Q-Would you please help me win a bet? The question is about the proper treatment of burns. I say they should be left exposed to the air, and my partner insists they require a dressing to heal properly.
A-Let me start with one important rule for you: All burns should be cooled by applying cold, wet compresses or, if possible, sticking the injured part into ice water until proper treatment can be provided. No butter, no margarine, no grease that can only complicate the treatment and lead to bacterial infection of the wound.
If the burn is minor-that means it is superficial, only causing the skin to become reddened and tender (the old "first-degree" burn)-you need only apply a mild emollient or softening cream to reduce the swelling and pain. Creams that contain aloe are very helpful. If you consider this a dressing, you have lost your bet.
With more serious burns, in which blisters form or there is tissue loss, bandaging is required to keep the wound clean and protect the area from further injury so healing can proceed without difficulty. In the case of a blister the fluid should be removed using a sterile needle. The skin over the blister should remain in place to protect the underlying tissue and prevent the wound from drying out.
When a burn wound dries out, more cells die and there is more loss of skin and scarring. Serious burns require proper dressings to prevent drying out and the fluid serum from accumulating and inviting infection. Dressings will protect the wound and not stick to the skin as the healing process progresses. Of course, wounds that require such treatment and dressings are major and best left to the care of your physician.
Q- Our 4-year-old son has dandruff and we are not able to stop it with his normal baby shampoos. Could you please recommend a good shampoo we could use that's safe for a child his age and doesn't need a prescription?
A-The presence of ugly flakes in a child's hair may not be as simple to treat as you might wish. A good diagnosis is the first requirement for any treatment, including an appropriate shampoo, which must be chosen with the exact knowledge of the problem.
The two most common causes of dandruff in a child are eczema (atopic dermatitis) and tinea capitis (ringworm of the scalp). They are quite different in nature and provoke different symptoms. While the eczema can stir up a great deal of itching, the ringworm can cause hair loss. The ringworm can be detected through a microscopic examination and culture of some scales scraped from the scalp, but medication useful for removing the infection will have no effect on dandruff resulting from eczema.
Since psoriasis, which produces scales as well, can also affect young people, there is a real need for an accurate diagnosis here and the possibility that only prescription medications will help solve your problem. In this case your money will be well spent for a doctor's diagnosis and advice.
Write to Dr. Bruckheim in care of the Chicago Tribune, Room 400, 435 N. Michigan Ave., Chicago, IL 60611.