What Are Alkali Burns?
Alkali burns result from contact with alkaline, or basic, substances, found in many common products. Unlike acid burns that cause coagulation necrosis by denaturing proteins and forming a protective eschar, alkalis induce liquefaction necrosis. This destructive process involves the saponification of fats and dissolution of proteins, allowing the chemical to penetrate deeper into tissues over time. The progressive damage means alkali burns can worsen significantly even after initial exposure.
Common household sources of alkali include drain cleaners containing lye (sodium hydroxide) or potassium hydroxide, oven cleaners, and certain heavy-duty degreasers. Industrial settings expose individuals to materials like cement, which contains calcium oxide, and some fertilizers. Even certain batteries, particularly button cell batteries, contain alkaline electrolytes that can cause severe burns if ingested or lodged in the body.
The symptoms and affected body parts vary depending on the exposure route. Skin contact typically causes redness, swelling, and blistering, which can progress to deep tissue damage. If the eyes are exposed, immediate and severe pain, redness, blurry vision, and even corneal opacification can occur. Ingesting alkaline substances leads to severe burns in the mouth, throat, esophagus, and stomach, causing intense pain, difficulty swallowing, and potential internal bleeding.
Immediate First Aid for Alkali Burns
Immediate and thorough first aid minimizes tissue damage from alkali burns. For skin exposure, quickly remove any contaminated clothing and continuously irrigate the affected area with copious amounts of cool running water. This flushing should continue for at least 20 to 30 minutes, or longer for concentrated chemicals, to dilute and wash away the substance, reducing its concentration and preventing further penetration.
Eye exposures require even more urgent and prolonged irrigation. Hold the eyelids open wide and flush the eyes with a gentle stream of cool water or saline solution for at least 30 minutes, or until emergency medical personnel arrive. Directing the stream from the inner corner of the eye outwards helps prevent contamination of the unaffected eye. Seek immediate medical attention for any eye contact with alkali.
If an alkali substance is ingested, do not induce vomiting, as this can cause further damage to the esophagus and airway. Instead, have the person rinse their mouth thoroughly with water if they are conscious and able to swallow. Call 911 or your local emergency number for immediate emergency medical help. Emergency services should always be contacted for eye contact, any ingestion, large area burns, or deep burns that appear white or leathery. Never use neutralizing agents like vinegar or lemon juice on alkali burns, as the heat generated from the neutralization reaction can worsen the burn.
Professional Medical Treatment and Recovery
After initial first aid, professional medical attention focuses on assessing the full extent of the alkali burn and preventing further damage. For eye burns, medical personnel use pH paper to check the eye’s pH, continuing irrigation until it returns to a normal range (7.0-7.4). Pain management is also an important part of treatment, often involving strong pain relievers.
Wound care for skin burns may involve debridement (removal of damaged or dead tissue) to promote healing and prevent infection. Specialized dressings are applied to protect the wound and support healing. For severe, deep burns, skin grafts may be necessary to cover large areas of tissue loss.
Eye burns may require specific topical medications, such as antibiotics to prevent infection or corticosteroids to reduce inflammation. In severe cases, surgery might be performed to repair damaged ocular structures. Potential long-term complications from alkali burns include significant scarring, chronic pain, and functional impairments. Eye burns can lead to permanent vision loss, while ingested alkalis can cause esophageal strictures, narrowing the food pipe and making swallowing difficult. Recovery is often lengthy, requiring ongoing follow-up care and sometimes rehabilitation.
Preventing Alkali Burns
Preventing alkali burns begins with proper handling and storage of alkaline chemicals in the home and workplace. Always store these substances in their original, clearly labeled containers to avoid confusion. Keeping them in a secure location, out of the reach of children and pets, is an important childproofing measure.
When handling any alkaline substance, using personal protective equipment (PPE) is important to prevent exposure. This includes wearing chemical-resistant gloves and safety glasses or goggles to protect against splashes. Ensuring adequate ventilation in the work area helps disperse any fumes, reducing the risk of respiratory irritation. Always read product labels and follow all safety instructions before use.