First degree burns
First degree burns (known in the UK as superficial burns), are amongst the most common types of burn. We discuss these burns and their treatment below.
What is a first degree burn?
A first degree burn is a burn of the top layer of skin only (the epidermis and superficial dermis). Of all burns that may need treatment, first degree burns are the most superficial.
How do people get first degree burns?
Probably the most common way to get a first degree burn injury is in the form of sunburn. Sunburn in the form of simple ‘redness’ does not count as a burn as such, but blistering sunburn is a form of first degree burn.
In cooks and chefs, burns from hot liquids are also extremely common, and are known as ‘scalds’. A scald burn can occasionally be deep, but usually is first degree only. Burns from touching a hot oven can sometimes be first degree, but the surface is so hot that even a short contact can cause deeper burn injury.
Any other cause of burns can also result in a first degree burn if the exposure is short – for example a flame injury will tend to only cause a first degree burn if the injury is a brief ‘flash’ of flame only (a common cause of this type of burn is if someone throws petrol or lighting fuel on a fire).
Does a first degree burn hurt?
Because a first degree burn affects the top layer of skin only, the nerve endings are still fully intact and so pain is felt – in fact the pain can often be pretty severe. This usually lasts for a few days, until the skin starts to heal itself. Simple painkillers or cold compresses can usually help with burn pain.
Are first degree burns dangerous?
Generally, most first degree burns can be painful but are not life threatening, although some can be dangerous depending on the size of the burn and age of patient. The size of the burn is worked out as a percentage of the ‘total body surface area’ (called ‘TBSA’ by burn specialists). As a rough guide, your palm and fingers are about 1% of your body surface area. In adults the head is about 9%, arms 9% each, legs 18%, back 18% and chest/abdomen 18%. The reason for being concerned about the size of the burn is that the higher the percentage of burn, the more serious it may be. Intravenous fluids (through a ‘drip’) might be need for larger first degree burns.
Additionally, as the skin can be damaged in a first degree burn, bacteria can now enter into the skin and from there into the bloodstream – this can cause redness, swelling and infection of the burn, or septicaemia and life-threatening illness (known as toxic shock syndrome) if it progresses.
First degree burn treatment
Most first degree burns will resolve in a few days and might just need simple painkillers or soothing lotions. Some, especially if they start to blister, may need cleaning and dressings for a few days.
Do first degree burns scar?
Not usually. Scarring from first degree burns is uncommon, but healing can be helped with treatments such as burn creams. Scars from burns are usually due to second or third degree burns.
What are the long-term problems of first degree burns?
Slow healing – first degree burns can occasionally take longer to heal than expected. This may be due to the patient themself being prone to poor healing (for example diabetics), or the wound being affected by factors such as infection or inappropriate treatment.
Skin colour changes – whilst first degree burns usually heal with no noticeable skin changes, they can occasionally leave an area of pigment changes. This is usually in the form of a paler patch of skin, which can be permanent (known as hypopigmentation).