What is a burn?
A burn is an injury caused by an energy source, such as heat, a flame, or solar radiation. Types of energy burns include thermal burns (burns from heat), chemical burns, electrical burns, and radiation burns (burns from x-rays, ultraviolet radiation, and other types of radiation). Sunburns are a type of radiation burn.
How common are burns during pregnancy?
Burns can occur as accidents during pregnancy just as much as they can occur outside of pregnancy. The same is true of sunburns, but pregnancy typically increases your susceptibility to sunburn, due to the hormonal changes. This means that it will take less time in the sunlight for you to burn while pregnant compared with being in sunlight at the same time of day and same time of year when you are not pregnant.
How are burns, including sunburns, diagnosed?
Burns are diagnosed based on your history of exposure to an energy source able to cause the burn plus physical examination of the burned area, or areas, of your skin.
Do burns, including sunburns, cause problems during pregnancy?
Mild burns localized to a small area of the skin do not cause problems other than pain and irritation in that area. The same is true of mild sunburns. Severe sunburns, as well as other bad burns, can lead to loss of body fluids, causing dehydration. They also can lead to changes in regulation of body temperature that can disrupt your physiology, leading to light-headedness, dizziness, and fainting. Severe burns can lead to infections, since the skin is an important barrier against penetration of agents into the body, including microorganisms.
Burns are rated in terms of severity as follows: First-degree burns affect only the epidermis, the outer layer of the skin. The affected site is red, dry, and painful, without blisters, and usually, there is no long-term damage. Mild sunburns typically fall into this category. Second-degree burns reach partway into the inner layer of skin called the dermis. The site is red, with blisters, and can be swollen and painful.
Third-degree burns involve both the epidermis and dermis, and also can damage underlying tissue, such as muscle, tendon, and bone although sometimes the term fourth-degree burn is applied to burns reaching muscle, tendon, and bone. The site is white, or charred, and sensation is lost, due to destruction of the nerve endings.
Long-term effects of sunburn include skin cancer, typically a mild type of skin cancer called basal cell carcinoma, which can disfigure, but does not kill. Some controversy, and certainly complexity, surrounds associations between sunlight exposure and a very dangerous type of skin cancer called cutaneous malignant melanoma.
In the case of severe burn injuries, survival or death is related directly to the total body surface area of burns (TBSAB). The greater the TBSAB, the lower the chance of survival.
Do burns, including sunburns, during pregnancy cause problems for the baby?
If any kind of burn is severe enough to disrupt your body fluids and/or temperature, this increases the risk of preterm labor, which can have long-term effects on the childs health as an infant, and possibly behavioral effects later in childhood. Such physiological changes also increase the risk of spontaneous abortion (miscarriage).
What to consider about taking medications when you are pregnant:
- The risks to yourself and your baby if you do not treat the burn
- The risks and benefits of each medication you use when you are pregnant
- The risks and benefits of each medication you use when you are breastfeeding
What should I know about using medication to treat burns during pregnancy?
Pain and irritation from minor burns can be treated with over the counter pain medications, such as acetaminophen and paracetamol, which are thought to be safe during pregnancy. However, NSAIDs (such as ibuprofen, naproxen) and salicylates (such as aspirin) should be avoided, particularly toward the end of pregnancy. In the past, it was thought that NSAIDs could be most dangerous during the earlier phases of pregnancy on the grounds that they could cause spontaneous abortion (miscarriage), but the overall picture from the evidence to date is that there is no major miscarriage risk from NSAIDs. On the other hand, there is increasing risk as pregnancy advances, due to the fact that NSAIDs work by preventing cells from manufacturing a substance called thromboxane and a group of substances called prostaglandins. During fetal life, blood enters the right side of the baby’s heart and much of it is detoured into the left side of the heart. The rest goes into the pulmonary artery, and from there is moved through a vessel called the ductus arteriosus, which carries the blood to the aorta, the same vessel that receives blood from the left side of the adult heart. Normally, the ductus arteriosus closes and disappears within a couple of days after birth, which helps the baby adjust to the outside environment, where their own lungs supply oxygen and remove carbon dioxide. Exposure to NSAIDs during fetal life can close the ductus arteriosus prematurely, causing high pressure in the lungs, in which case the baby can be born with a serious condition called persistent pulmonary hypertension in newborns (PPHN), which can be fatal. Its also possible that NSAIDs used during pregnancy may cause kidney problems in the child.
Along with pain medications, sunburns can be treated with lotions containing aloe vera, or a moisturizer, none of which are harmful during pregnancy.
Severe burns require several different types of medications, as well as procedures, but such injuries are life-threatening to the point that preserving the pregnancy may not always be possible.
Who should NOT stop taking medication for a burn, including a sunburn, in pregnancy?
As noted above, mild burns can be treated with medications that pose little or no risk to the baby, whereas severe burns require a range of medications and procedures, and can be life-threatening. Consequently, theres not always a choice to stop taking medication.
What should I know about choosing a medication for burns in pregnancy?
You may find Pregistrys expert reports about the individual medications to treat burns here. Additional information can also be found in the sources listed at the end of this report.
What should I know about taking a medication for burns when I am breastfeeding?
Acetaminophen, paracetamol, and NSAIDs are thought to be relatively safe in mothers who breastfeed. Lotions applied to the skin for burns, including sunburns, should be kept away from areas of the skin on the breast where the infant is nursing.
What alternative therapies exist besides medications to treat burns during pregnancy?
Burns can be treated with a range of surgical strategies, including skin grafts, after the initial management of fluids and electrolytes.
What can I do for myself and my baby when I have a burn during pregnancy?
It is very important to follow the instructions of your physician. Importantly, its also very important to do all t
hat is possible to prevent sunburn, especially while pregnant, given your skins increased vulnerability to sun damage. This means using sunscreen, wearing a hat, and minimizing your time in sunlight.
Resources for burns during pregnancy:
For more information about burns during pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or read the following articles: