Chemical Burn: Causes, Symptoms & Treatment

A chemical burn occurs when the skin or other parts of the body come into contact with chemical or organic solutions that cause a destructive reaction. Chemical burns usually leave deep wounds, cause severe pain, and require professional care, especially in drastic cases.

What is a chemical burn?

As a first measure, skin burns are rinsed with copious amounts of running water. Click to enlarge. In medical terms, a chemical burn is when the skin, mucous membranes or tissues of the body come into contact with a chemical or organic substance, such as alkalis and acids. Depending on the composition and concentration of the solution, it can cause more or less severe burns. Here it is essential to distinguish between the solutions and their potential danger, because there are less aggressive and extremely aggressive substances. Two other roles that influence the severity of the chemical burn are the sensitivity of the affected area of the body and the length of time the skin is exposed to the acid or alkali. Certain areas of skin are less sensitive than others, which can result in less severe wounds and scars. The most sensitive part of the skin is the mucous membranes, which offer little resistance to penetrating acids and alkalis.

Causes

The main cause is the contact with the skin, the second “cause” is the reaction that the substance unfolds on it. Acids, for example, cause a superficial killing of skin cells, which, depending on the type of acid and its concentration, can cause sores, as well as superficial clotting and clumping of cells. This can best be compared to a burn, where the skin surface also clumps and coagulates. However, this prevents the fluid from penetrating deeper into the tissue. The situation is different for burns with strong acids (such as sulfuric acid), which penetrate directly deep into the tissue due to the strong aggression. In the process, they attack the tissue and the overlying skin layers. Lyes, on the other hand, also penetrate directly into the tissue and kill the overlying skin layers. However, an alkali reacts differently to the proteins of the skin than an acid. Here, the surface does not clump together, but liquefies. This allows the lye to penetrate deeper and deeper into the tissue. The problem here is that caustic burns caused by alkalis appear less drastic at first, but can have serious consequences.

Symptoms, complaints and signs

The typical signs of a chemical burn involve the skin. However, chemicals, acids and alkalis can also damage the eyes. Because of the threat of vision loss, this case is considered very dangerous. Medical experts classify the symptoms on the basis of three degrees of severity. Typically, affected persons feel strong persistent pain on the respective skin surface. It shows a strong reddening. Blisters form within a short time. In severe cases of a chemical burn, there is a loss of fluid. Corrosive substances cause poisoning in the bloodstream. This affects the entire body. Shock is possible. If a chemical burn occurs in the eyes, there is often a risk of blindness. Initially, there is only clouding of the cornea. In addition, redness and pain occur. The eye reacts with a strong tear flow. Affected persons reflexively squeeze their eyes shut. If corrosive substances enter the throat, patients regularly complain of shortness of breath. The symptoms described can be classified according to an ascending degree of severity. Grade 1 is defined as reddening of the skin. Grade 2 is present with blistering and damage to the uppermost skin layer. Destruction of all skin layers without the lowest is referred to as grade 3.

Diagnosis and progression

Burns are manifested by severe and burn-like redness, by cracked and bloody skin, by a dissolved skin surface, and are accompanied by pain. However, only a doctor can specifically diagnose the severity of the burn and thus promptly initiate the right treatment. Depending on the type of solvent, it may even attack the internal organs or enter the bloodstream if it is not treated correctly or not at all.Therefore, it is immensely important in the case of difficult to assess or in the case of severe burns to immediately alert the emergency services, to immobilize the injured person and to free the affected skin from clothing and co.

Complications

Due to fluid loss, dehydration may occur. In particular, extensive burns then also cause neurological deficits. If the mouth and throat are affected, respiratory distress may occur, and in severe cases there is even a risk of suffocation. Caustic burns can cause severe damage, especially to the mucous membranes. The eye, mouth and throat areas are particularly at risk, because a chemical burn can quickly break through and damage the muscles and nerves located under the skin. Subsequently, the skin can scar, causing permanent damage to organ function. If the solvent comes into contact with internal organs or enters the bloodstream, it can cause serious health complications. In extreme cases, permanent organ damage occurs or blood poisoning develops. Even poisoning cannot be ruled out. During surgical treatment of a chemical burn, there is always a risk of further injury or infection. Improper aftercare can lead to wound healing problems, often resulting in scars. If painkillers are used, side effects and interactions cannot be ruled out. Occasionally, allergic reactions to the materials and medications used occur.

When should you go to the doctor?

If a chemical burn occurs, a physician should be consulted immediately. A chemical burn represents an injury to tissue and must be treated immediately. In the event of contact with acids and corrosive substances, emergency medical services should be alerted. This should be accompanied by calling the poison control center. Until the emergency physician arrives, the burn must be cooled. It is also advisable to leave the area to avoid further burns. Depending on the severity of the burn, different measures are possible. In the case of a mild chemical burn, such as may already occur on contact with an aggressive cleaner, one or two check-ups by the physician are sufficient. Provided that no complications occur, no further visits to the doctor are necessary. Particularly in the case of burns to the eyes, mouth, throat and pharynx, medical attention must be sought immediately. In the case of extensive burns, the tissue is destroyed, which can lead to perforations and other complications. The affected person should be placed in the shock position. All burns must be thoroughly flushed with sterile fluid. Alternatively, cold running water may be used. Because there is a risk of hypothermia and other discomfort here, this task should be performed by an emergency physician. Ointments or creams should also be applied only in consultation with a physician.

Treatment and therapy

Depending on the solvent, you can rinse the resulting wounds with plenty of water, but since this does not always have the desired effect, this should really only happen in an emergency without specialist instructions. By the way, the emergency service alerted by telephone can already give helpful instructions here. A specialist will examine the wound in detail, find out about the type of acid or alkali and then proceed accordingly. Some substances must first be neutralized before the wound can be cleaned and dressed. Here, again depending on the severity of the burn, one usually resorts to germ-free dressings and possibly also to ointments and tinctures that promote healing.

Prevention

Chemical burns can be counteracted by careful handling of risky solvents and by always wearing appropriate protective clothing. In addition, especially in the case of strong acids and alkalis, one should inform oneself about their effect and reaction on skin contact and also find out how best to proceed in the event of a chemical burn. This will not necessarily minimize the risk of a chemical burn, but it will help you know how to act more quickly and in a more targeted manner in an emergency, which could curb the severity of the injury.

Aftercare

In the case of a chemical burn, immediate measures play a particularly important role. Since the consequences can turn out to be life-threatening in a short time, the focus is on acute treatment. It is usually sufficient to ensure recovery. To prevent a chemical burn from recurring, patients must take their own precautions.However, these do not fall within the scope of medical responsibility. If necessary, a physician can provide information on protective measures with regard to the individual risk situation. If the consequences of a chemical burn remain, the follow-up depends on the symptoms. If the esophagus is affected, a malignant tumor may develop. In rare cases, even the esophagus must be replaced. If substances get into the eye, loss of vision is possible. The rhythm of follow-up care depends on the symptoms. In addition to a detailed discussion of the signs, the doctor usually performs a blood test as part of the checkup. Depending on where the burn occurred, imaging or a corneal examination may be ordered. These measures are intended to enable timely intervention should a deterioration of the general condition or complications become apparent. If a chemical burn leads to unrectifiable complications, palliative follow-up may also be indicated. Pain relief via medication then plays the significant role.

What you can do yourself

To prevent poorly healing wounds and especially scarring in cases of chemical burns, affected individuals should take immediate action. The first most important measure is that all clothing that came into contact with corrosive substance should be removed. Next, the burn should be rinsed with clean lukewarm water for at least 15 minutes. Care should be taken to ensure that this does not cause the acid to additionally reach healthy areas of skin. Afterwards, the burned area must be dressed in a germ-free manner. Patients should avoid using ointments, powders or similar products, as these can worsen the condition. If a corrosive substance gets into the eyes, there is a risk of losing sight. Therefore, the affected eye should be rinsed very thoroughly with clean water. For this purpose, the patient should preferably lie on his back with his head tilted to one side and the affected eye open. Then clean water should be poured into the inner corner of the eye from a height of about 10 centimeters so that the water flows outward. Care should be taken not to spread the substance to other areas of the face. The affected eye should then be sterilely bandaged. If a corrosive chemical has been swallowed, those affected are advised to drink water in small sips. Under no circumstances, however, should affected individuals vomit.