Caleb Foster
Burns on the hands can cause serious complications and may require emergency treatment. Depending on the severity of the burn, the healing process can vary, and burns on the hands can present a major hindrance to rehabilitation. First-degree burns are the mildest type of burn, affecting only the top layer of skin. Second-degree burns are more severe, affecting the top layer of skin and partially damaging the underlying layer, known as the dermis. Third-degree burns are the most severe, destroying both the epidermis and dermis. So, does a burn victim still have their fingernails after a hand burn?
| Characteristics | Values |
|---|---|
| Burn severity | First, second, or third-degree burns |
| Burn causes | Hot stoves, chemicals, electrical shocks, hot water, fires, hot food, the sun |
| Burn symptoms | Pain, swelling, redness, discolouration, blisters |
| Burn treatment | Running burn under cool water, over-the-counter pain medication, antibiotic ointment, bandaging, moisturising lotion or gel |
| Burn complications | Infection, scarring, joint deformities, reduced hand function |
| Burn aftercare | Refrain from applying nail products, avoid irritants, seek medical advice |
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What You'll Learn
Burn severity levels
Burns are primarily categorized into three types: first-degree, second-degree, and third-degree burns, depending on how deep and severe the burn has penetrated the skin's surface.
First-degree burns are the mildest type of burn, affecting only the epidermis or the outermost layer of the skin. The burn site is red, painful, dry, and with no blisters. Mild sunburn is an example of a first-degree burn. Long-term tissue damage is rare and usually consists of an increase or decrease in skin color. First-degree burns require minimal care and can often be treated at home by running the burn under cool water for 5 minutes to stop the burning process and using over-the-counter pain medications.
Second-degree burns are more severe than first-degree burns. They involve the epidermis and part of the dermis layer of the skin. The burn site appears red, blistered, and may be swollen and painful. Some common second-degree burn symptoms in children include blisters and swelling in and around the area.
Third-degree burns are the most severe and will likely require specialized treatment. Burns of this severity destroy both the epidermis and dermis layers of the skin. The burn site appears white or charred. There is no sensation in the area since the nerve endings are destroyed. Third-degree burns may also damage the underlying bones, muscles, and tendons. For third-degree burns, it is important to seek medical attention, even if the finger or a small area is the only affected part of the body.
In addition to the three primary categories, there are fourth-degree burns that go through both layers of the skin and underlying tissue, as well as deeper tissue, possibly involving muscle and bone.
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Burned skin treatment
Burns are injuries that damage the skin's layers, and they can range from first- to third-degree in severity. The treatment for burned skin will depend on the type and severity of the burn. Here is a step-by-step guide on how to treat burned skin:
Step 1: Stop the Burning Process
The first step in treating any burn is to stop the burning process. This may involve removing the person from the area, dousing flames with water, or smothering flames with a blanket. Ensure you do not put yourself at risk of getting burned as well.
Step 2: Cool the Burn
Run cool or lukewarm water over the burn for 15 to 20 minutes as soon as possible after the injury. This will help to reduce the burning sensation and prevent further damage. Avoid using ice, iced water, or any creams or greasy substances, like butter, on the burn.
Step 3: Remove Any Restrictions and Cover the Burn
Remove any jewellery or clothing near the burned area to prevent further irritation and constriction as the burn swells. Then, cover the burn with a dry, sterile bandage to keep it clean and protected.
Step 4: Pain Relief and Moisturizing
If necessary, take over-the-counter pain medication, such as ibuprofen or acetaminophen, to manage any pain or discomfort. Once the burn has cooled, apply a thin layer of a moisturizing lotion or gel, such as aloe vera, to soothe the skin and promote healing.
Step 5: Blisters
If blisters are present, do not open or drain them, as this can lead to infection. Leave them intact and allow them to heal on their own.
Step 6: Medical Attention
For minor burns, basic first aid and at-home treatment are usually sufficient, and the burn will typically heal without additional medical intervention. However, if the pain persists or increases after 48 hours, or if you notice any signs of infection, such as redness or swelling around the burn, seek medical advice.
For more severe burns, including large burns, deep burns, electrical burns, or burns on sensitive areas like the hands, face, or joints, seek immediate medical attention at a hospital. These types of burns may require specialized treatment and can lead to long-term issues, such as scarring, if not properly addressed.
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Hand burn rehabilitation
Burns to the hand can be incredibly painful and have a significant impact on a person's life, from self-care to self-esteem. Hand burn rehabilitation is therefore an essential part of the recovery process. The hand is one of the most frequent sites of burn-related deformities, and functional loss of hand use can lead to a reduction in life skills functionality by up to 57%.
Rehabilitation should begin as early as possible, ideally on the first day of admission to hospital, and can continue for months or even years. It is a collaborative process, involving the patient, their family, and a multidisciplinary team of medical professionals. This team may include an occupational therapist with specialised certification in hand therapy, who can guide the patient through the rehabilitation process.
The goal of hand burn rehabilitation is to minimise the adverse effects of the injury, including maintaining and maximising the patient's range of movement, preventing loss of motion and deformity, and reducing the impact of scarring. To achieve this, patients are encouraged to stretch each joint, finger, and the hand as a whole, at least 5-6 times per day, holding each stretch for 20 seconds to 2 minutes. This gentle stretching should be followed by exercise that includes active movement in repetitive functional patterns. Patients are advised to continue with their daily routines, as even short periods of inactivity can cause skin to shrink or tighten.
In the early stages of recovery, patients may experience significant oedema, particularly in the peripheries. To reduce this, elevation of all affected limbs is necessary, with hands splinted or positioned and feet kept at 90 degrees.
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Burned skin complications
Burns on the fingers or hands can range from first to third degree, with third-degree being the most severe. First-degree burns are the mildest type of burn, affecting only the epidermis or top layer of skin. Second-degree burns are more severe, damaging both the epidermis and the underlying layer, called the dermis. Third-degree burns are the most severe, destroying both the epidermis and dermis, and possibly affecting underlying bones, muscles, and tendons.
Burns can be caused by extreme temperatures, such as hot stoves, scalding liquids, or flames, as well as electrical currents, radiation, and chemicals. The treatment for burns depends on their severity, with first-degree burns often treatable at home by running cool water over the burn and keeping it clean and dry. More severe burns may require medical attention and can result in long-term complications.
One of the most common complications of burns is infections. Damaged skin cannot effectively keep germs out, making burns prone to infection. Deeper burns may also result in scarring, as they may form scar tissue instead of regenerating normal skin. Swelling, or edema, is another common complication, which can occur around the burn site or even in parts of the body away from the burn in severe cases.
Other severe or dangerous complications can arise when burns are deeper and cover a larger surface area. These include muscle or tissue damage, which may affect multiple body systems, and emotional problems such as depression, nightmares, or flashbacks. Severe burns can also result in physical disfigurement and loss of mobility or physical abilities.
It is important to seek medical care for deeper and larger burns to limit complications and aid in recovery. Additionally, nail technicians and salon employees are advised to refrain from working on skin that shows signs of burning or damage to avoid worsening the problem.
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Burned skin first aid
Burns can be extremely painful and dangerous, and it is important to know how to respond to such emergencies. The first step in treating any burn is to ensure your own safety and that of the person who is burned. Move them away from the source of the burn. If the burn is due to an electrical injury, turn off the power source before touching the person.
Minor Burns
Minor burns require immediate action but often don't require a trip to the emergency room. First-degree burns are the mildest type of burn, affecting only the top layer of skin. They can be caused by touching hot surfaces, such as a stove, or by sun exposure. Symptoms include a burning or painful sensation, redness, and mild swelling.
To treat a minor burn, follow these steps:
- Cool the burn: Run cool water over the burn for 10 to 15 minutes, or immerse the burned area in cool water. This helps to stop the burning process and reduce pain.
- Cover the burn: Use a clean, moistened cloth or bandage. For burns on hands, separate the fingers with dry, sterile, non-adhesive bandages.
- Pain relief: Consider taking over-the-counter pain medication, such as ibuprofen or acetaminophen.
- Moisturize: Once the burn has cooled, apply a thin layer of moisturizing lotion or gel, such as aloe vera, to soothe the skin.
- Blisters: If blisters form, let them heal on their own. Do not pop or drain them, as this can increase the risk of infection.
- Bandaging: Loosely bandage the burn with sterile gauze to protect the area. Avoid fluffy cotton, which can stick to the healing skin.
- Sun protection: Once the burn has healed, protect the area from the sun by seeking shade, wearing protective clothing, or using sunscreen with an SPF of 30 or higher.
Major Burns
For major burns, including second and third-degree burns, it is crucial to seek immediate medical attention. Call 911 or go to the nearest emergency room. Second-degree burns affect the top two layers of skin, while third-degree burns destroy both the epidermis and dermis, causing severe damage.
While waiting for emergency services, follow the same initial steps as for minor burns: cool the burn, cover it, and provide pain relief if possible. Additionally:
- Remove restrictive items: Take off any jewellery or tight clothing near the burned areas to prevent further injury.
- Do not immerse: Avoid immersing the person or burned body parts in water, as this can worsen the situation.
- Breathing: Check if the person is breathing. If needed, start rescue breathing if you have been trained to do so.
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Frequently asked questions
If you burn your hand, you should act fast. Place the burned area under running water that is slightly colder than room temperature for 10 to 15 minutes or until the pain eases. If necessary, take over-the-counter (OTC) pain medication such as ibuprofen (Advil, Motrin), naproxen (Aleve), or acetaminophen (Tylenol). Once it’s cooled, put on a thin layer of a moisturising lotion or gel such as aloe vera. Make sure you've had a tetanus shot within the last 10 years as you can get tetanus through an open wound in the skin. If your burn is major, you should seek immediate medical attention.
Burns on the hand are categorised by the levels of damage they cause. First-degree burns injure the outer layer of your skin, the epidermis. Second-degree burns injure the epidermis and the layer underneath, the dermis. Third-degree burns injure or destroy the deeper layers of skin and the tissue underneath.
Hand burn injuries often result in limited hand function, especially flexion/extension of fingers, and present a major hindrance in rehabilitation. Some common complications following a thermal injury to the hands include joint deformities, claw deformity, palmer contractures, scar contracture, hypertrophic scarring, restricted or reduced hand function, syndactyly or webspace deformity, and amputation.
