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You know what every.single.one of your readers are going to experience? INJURY
Minor cuts, bruises, and burns.
The Dings and Bangs of Life.
It just happens.
And what that means to you, is you need to get these right.
I’ve previously covered bruises (see the How Injuries Work links below). Most stories have bruises appear immediately, so that is an established trope. The instant bruise comes from two sources, I think. One – most of us are not used to grievous bruises. And Two – half the time, bruises just appear on our body, without us remembering how we got them. So it seems like they were “instant” bruises.
Burns don’t have the same trope to lean into.
The manuscript I’m looking at has second degree thermal burns sending the main character of the romance to the hospital when they covered nearly her entire back. The ER bandaged them and told her to rebandage them every few days to keep them clean. But later in the manuscript, they are described as first degree burns. Either way, they were fully healed in two weeks, despite her being on the run without proper sleep. (Sleep is needed for healing.)
Fine, fine. Just fix the second-first degree burn continuity issue. But, really, that amount of blistering takes more than two weeks to clear up.
Blistering? you ask. … Yes, blistering. That happens with second degree burns.
Let’s go over the level of burns.
Wait, first lets go over the types of burns:
- Thermal – Come from heat sources, like touching a hot stove.
- Radiation – Come from exposure to different types of radiation. The most common is a Sunburn.
- Chemical – Comes from strong acids or alkalies. Especially dangerous around the soft tissues like the eyes and nose. This is why every lab has an emergency wash station. In the house, you will run into chemical burns when working with detergents and solvents. After your first full-strength bleach blister and/or week of red sensitize skin, you learn to wear gloves.
- Electrical – These tend to just jump right to third degree, leaving tracks of dead cells between entry and exit.
Unlike bruises, burns and burn damage tends to show up immediately, but the symptoms may worsen as the body continues to “cook” afterwards. DO NOT PUT BUTTER OR OIL ON BURNS – this locks in the heat and continues the issue. You must wait until the skin/site cools. Do not put ice on it to do a quick cool – as Thermal type burns effects can be created both through the addition of heat AND the removal of heat. How many people have had red hands from cold weather? Cool water, running through a faucet or with paper towels. Remove the source of the burn as quickly as you can without causing further damage.
So what are the levels (degrees) of burns?
- First degree (superficial) – The skin reddens, often drying. It will be hot to touch. As it heals, the skin will remain sensitive and may be itchy. Lotion is usually enough to control the injury. For those interested in medicine, only the epidermis (outer layer of skin) is impacted.
- Second degree (partial thickness) – Red skin, swelling, painful, and blistering. Often the person is thirsty as the swelling and blistering is caused by the body moving resources, especially liquids, to the site for healing. Doctors get worried if burns are covering 10 percent of the body on children and 15 to 20 percent of the body on an adult. Bandages over the blisters are recommended to avoid picking at them. Do not pop them – the skin’s job is to protect the body from infection – popping them breaks this seal – so now the body is both trying to heal the injury and fight off invading microbes at the same time. Do not make your body’s immune/healing system do multi-processing.
As you can see the difference between first and second degree burns are huge. For a character on the run, first degree burns are a minor inconvenience. Second degree burns covering the entire back while traveling by car and bus, needing to change dressing, moving into a place and unpacking … major impact on movement ability and comfort.
Blister level injury takes about two to three weeks to replace the level of protection for the skin (the lowest level of skin growing out to the outer layer of skin), hence the peeling days after the injury. But another three weeks beyond that before the site starts looking “normal”. The character’s back should have been an ugly mass of peel and red at two weeks. When she ran into her old love interest, I wanted to hear “who hurt you”? Instead, nothing.
3. Third degree (full thickness) – Beyond injury, we are now at destruction. Say goodbye to that part of your epidermis and all layers of your skin at the site. The burn site will appear white or charred black; brown and yellow are also possible. No real pain around the initial site because nerve endings are destroyed. Healing is going to take a long time because the body has to rebuild, not just go through the normal ongoing replacement cycle. The body has to make the things that make the things. There will likely be scars – skin grafts can help. See a doctor – third degree burns are exactly what the Emergency Room is for!!!
We all have heard about first, second, and third degree burns. But wait, there is more! I found this out with an edit where the autopsy covered fifth degree burns. Why we don’t talk about these higher levels is, well, that area is dead and likely being amputated is the body survived the shock to the system. We can’t treat these degrees with first aid – hospitalization 100%, if not the morgue.
4. Fourth degree burns – Damage has extended into the fat.
5. Fifth degree burns – Damage has extended into the muscle.
6. Sixth degree burns – Damage has extended into the bone.
Things you learn while editing.
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In closing, for writers, get the burn degrees right. Everyone has lived through at least one round of sunburn. They know the swelling and red skin, the peel in a few days and the itch. You need to get this right. The plus side is everyone knows it, which means you can tap into that visceral memory and have the readers sympathize – feel what the character is feeling. You got a hook into the reader’s brain. Use it.
Editing Rant: How Injuries Work Series
1. Bruised and Battered (8/14/2018)
2. Gonna Leave a Bruise (4/13/2021)
3. The Burn (8/13/2024)
