Chemical burns: Symptoms, diagnosis, and treatment
Chemical burns can happen to anyone at any place - at home, at work, at school, when outdoors, or in an attack.
Chemical burns will cause some skin damage, but most people recover fully without any serious health consequences. Severe chemical burns do require immediate emergency care to prevent complications and, in some cases, death.
Common causes of chemical burns
Misusing products such as bleach, oven cleaners and paint thinners may result in chemical burns.
Most chemical burns occur as a result of misuse of products. Some of the most common household and workplace products linked to chemical burns include:
- car battery acid
- swimming pool cleaners
- toilet and drain cleaners
- oven cleaners
- metal cleaners
- concrete mix
- paint thinners
Many other products used at home and work may contain chemicals that cause burns.
Anyone that keeps chemicals for any reason must store chemicals safely to avoid accidents. They must also label the containers in case of exposure so that doctors know what chemicals they are dealing with.
Chemical burns tend to be deep burns, and symptoms of a chemical burn will vary depending on a variety of factors.
Symptoms of chemical burn depend on:
- when the skin was in contact with the chemical
- whether the chemical was inhaled, swallowed, or touched
- whether there were open cuts during contact
- the contact location on the body
- the amount and strength of the chemical
- whether the chemical was gas, liquid, or solid
Knowing the type of chemical that caused the burn is important. Symptoms will vary based on how the chemical responds once in contact with the skin, eyes, or inside of the body. Symptoms also vary if the chemical was swallowed or inhaled.
General and common symptoms of chemicals touching skin and eyes are:
- skin that appears black or dead
- irritation, redness, or burning in the area that was affected
- numbness and pain in affected areas
- vision change or loss if the chemical comes in contact with the eyes
If someone has swallowed or inhaled a chemical, they may experience one or more of the following symptoms:
- irregular heartbeat or cardiac arrest
- low blood pressure
- shortness of breath
- muscle twitching
Seeking medical care
The emergency medical services should be called for serious chemical burns.
If someone has been exposed to a chemical affecting the skin or eyes, the first thing to do is take off contaminated clothes. They should then wash the affected area with water for at least 20 minutes. If this is done quickly enough, burns will be less severe and recovery time might be shortened.
Chemical burns often require some kind of medical treatment or a trip to the hospital.
If a parent suspects that a child has inhaled or swallowed a chemical, the parent should first call their local poison control center and find out how to proceed in order to avoid further injury.
For serious chemical burns and exposures, it is a good idea to call for emergency medical services.
A few examples where emergency services should be called include when:
- The person feels faint, has a pale complexion, clammy skin, or shallow breathing. These might be symptoms of shock.
- The chemical has gone through the first layer of skin or the affected area of skin is larger than 3 inches.
- The burn is affecting the eyes, hands, feet, face, groin, buttocks, or a major joint.
In the emergency room, the person will be evaluated rapidly to determine how much tissue has been affected and the extent of the injury. After evaluation, they will be stabilized.
Doctors may carry out further lab work and other diagnostic tests to determine any further health concerns. A treatment plan will then be prepared based on the person's overall condition, the type of exposure, and the likelihood that the person's symptoms may worsen.
Treatment of chemical burns
Burns can cause swelling, blisters, scars, pain, shock, and can even be fatal. They can also lead to infection. Treatment will depend on the cause, severity, deepness of burns, and the extent of tissue that has been damaged.
The first step in treatment is to determine the burn type, as follows:
- first degree burns affect the top layer of the skin
- second degree burns cause injury to the second layer of skin
- third degree burns affect the deepest layers of the skin and tissues underneath
Depending on the severity of the burn, doctors will employ different methods to treat chemical burns, such as:
- antibiotics and anti-itch medicines
- fluids given through the vein - fluid loss in common with burn injuries
- cleaning and removing dead tissue
- skin grafting - removing healthy skin from one part of the body to cover the wound
More serious chemical burns require rehabilitation, which may include:
- skin replacement
- pain management
- plastic surgery
- occupational therapy
Who is at risk?
Industries where chemical burns may happen include manufacturing, construction and agriculture.
The people at the highest risk for chemical burns are infants, young children, older adults, and people with disabilities because these groups may not be able to handle chemicals properly.
Others at risk are those who work in industries where exposure of chemicals to skin is common.
Chemical burns at home are sometimes related to cosmetic products, including chemical peels and acne creams. While these types of burns are rare, they can cause very serious injuries and complications.
One study looked at the case of a 38-year-old Asian man who had been using an acne treatment. Upon seeing good results, the man increased his daily dose of the medicine.
Within a few days, this resulted in chemical burns to the first skin layer on most of his face. The man was treated for his chemical burns but did not return for follow-up, leaving researchers unsure of his treatment outcome.
The Centers for Disease Control and Prevention (CDC), report more than 13 million Americans work in industries where their skin and eyes may be exposed to chemicals. Some of these industries include:
One report from the Joseph M. Still Burn Center at Doctors Hospital in Augusta, GA, found that chemical burns accounted for 16 percent of burn injuries. At this burns center, chemical burns may account for 42 percent of work-related injuries.
According to a review of occupational chemical burns treatment over a 2-year period in an emergency room setting, chemical burns cause more tissue damage than other types of burns. The researchers noted the severity of these kinds of wounds were due to the high toxicity of industrial chemicals and methods of use.
Carelessness was the most common reason for injury to exposed areas of the body in the workplace. However, the researchers noted that workplace safety protocols, training, and protective equipment have led to fewer accidents, better outcomes, and fewer deaths related to chemical burns.
The outlook for chemical burns depends on the severity of the injury. Minor chemical burns will heal quicker with treatment while more severe injuries require extensive and more advanced treatment methods.
Most people can recover and have normal lives with appropriate treatment and rehabilitation services if needed.