A scald is a thermal burn caused by heated fluids like hot water or steam. These injuries range from minor to life-threatening, depending on depth and size. Immediate action minimizes damage.
Immediate First Aid Steps
Upon experiencing a scald, immediately remove the heat source. Cool the affected area under cool, running water for at least 20 minutes. This reduces pain, swelling, and limits skin damage. While cooling, carefully remove any clothing or jewelry, unless stuck to the skin. Forcibly removing stuck items can cause further injury.
Use cool, not icy, water. Very cold water or ice can damage tissue and lead to hypothermia, especially in young children or the elderly. After cooling, loosely cover the burn with clean, non-adhesive material like cling film. This protective layer prevents infection and reduces pain by shielding exposed nerve endings. Do not apply butter, oils, toothpaste, or creams; these can trap heat, increase infection risk, and complicate medical assessment.
Assessing Scald Severity
Scalds are categorized by depth to determine the necessary course of action. First-degree scalds affect only the outermost skin layer, appearing red, painful, and without blisters, much like a sunburn. Pain typically subsides quickly.
Second-degree scalds (partial-thickness burns) damage both outer and underlying skin layers. They are characterized by redness, significant pain, and blisters. The skin may appear mottled red and white, swollen, and moist. If blisters rupture, the wound becomes more susceptible to infection.
Third-degree scalds (full-thickness burns) extend through all skin layers, potentially affecting underlying fat, muscle, or bone. The skin may appear white, leathery, charred, or black. Due to nerve damage, there may be little to no pain in the immediate area, though surrounding areas may be painful.
When to Seek Medical Attention
While minor scalds can often be managed at home, certain situations require professional medical attention. Any third-degree scald, regardless of size, requires immediate medical evaluation. Large scalds (larger than the affected person’s hand) also warrant prompt medical care.
Burns on sensitive or functionally important areas (face, neck, hands, feet, genitals, or major joints) should be assessed by a healthcare professional. These locations pose a higher risk for complications like scarring or functional impairment. Children (particularly under 10) and elderly individuals are more susceptible to severe outcomes and should receive medical attention for any burn beyond first-degree. Signs of shock (pale, clammy skin, rapid pulse, shallow breathing) or underlying medical conditions that could complicate healing warrant immediate medical help.
Aftercare and Healing
For minor scalds not requiring immediate medical attention, careful aftercare supports healing and prevents complications. After cooling, keep the wound clean by gently washing daily with mild soap and cool water. This prevents infection, especially if blisters have broken. Do not intentionally pop blisters; they provide a natural protective barrier against infection and aid healing.
Once clean, cover the scald with a sterile, non-stick dressing to protect it and reduce pain. Petroleum jelly or aloe vera can moisturize the burn, but avoid thick creams or ointments unless advised by a medical professional. Over-the-counter pain relievers (ibuprofen or acetaminophen) can manage discomfort.
Monitor the scald for signs of infection during healing. Signs include:
Increased redness or swelling
Pus or fluid discharge
Unpleasant odor
Worsening pain
Fever
If these signs appear, or if the wound does not show signs of healing within two weeks, consult a healthcare provider.