Everyday, dozens of people are admitted to hospital with burns to their face. Mercifully, most people will only have first-degree minor burns, but every year about 2000 people get significant facial burns that cause lasting facial disfigurement. Treating these can be extremely difficult and there are many risks to physical and mental involved.
Treating minor Burns
A first-degree burn only involves the top layer of skin, the epidermis. These are fairly easily treatable at home. Common minor burns to the face include sun burn, cooking oil splashes and more recently laser hair removal burns. However, if you have any doubt as to the severity of the burn you should attend an emergency department at your local hospital or medical centre immediately.
The first step is to immerse the wound in cool water. Do not use running water as it will increase inflammation. Very cold water is not advisable. The aim is to reduce inflammation, so you should do it until it is stopped hurting or a maximum of about 20 minutes. Petroleum jelly is very effective at keeping the wound from becoming infected if applied several times a day. Do not use ointments or pigments, they can increase the risk of infection. A non-stick sterile bandage should be applied and replaced at least daily. Blisters might appear, if they do let them form and do not pop them. Over-the-counter medication such as acetaminophen and ibuprofen are suitable for reducing the pain and inflammation from a first-degree burn. Keeping the damaged area out of direct sunlight will help to reduce redness and scarring as it heals.
Treating major Burns
If you think you have received a burn that is more severe than a first-degree burn, you should go immediately to an accident and emergency room.
Second-degree burns involve damage to the epidermis and the tissues below. Third-degree burns are known as full thickness burns. These are burns that have damaged all of the layers of the skin down to the dermis beneath. The treatment of these burns should be carried out by and in consultation with a trained professional.
How a burn is treated depends very much on where it is and the extent of the burn. For severe facial burns, the first step is usually cleaning and debriding the wound. This involves removing the dead tissue that could become infected and ensuring that no dirt or other matter is left inside. If infections look like they are forming, the patient will be given antibiotics, either as topical ointments/creams or an intravenous solution. In many cases, patients will be given a tetanus shot. Pain relief and intravenous fluids are usually applied to promote healing, reduce harmful inflammation, and control pain.
For severe burns, there is often very little that can be done to save the tissue that has been damaged. In order to prevent infection, the dead tissue is removed. While skin does have remarkable abilities to heal itself, it cannot replace itself very well. Severe facial burns will form thick scars. For patients in this situation, usually the only available option is skin grafting.
Skin grafting is the process of taking healthy skin from another part of the body and attaching it to an area that has damaged or non-existent skin. Depending on the area of skin needed, this grafted skin can come from the buttocks, legs, arms, or in the case of small grafts, even from the neck. One of the problems with this procedure is that skin types are different all over the body and people can end up with mismatching skin tone and amounts of hair on their face. Then there is the necessity of removing somebody’s skin and the risks of infection that come with that.
Some patients do not have the skin type or the immune system to allow skin grafts. For some who have extensive facial Burns karma, the only option is a transplant from another individual. This means that the immune system has to be suppressed, leaving them open to infection for the rest of their lives.
Recent advances in biological sciences have raised the hopes of remarkable treatments becoming available for people with facial burns in the near future. The most significant is the growing ability to manipulate stem cells. These are cells that can grow into any other kind of cell. Currently, scientists are able to take a cell from somebody’s body and turn it into a stem cell. They can then tell that stem cell to grow into skin. In the last few years, laboratories have shown that they are able to grow small amounts of skin that could potentially be grafted onto a wound. The technology is not quite viable yet, but it is tantalisingly close. For people with significant facial disfigurement from burns, the use of stem cell technology to grow them their own skin back will be literally transformative. Watch this space, change is coming.