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What Doctors Don't Tell You

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October 2020 (Vol. 5 Issue 7)

Treating minor burns

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Treating minor burns image

Q) My daughter accidentally burned her arm with her hair straighteners, leaving a bright pink mark about two inches wide

Q) My daughter accidentally burned her arm with her hair straighteners, leaving a bright pink mark about two inches wide. I've been keeping the area cool and clean with cold-water compresses, but are there any natural remedies to speed up healing and prevent scarring?-H.E., London

A) Assuming the contact with the iron was brief, it sounds like your daughter has a first-degree burn-the least serious type, affecting only the outermost layer of skin. Despite being red, swollen and painful, it will probably heal by itself in 3-5 days. However, if blisters develop and the skin takes on a bright red, splotchy appearance, there may be damage to deeper layers of the skin-a second-degree burn. Third-degree burns are the worst, extending through all layers of the skin and causing nerve damage.

Only first- and minor second-degree burns (no larger than three inches in diameter and not on the hands, feet, face, groin, buttocks or a major joint) are considered self-treatable. More severe burns require medical attention as they have greater risks of complications such as skin and systemic infections, fluid loss and shock.

Considering the size and location of your daughter's burn, it should be safe to treat her at home. But if you have any doubts, see your doctor.

Natural treatments

One of the best-known alternative remedies for burns is aloe vera. The plant's moisturizing, anti-inflammatory and mildly antiseptic effects are well known (J Med Assoc Thai, 2000; 83: 417-25; Adv Drug React Toxicol Rev, 2001; 20: 89-103). Burns treated with aloe vera heal, on average, nine days faster than those treated by other methods (Burns, 2007; 33: 713-8), and first-, second- and even third-degree burns may benefit from aloe vera (Plast Reconstr Surg, 1988; 81: 386-9).

Raw honey and gauze was significantly better than conventional bandages for superficial burns treated at a hospital (Br J Plast Surg, 1993; 46: 322-3; Burns, 1994; 20: 331-3). Honey is also more effective than silver sulphadiazine (SSD), a topical anti-infective dressing that comes with a load of side-effects. Also, 87 per cent of burns treated with honey were healed within 15 days compared with only10 per cent with SSD. In addition, the honey relieved pain, reduced scarring and had superior antibacterial properties compared with SSD (Br J Surg, 1991; 78: 497-8).

Moist exposed burns ointment (MEBO), an oil-based ointment developed in China, is also better than SSD for burns. Containing beta-sitosterol (anti-inflammatory), ber-berine (antimicrobial), sesame oil and small quantities of other plant ingredients, it's just as effective at wound healing as SSD, but with less skin sloughing, allowing better assessment of healing progress, and is simply easier to use (Ann Acad Med Singapore, 2000; 29: 7-10). Moreover, MEBO brings greater pain relief than conventional burns treatments (J Burn Care Rehabil, 2003; 24: 289-96).

A number of herbs-used as either creams or oils-may also be useful for burns. These include St John's wort, Calendula officinalis (marigold) and gotu kola (Centella asiatica) (J Pharm Biomed Anal, 2007; 45: 756-61; Acta Physiol Pharmacol Bulg, 1982; 8: 63-7; Dakar Med, 2005; 50: 77-81). In Viet-nam, the water extracted from the bark of Choerospondias axillaris (hog plum tree or lapsi) is often used as a burns remedy because it is inexpensive. In one trial, 20 patients with second-degree burns treated with the bark extract were healed in just 11 days vs 17 days with saline gauze; the number of wound infections was significantly lower,too (Scand J Plast Reconstr Surg Hand Surg, 1996; 30: 139-44).

Certain fruits and vegetables also have burns-healing properties. A papaya-based preparation has demonstrated anti-inflammatory, antibacterial and antioxidant activity and-although the results may not apply to humans-it accelerated healing and reduced inflammation in rats with burns wounds (Bull Exp Biol Med, 2004; 137: 560-2). Boiled potato peelings can also make good burns dressings (Burns, 1990; 16: 137-43). However, it was only half as effective as honey, according to one study (Burns, 1996; 22: 491-3).

Finally, studies in hospitalized patients with severe burns suggest that certain supplements-including ornithine alpha-ketoglutarate (OKG), arginine, zinc, copper and selenium-can also aid healing (Clin Nutr, 1999;18: 307-11; Zhonghua Zheng Xing Shao Shang Wai Ke Za Zhi, 1990;6: 83-6, 155; Am J Clin Nutr, 1998; 68: 365-71).

First aid for burns

- Cool the burn, ideally within 20 minutes of the injury. Hold the burned area under cold running water for at least five minutes or until the pain subsides. Alternatively, immerse the burn in cold water or cool it with cold compresses.

- Never apply ice or butter to the burn.

- Cover the burn with a sterile gauze bandage. Wrap the gauze loosely to avoid putting pressure on burned skin.

- Don't break blisters. Broken blisters are vulnerable to infection.

- Watch for signs of infection, such as increased pain, redness, fever, swelling or oozing. If infection develops, seek medical help.

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