Have Medical Questions? Ralph La Guardia M.D., author of The Doomsday Book of Medicine, will answer them! Here is a question that we had that he answered. See below for more details!
Question: What is the best treatment for a burn?
As I always do , I prefer the begin with the normal anatomy , in this case of the human skin. The human skin is the largest organ of the body . Skin has two layers , an outer epidermis and an inner dermis . Below the dermis is the subcutaneous tissue ( sub means below and cutaneous means the skin, hence the layer beneath the skin) , which is primarily a layer of adipose or fatty tissue.
The skin has multiple functions , but primarily acts as a barrier between the cruel outside world and our tender bodies . The skin prevents dehydration and acts as a physical barrier to the entry of all kinds of pathogens (germs), chemical exposure and temperature variations. The skin also produces vitamin D when exposed to sunlight . The skin also controls body temperature by changing the blood flow to the skin and by sweating, all of these functions help us to maintain our internal environment . The skin is also a sensory organ allowing us to feel hot and cold as well as touch and pain . The skin is amazing , on top of all of these functions it also lubricates itself with sebaceous secretions and produces melanin to shield itself from the damage caused by the ultraviolet radiation in sunshine.This damage is primarily to the nucleus of the cell where the cells brain or DNA is located . How incredible is that , the skin has cells such as melanocytes that produce a substance to protect all of its cells from any damage by sunlight .Think of all the cuts , scrapes and burns you have subjected your skin to over the course of your life and how the vast majority of them are not visible at all , then you will stand in awe of your skin as I do .
Here we go , Burns 101 : As most people are aware , there are three types of burns, first , second and third degree . What they harm is really easy to determine , since it follows their names. First degree burns damage the first or outer layer of skin , the epidermis . Second degree burns involve the outer two layers of skin , the epidermis and the dermis. Third degree burns damage the two outer layers (the epidermis and dermis) as well as the underlying subcutaneous structures, and is therefore a full thickness burn through the skin.
An example of a first degree burn would be a sunburn . It involves the epidermis or outer layer of skin and as you know causes it to be red , swollen and painful . Usually these types of burns are considered minor unless they involve a large percentage of the body’s surface area .Treatment of first degree burns involves cooling off the area asap , either by immersion in a bath , pool , lake , ocean or stream If it is a small area you might be able to run cool or cold water over it to give you some relief. Aloe vera gel or even liquid aloe vera ( also known as aloe vera juice) is absolutely wonderful for the treatment of any burns , it is cooling and helps rapidly heal any skin lesions. Aloe also promotes the growth of new skin cells to help heal any injury .
First degree burns can also be treated with zinc and silver preparations such as zinc oxide and silvadene cream (which is made from silver sulfadiazine). Zinc helps heal all lesions of the skin and mucous membranes (the lining of your mouth , vagina etc ) . I would also take 50 mg of oral zinc along with at least three thousand mg or three grams of vitamin C daily until my burns healed. That composition helps promote healing and regrowth of the skin , especially the all important collagen which will give skin its strength and structure.
Honey is also important in treating burns . Honey has no shelf life because it never spoils . Why doesn’t it spoil? Because bacteria , fungi and viruses are unable to grow in it . Honey also seals off the wound acting as a barrier to the outside and thus preventing further water loss , keeping the burn moist and thereby promoting healing . The osmotic effect of honey pulls water and blood and body fluid into the burn , thus preventing infections , moisturizing the wound and allowing the bodies scavenger cells to clean up the dead skin debris. Manuka honey from New Zealand is the most potent of the medicinal honeys , but any honey will work just fine.
Activated charcoal can also be used to heal burns, by making it into a poultice. A poultice is a paste of wet material , either an herb , clay , activated charcoal or salt mixture , it is applied to the skin and covered with a double layer of cloth or wound dressing and that in turn is wrapped in plastic or other material to prevent it from drying out . When the second or outer layer of the cloth is wet , then it is time to change the entire poultice .Frequently these poultices are changed several times a day , the idea is to keep the moist material in constant contact with the skin to promote healing . They should never be left to dry out . Poultices can be used on any skin problem , not just burns . You can use a poultice on an infection, rash , abrasion , boils and splinters . The incredible surface area of activated charcoal allows it to adsorb ( chemically bind and inactivate) materials onto its surface such as microbes , toxins and wound contaminants.
Many substances will work to promote the healing of burns , and I go into them in my book the Doomsday Book of Medicine in great detail. Here are some of the substances I describe how to use : Bee propolis, the herb calendula , witch hazel , vinegar and cold water , Saint-John’s wort flowers, comfrey leaves , baking soda and corn starch., essential oils such as lavender and tea tree oil, whole milk , yogurt and tallow from beef or mutton fat
Second Degree burn treatment is similar to first degree but since it involves both the epidermis and the dermis it involves some differences . These type of burns cause the production of large fluid filled blisters and also large red blotchy areas of skin. To treat these burns you will need to drain the blisters , do not ever remove the skin , that is a colossal mistake and will result in an infection of the underlying open areas. Take a small pin and sterilize it either with a match or with some alcohol , perforate a small hole into the bottom of the blister and gently squeeze from to bottom to drain out all the underlying fluid . So so gently , these people will be in a lot of pain . If you have the luxury of having any pain killers available now is the time to give them. Once drained then cover it with some antibiotic cream if you have any , if not cover it with honey and a clean dressing . Spenco also makes a line of second degree wound pads which are wonderful and should be in any preppers survival medicine chest , along with spenco foot pads for foot sores . An alternative treatment for second degree wounds is to mix some baking soda in cold water and soak some clean cloths in this and apply them to the burn , do so until the burn is no longer giving off any heat.
Third degree burns are the worst by far since they not only penetrate the epidermis and dermis , but rather continue on into the underlying subcutaneous tissues and structures . They can either be a charred black color or a dry white color . They are full thickness burns meaning they go through the entire skin and into the underlying muscles and nerves. These burns can be very painful and paradoxically some of the worst burns are painless , because the nerves are totally destroyed!
Treatment for third degree burns is much more complicated than first or second degree burns , because the skin as a barrier is removed you have problems with hydration and maintaining adequate body fluids. Under normal circumstances these third degree burn victims would be receiving IV fluids as well as pain killers . Since it is very unlikely that there will be IV fluids and tubing available , so all hydration needs to be done orally . Pushing fluids on these patients is critical and should be done with high electrolyte fluids like gatorade . By the way gatorade powder is very cheap and available everywhere, that is great for your survival medicine chest/food stash .
All the other treatments for first and second degree burns can be used here especially the use of poultices covering large areas of burns .Spenco skin pads can also be used , as they are for second degree burns , you don’t need them for first degree burns.
In my book The Doomsday Book of Medicine I go into further detail about the care and treatment of specialty burns from chemicals, electrical burns , and radiation burns from thermal radiation, radiofrequency energy , ultraviolet light and ionizing radiation.
-Dr. Ralph La Guardia M.D.
Burn Photos Courtesy of WebMD
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