What is the Most Effective Remedy to Treat Third-Degree Burns?

What is a burn? A burn is damage to the skin through a variety of causes. They are

inevitable in one’s life, whether that be a personal experience or through hearing from another.

Burns have a range of different degrees: first-degree, second-degree and third-degree. Each

degree of burn deals with specific layers of the skin. First-degree burns are mild and affect the

epidermis while second-degree burns affect both the epidermis and the dermis. Third-degree

burns are the most severe because they affect all layers of skin and possibly further through the

tissues (WebMD, 2017-a). Any type of burn is typically caused by radioactive agents, thermal,

chemical, electrical or friction that causes lesions among the tissue that covers the body. The real

question is what is the most effective remedy to treat second-degree and/or third-degree burns?

There are a great amount of new upcoming treatments with the use of aloe vera, honey,

sugar and many more. However, the two main ones covered will be silver sulfadiazine and

photobiomodulation. Both treatments are common for burns but are similar in certain aspects

while also differing in other aspects. Knowing about remedies for burns is important because

burns are bound to occur in someone’s life; being aware of how to treat a burn is key to

minimizing any further damage to one’s skin. It is also essential to know more information about

burns because patients need to know how each medication works and what the precautions or

side effects are. Not only that, but it is vital to know if it is cost effective to be paying money for

a treatment that may not even work.

Personally, I am intrigued on the process of burns and how skin burns. I have

experienced a second-degree burn and after that part of my life, it only fueled my interest in skin.

Subsequently, I am intrigued and fascinated by dermatology, a potential field I see myself in.
 There is a great amount of remedies for burns, but one of the most popular treatments for

burns is 1% silver sulfadiazine (SSD), a cream used to speed up the healing process and prevents

further infection of a burn. The general cost of buying a 400-gram jar of SSD cream is about $50

(Medplus Physician Supplies, 2017). Depending on the severity of the burn, this jar will last for a

great amount of time. Looking back in history, silver itself dates all the way to ancient times.

Today, silver is still used as a disinfectant and it can prevent further infection of a burn. SSD

works through the process of cellular death of the bacteria. The ions in the silver sulfadiazine

cause disruption within the bacterial cells (Capeding, Albert & Guerrero, 2017).

The process of using this cream is simple: apply a moderate amount of the cream once or

twice a day to the disinfected area of the wound and cover it with gauze to prevent any additional

pathogens from entering. Reapplication of the cream is to be repeated until the skin heals

completely or is ready for skin grafting. Skin grafting is a surgical procedure where skin is

removed from one area of the body and transplanted to another (WebMD, 2017-b). One thing to

be weary of, is that there are some adverse side effects of pain or itchiness to the affected area. In

my personal experience, I had a lot of uncomfortable itchiness to my palm but was advised

against scratching the burn since it would have potentially created even more problems, such as

extending the time of healing or creating additional damage to the burn.

Cream is not the only way to treat burns—there is also photobiomodulation, which is also

known as low level laser therapy (LLLT). This specific type of treatment uses lasers to modulate

cellular activity, leaving the skin cells to regenerate faster which makes recovery quicker (Gomes

et al., 2017). Research shows that LLLT treatments are successful to the infected area as it shows

similar results to the SSD cream. In just a week, there was less inflammation in the skin of rats

(Ezzati, Bayat & Khoshvaghti, 2010). However, there are potential side effects that come with
LLLT. First, there are a handful of insurance providers that do not cover this treatment. That

means it would be out-of-pocket for a treatment that occurs once a week, which is very

expensive. The physical side effects of using LLLT is the potential for damage to the internal

organs of your body. Since it is an actual laser, using protective eyewear is vital as the laser can

damage your retinas, leaving you blind.

Currently, there are only a handful of research studies that find which treatment is the

most effective and quick for burns. Two of three of the studies described below both use a rat

model, meaning that each trial was tested on a group of rats. Both studies conducted by Gomes et

al. (2017) and Ezzati et al. (2010) used similar methods in burn procedure. Each group of rats

were scalded using extremely hot water for a set amount of seconds. Promptly after receiving the

burns, each group was divided into subgroups and then treated with different remedies for each

burn area. Both articles had done a similar test with minor differences, those being the types and

quantity of rats and ways of healing the burn. One article focused on healing the rats’ burns with

both the SSD cream and with LLLT while the other article focused on treating the rats with

different exposures to the lasers. In another research article, pediatric patients were treated and

observed using 1% silver sulfadiazine cream (Capeding et al., 2017). This article was a pilot

study held in the Philippines. All three studies showed positive results in that both

photobiomodulation and the use of 1% silver sulfadiazine were highly effective and increased

the rate of which the healing process took place. Although both treatments are effective, the 1%

SSD cream is more favorable because it is one that has been used for centuries and has shown

much better results when observing the burn areas and its physical appearance. Each study

showed positive results without any failure, yet, I would personally like to see additional studies

with actual pediatric patients since they will be able to communicate their symptoms to the
doctors and are able to give feedback. I am a bit weary on the pilot study because it was a 100%

success rate, but, it does show the correlation of SSD cream being effective, leading to the

conclusion of it being reliable. Furthermore, I would like to see that there are some studies with

failures because there needs to be at least one aspect to continue research upon.

As mentioned earlier, I had experienced being the victim of a burn. Although it was a

second-degree burn, the process of using 1% silver sulfadiazine was very straightforward. Long-

story short, I wanted to sweeten my kettle corn that had little to no sugar covering it, so I decided

to microwave cane sugar and corn syrup in a plastic cup. I did not even realize that those two

would not mix well and burn through the cup. Anyway, I dropped the scalding hot sugar onto my

right hand and was rushed to the burn clinic in Phoenix, Arizona. I was told that I had a second-

degree burn on the brink of being a third-degree burn. They had to cut away to blistering skin on

my right hand because it was inflamed and filled with fluid. The nurses had to strip away the

damaged skin, leaving my twelve-year-old palm screaming at me with red all over. I was

immediately treated with 1% silver sulfadiazine, something I was not aware of. The doctor had

mentioned that it held silver in the cream and that made me a bit hesitant because I had no prior

knowledge of silver having any healing agents. These were trained professionals, I had to trust

them because they knew more than me. With my raw and inflamed skin exposed to the warm air

in the clinic, it only made the situation worse, until the nurse slathered on the SSD cream. That

was an instant relief from the burning sensation in my hand. After dressing the wound I was sent

home and was to return once a week until my wound was completely healed.

The process of healing my burn was excruciating and fascinating all at the same time.

After the first week of treatment, there was a visible difference in my hand; it was not as

inflamed and was already beginning the process of looking like it had looked before. Over the
course of one month, I went to the burn clinic every week and only got positive results of

recovery and eventually I was given a split to use when I slept, preventing my fingers from

curling (which is bad because my fingers would be retrained to curl inward instead of being

straight and flexible). I had to start from the very beginning with exercises to make my hand

flexible and to prevent it from scarring. As the weeks progressed, I began to use my right hand

again for daily tasks, like eating or brushing my teeth. I also had observed that the SSD cream

was very effective and was a quick and simple process. I have not tried photobiomodulation, but

I hold a bias that the silver sulfadiazine cream is highly effective to treat wounds.

It is evident that the 1% silver sulfadiazine cream is favorable over any other methods to

treat burns because a great amount of the studies conducted show that SSD cream is effective.

SSD cream shows wanted results in just a week of fast healing. Most of the studies only added to

my opinion that SSD cream is effective because the research shows similar or the same outcomes

of healing. Silver sulfadiazine is effective to reduce any chances of infection in wounds, in which

it has been successful. However, I would prefer to see additional research studies with the

effectiveness of silver sulfadiazine because both studies, I had found, deemed to be both

successful which is highly suspect if there was not any failure in either study. I plan to educate

those who I encounter in my near future as a dermatologist regarding burns because I do not

wish to have anyone who ends up with a burn, being clueless as to how to treat it. I want my

future patients to know how to deal with burns in a safe and effective way. This research will not

only add to my knowledge of treatments for burns but will provide additional insight behind the

molecular aspect of the healing process.

 References

Capeding, M., Albert, E. & Guerrero, J. (2017). The effectiveness and safety of 1% silver

sulfadiazine (flamazine) cream in preventing infection in potentially contaminated

traumatic wounds among pediatric patients 2 to <18 years old: An open-label arm phase 3

clinical trial. J Trauma Treat, 6(395), 2167-1222. doi: 10.4172/2167-1222.1000395.

Ezzati, A., Bayat, M. & Khoshvaghti, A. (2010). Low-level laser therapy with a pulsed

infrared laser accelerates second-degree burn healing in rat: A clinical and microbiologic

study. Photomed Laser Surg, 28(5), 603-11. doi: 10.1089/pho.2009.2544.

Gomes, M.T., Campos, G.R., Piccolo, N., Franca, C.M., Guedes, G.H., Lopes, F., …

Silva, D.F. (2017). Experimental burns: Comparison between silver sulfadiazine and

photobiomodulation. Rev Assoc Med Bras, 63(1), 29-34. Doi: 10.1590/1806-

9282.63.01.29.

Medplus Physician Supplies. (2017). SSD (Silver sulfadiazine cream USP). Retrieved

from https://www.medpluspro.com/ssd-silver-sulfadiazine-cream-usp.html

WebMD. (2017-a). Pain caused by burns. Retrieved from https://www.webmd.com/pain-

management/guide/pain-caused-by-burns

WebMD. (2017-b). Plastic surgery for burns and other wounds. Retrieved from

https://www.webmd.com/skin-problems-and-treatments/plastic-surgery-burns#3