Burns of the Hand

What causes it

• Heat: stovetops, hot liquids, steam, or hot pavement
• Fire: grilling, fireworks, campfires, house fires
• Chemicals: exposure to dangerous substances
• Electricity: damaged cords, outlets, tools, or lightning. These may leave a small skin burn over much deeper damage.
• Sun: radiation burns from sun exposure

Symptoms

• Pink, red, white, tan, or black skin
• Blisters or peeling
• Swelling and tightness that make the fingers hard to move
• Pain, although very deep burns can be painless because nerves are damaged

How burns are classified

• First degree: top layer of skin only; red without blisters
• Second degree: deeper layers; red, pink, or white with blisters
• Third degree: all layers of skin; white or tan and leathery
• Fourth degree: damage to tendons, muscles, joints, or bone

The size of your palm is roughly 1% of your body's skin surface, which helps estimate how much skin is burned.

Treatment

First aid means removing the hand from the source, cleaning it, and cooling the burn. Further treatment focuses on removing dead tissue, preventing infection, and preventing stiffness.

• First degree: kept clean, sometimes with an ointment or dressing. Usually heals within days to weeks.
• Second degree: wound care with ointments or bandages, and a splint and therapy to prevent the healing skin from stiffening the fingers. Usually heals within two to eight weeks.
• Third and fourth degree: the dead skin is removed and replaced with a skin graft, a wound matrix, or, for deeper burns exposing tendon or bone, flap surgery. Splinting and therapy follow. Healing takes weeks to months and may need several procedures.

Deep or large burns may need care at a hospital that specializes in burns. Scar contractures can develop months or years later, so severe burns and burns over joints need long-term follow-up. Because burns can worsen over the first few days, hand burns are worth having evaluated.