When your skin is exposed to excessive heat (as from fire), electricity, or corrosive chemicals, the resulting tissue damage is known as a burn.

Burns are generally categorized as follows, according to the severity of tissue damage:

• First-degree burns—affect only the outer layer of the skin (epidermis), causing pain and redness
• Second-degree burns—extend to the layer below the epidermis (the dermis), causing pain, redness, and blisters that may ooze
• Third-degree burns—involve all layers of the skin and may also damage the underlying bones, muscles, and tendons.

The burn site appears pale, charred, or leathery and there is generally no sensation in the area because the nerve endings are destroyed.

Between 1 and 2 million Americans seek medical attention for burns each year. Most burns occur at home, at work, or are part of an injury from a motor vehicle accident. Between 50,000 and 70,000 people are hospitalized for burns every year in the United States, 30% to 40% of whom are children younger than 15 years of age.

All burns—even minor ones—may cause functional or cosmetic damage if they are not properly cared for. Skin is a natural barrier to infection, so when it is burned a person loses that protection. Because people who sustain a burn are very prone to developing infections, treatment usually involves preventing or eliminating infections.

In general, signs and symptoms of burns differ according to the severity of the burn (as described above). Evaluation of the extent of the burn (that is, the amount of skin or body surface area that the burn covers) is important as well because it helps a healthcare practitioner assess the risk for such complications as infection, dehydration, and/or disfigurement.

People who sustain a burn are very prone to infection. Unfortunately, knowing if an infection is present or not is often difficult because the skin surrounding a burn is usually red, and changes in body temperature (a sign of infection). This also a normal response to a large or deep burn. Any change in the appearance of the burn or in the way that the burn victim feels should be brought to the attention of a physician. Potential signs of infection include:

• Change in color of the burnt area or surrounding skin
• Purplish discoloration, particularly if swelling is also present
• Change in thickness of the burn (the burn suddenly extends deep into the skin)
• Greenish discharge or pus
• Fever
• Dehydration

A burn injury can lead to loss of fluid through the skin. If dehydration is suspected, a physician who will decide whether or not intravenous fluid is necessary. Potential signs of dehydration include:

• Thirst
• Lightheadedness or dizziness, particularly when moving from sitting or lying position to standing
• Weakness
• Dry skin
• Urinating less often than usual

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