A burn is tissue damage caused by energy sources like heat, electricity, chemicals, or radiation, resulting in the destruction of skin cells. Severity depends on the depth of penetration and the total body surface area affected. The immediate goal of initial treatment is to halt the destructive process and limit the damage to underlying tissues. Rapid intervention reduces pain and improves the long-term healing outcome.
Assessing Severity and When to Seek Medical Help
Understanding the depth of the burn, categorized into three main degrees, determines the appropriate course of action. A first-degree burn is the most superficial, affecting only the epidermis (outermost layer), characterized by redness, pain, and dryness without blistering. Second-degree burns extend into the dermis and are identified by fluid-filled blisters, intense pain, and a moist appearance. Third-degree burns are the most severe, destroying both the epidermis and dermis, potentially damaging underlying fat, muscle, or bone tissue.
A full-thickness burn often appears white, leathery, or charred. It may cause little to no pain because the nerve endings have been destroyed. This lack of sensation is a serious sign requiring immediate medical attention. Any burn presenting with these characteristics, regardless of size, must be treated as a medical emergency.
For triage purposes, seek emergency medical help immediately for the following:
- Any burn covering an area larger than three inches.
- Burns involving the face, hands, feet, genitals, or major joints.
- All electrical burns, chemical burns, or those accompanied by smoke inhalation, as internal damage may be present.
- Burns on infants, young children, or elderly individuals due to increased risk of complications.
- A second-degree burn larger than the size of the person’s palm, or if there is any doubt about the burn’s severity.
Immediate First Aid for Minor Burns
Once the burn is determined to be minor (first-degree or small second-degree), the priority is stopping the burning process. Remove the source of heat and gently remove any clothing or jewelry near the site, unless the fabric is stuck to the skin. The most effective subsequent treatment is the immediate and prolonged application of cool water.
The burned area should be held under cool, running tap water for at least 10 minutes, with 20 minutes recommended for maximum cooling benefit. This action limits the spread of heat deeper into the tissue, reduces pain, and lessens swelling. Use cool water, not cold water or ice, as extreme cold can cause further damage through intense vasoconstriction.
After cooling, gently clean the burn using mild soap and water to prevent infection. Once the skin is clean and dry, apply a thin layer of a soothing agent like aloe vera or petroleum jelly. These agents keep the wound bed moist, which aids healing and prevents the skin from drying out.
The final step is to cover the wound to protect it from the environment and infection. Use a sterile, non-stick gauze pad, or loosely cover the burn with clean household cling film, laying it over the injury rather than wrapping it tightly. The dressing must be non-adherent to prevent sticking, which could cause further injury upon removal. Pain can be managed with over-the-counter options such as acetaminophen or ibuprofen.
What to Avoid During Treatment
Common folklore remedies can be detrimental and should be strictly avoided in favor of scientific first aid. Applying ice or ice-cold water directly to a burn is harmful because the intense cold can lead to further tissue damage and cause blood vessels to constrict, potentially worsening the injury.
Do not apply substances like butter, cooking oils, powders, or toothpaste to the wound. These greasy or thick materials trap heat in the skin, which can cause the injury to deepen. They also increase the risk of infection by creating a breeding ground for bacteria. Only sterile, water-based products or recommended topical ointments should be used after the burn has been thoroughly cooled.
The blisters that form on second-degree burns serve a protective purpose against infection. Do not intentionally pop or break any blisters, as this opens the wound to bacterial entry and delays healing. If clothing, such as nylon or synthetic material, has melted onto the skin, do not attempt to peel or pull it off. Removing adherent material can tear the underlying tissue and worsen the injury; this should be left for medical professionals to handle.
Post-Treatment Care and Monitoring
After initial first aid, attention shifts to managing the healing process over the following days. The non-stick dressing applied to the minor burn should be changed daily to keep the wound clean and dry, minimizing the risk of bacterial growth. Gentle cleaning with soap and water should accompany each dressing change.
Pain management can continue with over-the-counter pain relievers as needed. As the burn begins to heal, the area may become intensely itchy, but scratching should be avoided to prevent breaking the fragile new skin. Once the burn has fully healed, apply a daily moisturizer or specialized cream to keep the new skin pliable and reduce long-term scarring.
Monitor the wound closely for signs of infection, which can complicate healing. Immediate medical attention is required if you notice:
- Increasing pain, spreading redness, or swelling around the wound.
- A foul odor, pus, or cloudy drainage.
- A fever or a red streak extending from the burn site.
Minor burns can take up to three weeks to fully heal. If the wound does not show signs of improvement within two weeks, or if the initial pain is not subsiding, seek a professional consultation.