Burns occur when skin contacts extreme heat, cold or certain chemicals. Burn severity ranges from first degree (redness, no blistering) to fourth degree (involvement of deep structures, such as tendons or bones). Minor burns in the hand are common and can often be treated with observation or topical creams and dressing changes. More severe burns may require surgery to remove damaged skin and replace it with skin grafts. Your doctor will evaluate your burn to determine the most appropriate course of treatment.