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- What are the symptoms of burns?
Symptoms depend on the severity and cause of the burn
but usually include pain and sensitivity to touch. The
skin may appear swollen, blistered, dried, charred, weeping,
or red, gray, or black-colored.
- Medical treatments
Over the counter lotions, creams, and sprays are used
to provide temporary relief of pain due to minor burns.
Some products contain a local anesthetic, such as lidocaine
(Solarcaine Aloe Extra Burn Relief®) and benzocaine
(Solarcaine®, Americaine Anesthetic®, Lanacane®,
Dermoplast®). Other products contain vitamins A, D,
and E (A and D Ointment®, Coppertone Cool Beads®),
as well as aloe
vera 
(Pacquin Plus with Aloe®, Coppertone Cool Beads®).
The prescription medications silver
sulfadiazine 
(Silvadene®) and mafenide (Sulfamylon®) are used
topically to prevent and treat uncomplicated bacterial
infection in second and third degree burns, as are oral
antibiotics such as levofloxacin
(Levaquin®) and cephalexin
(Keflex®).
Severe burns require hospitalization. They are typically
treated by surgical removal of burned tissue followed
by grafting of skin or synthetic substitutes.
- Dietary changes that may be helpful
The body repairs and builds new tissues in a process
called anabolism. Adequate amounts of calories and protein
are required for anabolism, as the skin and underlying
tissues are comprised of protein and energy is needed
to fuel repair mechanisms. While major injuries requiring
hospitalization raise protein and calorie requirements
significantly, injuries such as minor burns should not
require changes from a typical, healthful diet.1
- Nutritional supplements that may be helpful
Antioxidants
may protect the skin from sunburn due to free radical-producing
ultraviolet rays.2 Combinations of 1,000 to 2,000 IU per
day of vitamin E and 2,000 to 3,000 mg per day of vitamin
C, but neither given alone, have a significant protective
effect against ultraviolet rays, according to double-blind
studies.3 4 5 Oral synthetic beta-carotene alone was not
found to provide effective protection in a recent double-blind
study,6 it may be effective in combination with topical
sunscreen.7 However, other carotenoids such as lycopene
may be more important for ultraviolet protection. One
recent uncontrolled trial found 40 grams per day of tomato
paste providing 16 mg per day lycopene for 10 weeks protected
against burning by ultraviolet rays.8 Another uncontrolled
trial found 25 mg/day of natural mixed carotenoids also
protected against ultraviolet radiation, especially when
combined with 500 IU per day of vitamin E.9
Double-blind research has also shown that topical application
of antioxidants protects against sunburn if used before,10
but not after, exposure.11 12
Despite a lack of research on the subject, using vitamin
E topically on minor burns is a popular remedy. This makes
sense, because some of the damage done to the skin is
oxidative, and vitamin E is an antioxidant. Some doctors
suggest simply breaking open a capsule of vitamin E and
applying it to the affected area two or three times per
day. Vitamin E forms are listed as either “tocopherol”
or “tocopheryl” followed by the name of what
is attached to it, as in “tocopheryl acetate.”
While both forms are active when taken by mouth, the skin
utilizes the tocopheryl forms very slowly.13 14 Therefore,
those planning to apply vitamin E to the skin should buy
the tocopherol form.
Burns affecting a large proportion of the body may result
in vitamin D deficiency15 , potentially increasing the
risk of osteoporosis, which is a frequent long-term consequence
of severe burns.16
Colloidal silver has been used as a topical antiseptic
for minor burns for over a century. Internal use of colloidal
silver is not recommended for this condition.
Are there any side effects or interactions?
Refer to the individual supplement for information about
any side effects or interactions.
- Herbs that may be helpful
Aloe is another popular remedy for minor burns and a
small preliminary study found it more effective than Vaseline
in treating burns.17 The stabilized aloe gel is typically
applied to the affected area of skin three to five times
per day. Older case studies reported that aloe gel applied
topically could help heal radiation burns,18 but a large,
double-blind trial did not find aloe effective in this
regard.19
Calendula cream may be applied to minor burns to soothe
pain and help promote tissue repair. It has been shown
in animal studies to be anti-inflammatory20 and to aid
repair of damaged tissues.21 The cream is applied three
times per day. Plantain is regarded as similar to calendula
in traditional medicine, though usually the whole leaf
is applied directly to the burn as a poultice.
Gotu kola has been used in the medicinal systems of central
Asia for centuries to treat numerous skin diseases. Saponins
in gotu kola beneficially affect collagen (the material
that makes up connective tissue) to inhibit its production
in hyperactive scar tissue following burns or wounds.22
Are there any side effects or interactions?
Refer to the individual supplement for information about
any side effects or interactions.
- Holistic approaches that may be helpful
Acupuncture
may be useful in the treatment of serious burns. A report
of patients suffering from extensive second-degree burns
suggests acupuncture can reduce shock and pain following
the acute injury and may reduce infection and pain when
used as a part of post-injury wound care.23 A preliminary
report described ten patients with second-degree burns
that did not respond to conventional medical treatment.
A majority of these patients achieved greater than 90%
recovery following electrical stimulation to the wound
(similar to electroacupuncture).24 Ear (auricular) acupuncture
with electrical stimulation was studied in a small controlled
trial, in which a significantly greater reduction in pain
from burns was achieved with acupuncture. The relief lasted
at least 60 minutes following acupuncture treatment.25
References
1. Souba WW, Wilmore D. Diet and nutrition
in the care of the patient with surgery, trauma, and sepsis.
In Shils ME, Olson JA, Shike M, et al. Modern Nutrition in
Health and Disease, 9th ed. Baltimore: Williams & Wilkins,
1999, 1589–618.
2. Fuchs J. Potentials and limitations of
the natural antioxidants RRR-alpha-tocopherol, L-ascorbic
acid and beta-carotene in . Free Radic Biol Med 1998;25:848–7.
3. Fuchs J, Kern H. Modulation of UV-light-induced
skin inflammation by D-alpha-tocopherol and L-ascorbic acid:
a clinical study using solar simulated radiation. Free Radic
Biol Med 1998;25:1006–12.
4. Eberlein-Konig B, Placzek M, Przybilla
B. Protective effect against sunburn of combined systemic
ascorbic acid (vitamin C) and d-alpha-tocopherol (vitamin
E). J Am Acad Dermatol 1998;38:45–8.
5. Werninghaus K, Meydani M, Bhawan J, et
al. Evaluation of the photoprotective effect of oral vitamin
E supplementation. Arch Dermatol 1994;130:1257–61.
6. Garmyn M, Ribaya-Mercado JD, Russel RM,
et al. Effect of beta-carotene supplementation on the human
sunburn reaction. Exp Dermatol 1995;4:104–11.
7. Gollnick PM, Hopfenmuller, W, et al. Systemic
B-carotene plus topical sunscreen are an optimal protection
against harmful effects of natural UV-sunlight. Eur J Dermatol
1996;6:200–5.
8. Stahl W, Heinrich U, Wiseman S, et al.
Dietary tomato paste protects against ultraviolet light-induced
erythema in humans. J Nutr 2001;131:1449–51.
9. Stahl W, Heinrich U, Jungmann H, et al.
Carotenoids and carotenoids plus vitamin E protect against
ultraviolet light-induced erythema in humans. Am J Clin Nutr
2000;71:795–8.
10. Dreher F, Gabard B, Schwindt DA, et al.
Topical melatonin in combination with vitamins E and C protects
skin from ultraviolet-induced erythema: a human study in vivo.
Br J Dermatol 1998;139:332–9.
11. Dreher F, Denig N, Gabard B, et al. Effect
of topical antioxidants on UV-induced erythema formation when
administered after exposure. Dermatology 1999;198:52–5.
12. Fuchs J. Potentials and limitations of
the natural antioxidants RRR-alpha-tocopherol, L-ascorbic
acid and beta-carotene in cutaneous photoprotection. Free
Radic Biol Med 1998;25:848–73 [review].
13. Beijersbergen van Henegouwen GM, Junginger
HE, de Vries H. Hydrolysis of RRR-alpha-tocopheryl acetate
(vitamin E acetate) in the skin and its UV protecting activity
(an in vivo study with the rat). J Photochem Photobiol B 1995;29:45–51.
14. Norkus EP, Bryce GF, Bhagavan HN. Uptake
and bioconversion of alpha-tocopheryl acetate to alpha-tocopherol
in skin of hairless mice. Photochem Photobiol 1993;57:613–5.
15. Klein GL, Chen TC, Holick MF, et al. Synthesis
of vitamin D in skin after burns. Lancet 2004;363:291–2.
16. Garrel D. Burn scars: a new cause of vitamin
D deficiency? Lancet 2004;363:259–60.)) Vitamin D deficiency
may result from the inability of previously burned skin to
manufacture vitamin D after exposure to sunlight. People with
a history of an extensive burn might benefit from vitamin
D supplementation.
17. Visuthikosol V, Chowchuen B, Sukwanarat
Y, et al. Effect of aloe vera gel to healing of burn wound:
A clinical and histologic study. J Med Assoc Thai 1995;78:403–9.
18. Loveman AB. Leaf of Aloe vera in treatment
of Roentgen ray ulcers. Arch Derm Syph 1937;36:838–43.
19. Williams MS, Burk M, Loprinzi CL, et al.
Phase III double-blind evaluation of an Aloe vera gel as a
prophylactic agent for radiation-induced skin toxicity. Int
J Rad Oncol Biol Phys 1996;36:345–9.
20. Della Loggia R, Tubaro A, Sosa S, et al.
The role of triterpenoids in the topical anti-inflammatory
activity of Calendula officinalis flowers. Planta Medica 1994;60:516–20.
21. Patrick KFM, Kumar S, Edwardson PAD, Hutchinson
JJ. Induction of vascularisation by an aqueous extract of
the flowers of Calendula officinalis L the European marigold.
Phytomedicine 1996;3:11–8.
22. Werbach MR, Murray MT. Botancial Influences
on Illness. Tarzana, CA: Third Line Press, 2000, 143–7.
23. Jichova E, Konigova R, Prusik K. Acupuncture
in patients with thermal injuries. Acta Chir Plast 1983;25:102–8.
24. Sumano H, Mateos G. The use of acupuncture-like
electrical stimulation for wound healing of lesions unresponsive
to conventional treatment. Am J Acupunct 1999;27:5–14.
25. Lewis SM, Clelland JA, Knowles CJ, et
al. Effects of auricular acupuncture-like transcutaneous electric
nerve stimulation on pain levels following wound care in patients
with burns: a pilot study. J Burn Care Rehabil 1990;11:3229.
Copyright © 2004 Healthnotes, Inc. All rights reserved.
The information presented in Healthnotes is
for informational purposes only. It is based on scientific
studies (human, animal, or in vitro), clinical experience,
or traditional usage as cited in each article. The results
reported may not necessarily occur in all individuals. For
many of the conditions discussed, treatment with prescription
or over-the-counter medication is also available. Consult
your doctor, practitioner, and/or pharmacist for any health
problem and before using any supplements or before making
any changes in prescribed medications. Information expires
December 2005.
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See
also: Homeopathic Remedies for