Burns

Eighty percent of burns occur in the home and about 5 percent require hospitalization. Most burns can be managed at home or with a trip to your health care provider's office. Sunburn scalding electrical burns and chemical burns are cared for in similar ways.

Signs and Symptoms

You can assess burns by their appearance and cause.

• The skin is red and painful but there are no blisters or oozing. You can generally handle this type of burn at home.
• Besides the redness and pain there are also blisters and oozing. You may want a health care provider's help.
• The skin looks charred white or brownish yellow and leathery but without blisters and often without pain. You need immediate care.
• The burned area is more than superficial and involves the face neck shoulders elbows hands genital area ankles or feet where the skin is thin. You need immediate care.
• The burn was caused by a chemical. See a health care provider right away especially if your eyes were affected.
• The burn was caused by electricity. You need immediate care.

What Causes It?

The causes of burns are listed below.

• Fires
• Electricity
• Hot water or steam
• Chemicals
• The sun

What to Expect at Your Provider's Office

Before you reach your health care provider's office cool the burned area with cold water or ice and cover the area loosely with dry gauze. Don't pop any blisters or apply butter or other greasy substance.

Your health care provider will estimate how serious the burn is. He or she may cleanse the area open blisters and remove dead skin. Next he or she will apply antibiotic cream and a soft covering. Your health care provider may tell you to do the following.

• Keep the burned area elevated above your heart whenever possible.
• For moderate swelling and redness use warm moist bandages. If you develop a fever or swelling call your provider.
• For itching use a moisturizing cream.

Treatment Options

Treatment Plan

Treatment of burns varies with what caused the burn. Cool burns from fire with cold water or ice. If it is a serious burn your health care provider will remove any dead skin. Antibiotic cream then is applied and the wound is bandaged. You will need to reapply the cream and a fresh bandage twice daily. Electrical chemical and third-degree burns all require hospitalization.

Drug Therapies

Prescription

• Antibiotics—use to avoid infection; side effects include pain and delay in the regrowth of cells

Over the Counter

• Antibiotic creams—for mild burns; use to avoid infection

Complementary and Alternative Therapies

Herbs can help speed wound healing reduce the risk of infection and may help prevent scarring. Homeopathic remedies can provide excellent pain relief.

Nutrition

• Hydration is important in managing moderate to severe burns. Drink plenty of juices water and electrolyte replacement drinks.
• Vitamin C (1 000 to 1 500 mg three times per day) zinc (30 to 50 mg per day) and beta-carotene (100 000 IU per day) to support immune function and enhance skin healing.
• Vitamin E (1 200 IU d-alpha tocopherols three times a day) is a strong antioxidant and reduces scarring.
• Bromelain (250 to 500 mg four times a day between meals) can help decrease inflammation. Use with turmeric (Curcuma longa 500 mg four times a day) to heighten effects.
• L-glutamine (3 to 10 grams three times a day) provides amino acids that may be necessary to prevent damage caused by severe burns.

Herbs

Herbs may be used as dried extracts (capsules powders teas) glycerites (glycerine extracts) or tinctures (alcohol extracts).

• To stimulate the immune system and reduce risk of infection during the period right after the injury combine equal parts of tinctures of coneflower (Echinacea purpura)and goldenseal (Hydrastis canadensis). Take 30 to 60 drops every three to four hours.
• Daily application of gotu kola (Centella asiatica) to the burn site prevents or limits the shrinking and swelling of the skin inhibits scar formation and increases healing.
• Some herbs enhance circulation to the skin. Combine equal parts of the following in a tea (1 cup four to six times a day) or tincture (30 to 60 drops three to four times a day): yarrow (Achillea millefolium) cleavers (Gallium aparine) prickly ash bark (Xanthoxyllum clava-herculis) marigold (Calendula officinalis) plantain (Plantago major) and ginger root (Zingiber officinalis).
• For relief of severe pain combine equal parts of tincture of Jamaican dogwood (Piscidia erythrina) valerian (Valeriana officinalis) St. John's wort (Hypericum perforatum) and California poppy (Escholzia californica) with one-half part of gelsemium (Gelsemium sempiverens). Take 10 to 15 drops every 15 minutes for up to eight doses when you are in pain.
• Aloe vera: Cut a fresh leaf and apply the gel to burn or peel leaf blend pulp then apply to burn.
• Comfrey leaf (Symphytum officinalis): Make a strong tea with 1 heaping tsp. herb per cup. Use as a wash for the burned area.
• Combine powders of slippery elm (Ulmus rubra) marshmallow root (Althea officinalis) goldenseal and comfrey root. Apply to burns to speed healing and reduce risk for infection.

Homeopathy

Common remedies for burns are listed below. Usually the dose is 12X to 30C every one to four hours.

• Cantharis for burns and scalds with cutting burning or smarting pains that are relieved with cold applications.
• Carbolic acid for fainting following a burn with coldness of the skin and rapid progression to shock and collapse.
• Carbo vegetabilis for burns with severe lightheadedness and sluggishness of circulation.

Topical homeopathic preparations for burns may provide relief of acute pain. Do not apply over broken skin.

Following Up

Your health care provider may want to check you periodically. Most burns heal in three to five weeks. If the burn is large he or she may refer you for physical therapy or reconstructive surgery.

Special Considerations

Electrical burns often affect the nervous system and muscles so emergency cardiopulmonary resuscitation (CPR) and life support may be needed.

Supporting Research

Bartram T. Encyclopedia of Herbal Medicine. Dorset England: Grace Publishers; 1995:77.

Blumenthal M ed. The Complete German Commission E Monographs. Boston Mass: Integrative Medicine Communications; 1998:423.

Castro M. The Complete Homeopathy Handbook. New York NY: St. Martin's Press; 1991.

Foley D Nechas E Perry S Salmon DK. The Doctor's Book of Home Remedies for Children. Emmaus Pa: Rodale Press; 1994.

Forgey WW ed. Wilderness Medical Society Practice Guidelines for Wilderness Emergency Care. Merrillville Ind: ICS Books Inc; 1995.

Kruzel T. The Homeopathic Emergency Guide. Berkeley Calif: North Atlantic Books; 1992:48–50.

Lynn SG Weintraub P. Medical Emergency! The St. Luke's-Roosevelt Hospital Center Book of Emergency Medicine. New York NY: Hearst Books; 1996.

Noble J ed. Textbook Of Primary Care Medicine. St. Louis Mo: Mosby-Year Book; 1996.

Tierney Jr LM McPhee SJ Papadakis MA eds. Current Medical Diagnosis and Treatment. Norwalk Conn: Appleton & Lange; 1994.

Tyler VE. Herbs of Choice: The Therapeutic Use of Phytomedicinals. New York NY. Pharmaceutical Products Press; 1994.

Copyright © 2000 Integrative Medicine Communications

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application use or misuse of any of the information contained herein including any injury and/or damage to any person or property as a matter of product liability negligence or otherwise. No warranty expressed or implied is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor pharmacist nurse or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage precautions warnings interactions and contraindications before administering any drug herb or supplement discussed herein.