowcountry.