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 might 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 (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 (dermis). These might be referred to as “partial-thickness” burns. Second-degree burns are pink or red, swollen and painful, and they develop blisters that might ooze a clear fluid. The burned area might whiten when touched.
  • Third-degree burns extend through all three layers of skin (epidermis, dermis, and fat-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: 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 might be all that is necessary to treat small, shallow burns that are clean.

Running cold water over the burn can help relieve pain. In general, a clean burn is one that affects only clean skin and that does not contain any dirt particles or food. Additionally, covering the burn with an antibiotic ointment and nonstick, sterile bandage can help prevent infection.

If the burn has the following traits you should seek 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.

If you have had a burn that needs professional treatment, call a dermatologist.

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