Burns

Overview

A burn is an injury to the skin or deeper tissues caused by heat, chemicals, electricity, or radiation. The skin may become red, blistered, charred, or even white and leathery depending on how deep the damage goes.

Yes, burns are a very common injury worldwide. In the UK alone, around 250,000 people visit emergency departments for burns each year.

Anyone can get a burn, but children under five and adults over 65 are more likely to need hospital care. People with limited mobility, certain medical conditions (like epilepsy), or working in high-risk jobs (cooks, firefighters) are also at greater risk.

Symptoms

Common symptoms

• Red, painful skin that may feel hot to the touch
• Blisters that can break open and ooze clear fluid
• Swelling around the injured area
• Peeling skin as the wound heals
• Charred or white, leathery patches if the burn is deep

Symptoms in children

• Crying, fussiness, or refusing to be touched
• Fast breathing or signs of shock (pale, clammy skin)
• Smaller burns can still be serious because a child’s skin is thinner

Symptoms in older adults

• Slower healing and higher risk of infection
• Burns may appear less severe because skin is thinner – underlying damage can be deeper
• Confusion or dizziness if the burn is large (shock)

Causes

Main causes

• Heat from flames (house fires, cooking accidents, campfires)
• Hot liquids (scalds from tea, coffee, bath water, soup)
• Hot objects (stoves, irons, hair tools, radiators)
• Chemicals (acids, alkalis, bleach, drain cleaners)
• Electricity (touching live wires, faulty appliances, lightning)
• Friction (rope burns, road rash from falls)
• Radiation (sunburn, tanning beds, medical radiation therapy)

Risk factors

• Living alone or with limited mobility (harder to escape a fire)
• Epilepsy or seizures (may fall onto a hot surface)
• Alcohol or drug use (impaired judgment and coordination)
• Cooking in loose clothing or reaching over hot stoves
• Using space heaters or open flames without fireguards
• Jobs in kitchens, factories, or around electricity
• Children exploring hot objects (stove knobs, matches)

When to see a doctor

See a doctor urgently if:

• Any burn larger than the size of your own hand (even if it doesn’t look deep)
• Burns on the face, hands, feet, genitals, or major joints
• Deep burns (white, waxy, charred, or painless)
• Electrical or chemical burns (even if the skin looks normal)
• Difficulty breathing or swelling of the face/lips
• Signs of shock (feeling faint, fast heartbeat, confusion)

Book a routine appointment if:

• Small, shallow burns that are not healing within a few days
• If you have a chronic condition like diabetes that slows healing
• If you are unsure about tetanus vaccination status
• Wound dressing needs or advice on scar management

Diagnosis

A doctor will ask how the burn happened and examine the skin closely to see how deep and how large it is. They will also check for signs of infection or injury to the lungs if there was smoke inhalation.

Tests that may be done

• Wound swab to test for bacteria if infection is suspected
• Blood tests for large burns to check fluid levels, kidney function, and signs of infection
• X-ray or CT scan if there is concern about an electrical burn damaging deeper tissues

What to expect at your appointment

The doctor will clean the wound and may remove dead skin or burst blisters if needed. They will apply a dressing and give you advice on how to care for it at home. For serious burns, you may be transferred to a specialist burns unit. The process can be uncomfortable but pain relief will be given.

Treatment

Treatment depends on the burn’s depth, size, and location. The main goals are to stop the burning process, prevent infection, control pain, and support healing. Mild burns can be treated at home with cooling and simple dressings. More severe burns may need hospital care, including fluids, antibiotics, and sometimes surgery.

Self-care at home

• Cool the burn under cool (not ice-cold) running water for at least 20 minutes immediately after injury
• Remove any clothing or jewellery near the burn unless it is stuck
• Cover the burn loosely with cling film (plastic wrap) or a clean plastic bag – do not use butter, ice, or toothpaste
• Take over-the-counter pain relievers like paracetamol or ibuprofen (always follow the label instructions)
• Keep the burn clean and dry; do not pop blisters – they protect the skin underneath

Medical treatments

For deeper or larger burns, doctors may clean the wound with a sterile solution, remove dead tissue (debridement), and apply medicated dressings. They might prescribe antibiotics if infection is a risk. Pain control is managed with medicines, sometimes given intravenously. For severe burns, a specialist burns team will provide fluid replacement, nutritional support, and wound care to prevent complications.

When is surgery considered?

For deep, full-thickness burns (third-degree), skin grafting surgery is often needed. This involves taking a thin layer of healthy skin from another part of the body (donor site) and placing it over the burned area to help it heal and reduce scarring.

Living with this condition

Recovering from a burn takes time. You will need to follow your doctor’s instructions for dressing changes and wound care. Keep the area clean and watch for signs of infection. Once healed, moisturise the skin daily and protect it from sun exposure for at least a year. You may need physiotherapy to prevent tightness and maintain movement if the burn is over a joint.

Lifestyle tips

• Avoid smoking, as it slows healing and increases scarring risk
• Protect healed burns from the sun with high-SPF sunscreen and clothing
• Wear loose, soft clothing over the area to avoid irritation

Diet and exercise

Eating a balanced diet rich in protein (lean meat, beans, dairy) and vitamins (especially vitamin C and zinc) helps the skin repair. Stay hydrated. Gentle exercise can be resumed once the wound is healed, but avoid stretching that pulls on the scar. A physiotherapist can guide you on safe movement.

Mental health and emotional wellbeing

Burns can be emotionally challenging. People may feel anxious, depressed, or self-conscious about scars, especially on visible areas. Post-traumatic stress (PTSD) is possible after a severe burn. It is normal to have these feelings – speaking with a counsellor, joining a support group, or talking to your doctor can help. If you feel overwhelmed, reach out to a mental health professional.

Prevention

Many burns can be prevented with simple safety steps. Install smoke alarms on every floor and test them monthly. Set your water heater thermostat to 48°C (120°F) to avoid scalds. Keep hot drinks, matches, and electrical cords away from children. Use oven mitts, turn pot handles inward, and never leave cooking unattended. Cover electrical outlets and teach children about fire safety. At work, follow safety protocols for chemicals and electrical equipment.

Vaccines

Make sure your tetanus vaccination is up to date, especially if the burn is dirty or deep. A tetanus shot may be given if it has been more than 5 years since your last booster.

Complications

If left untreated

• Infection – the biggest risk, can spread to the bloodstream (sepsis)
• Scarring and contractures – tight, thickened skin that limits movement
• Hypothermia – large burns cause heat loss, leading to dangerously low body temperature
• Shock – loss of fluid from damaged skin can drop blood pressure
• Chronic pain and nerve damage in the burned area

Long-term outlook

Most minor burns heal within a week or two without leaving significant scars. Moderate burns may take a few weeks and often heal with careful wound care. Severe burns are serious but with modern treatment – including special dressings, skin grafts, and intensive care – many people make a good recovery. Scarring can be improved over time with treatments like pressure garments, silicone sheets, and laser therapy. The emotional journey can be long, but support is available. With proper medical care and patience, most people return to a full, active life.

Find support

International organisations

• British Burn Association ↗
• American Burn Association ↗

Local organisations

• Children's Burns Trust (UK) ↗ · United Kingdom
• NHS – Burn aftercare (Scotland) ↗ · Scotland

Helplines

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