Burns and Pain

Burns are a common type of injury that most often results in pain. This can be brought on by contact with flames, scalding liquids, hot grease, hot metals or steam in various situations including house fires, kitchen accidents, electrical malfunctions, and vehicle crashes that cause fires or explosions.
Burns are often difficult to treat because there are different types and they range in severity. Burns can be caused by fire, steam, hot liquids, chemicals, electricity, the sun, radiation, friction or hot objects. There are three degrees of pain – first, second and third degree. First-degree burns are mild compared to the other two. They result in pain and the outer layer of skin (epidermis) can become red. Second-degree burns cause pain, redness, swelling and blistering and affect the epidermis and dermis, or lower layer of skin. Third-degree burns are the most serious and usually result in very significant pain. This type of burn affects the dermis but goes deeper, resulting in damage to underlying fatty tissues. The skin can turn white or look charred or blackened. Numbness sometimes accompanies these burns but long-term recovery can be very painful.
Burn symptoms can include pain, redness, blistering, swelling, itching, peeling and the appearance of charred skin. Shock is also a symptom. This can cause pale, clammy skin, weakness, blue fingernails and skin and problems with alertness.
Doctors who treat burns will first want to assess the type and severity of the injury. First-degree burns can be treated with topical or skin care products such as aloe vera gel. Antibiotic ointments may also be used. Some people prefer home remedies with products like soy sauce or mustard. Pain due to first-degree burns is often treated with over-the-counter medications containing acetaminophen or ibuprofen. Second-degree burns are often treated with doctor-prescribed ointments or creams and some may contain antibiotics. Third-degree burns can cause severe pain and the treatments involved can also be painful. The pain from a third-degree burn can be persistent and prolonged. The wounds must be kept clean and the dressings are changed regularly to prevent infection, which is a serious concern. A serious burn of this nature can make it difficult for the skin to grow back. This may mean that patients need to undergo skin grafts and surgery.
Managing pain from third-degree, or full thickness burns can be challenging. Prescription opiates are often used to treat serious burns but may be used in conjunction with other therapies. Non-steroidal anti-inflammatory drugs and benzodiazepines may also be used. Other options are electrical nerve stimulation, psychological treatment, and topical preparations.