Electrical stimulation burns are localized thermal injuries, typically low-voltage, occurring when electrical current is improperly applied to the skin, often from devices like Transcutaneous Electrical Nerve Stimulation (TENS) units or muscle stimulators. These burns result from a concentration of energy that generates heat on the skin’s surface, rather than a high-voltage accident. The injury mechanism involves high current density heating the skin tissue. This usually happens due to poor contact between the electrode pad and the skin, a dried-out conductive gel layer, or excessive intensity settings. Since the skin acts as a resistor, localized heat production occurs when the current is forced through a small area.
Immediate First Aid for Stimulation Burns
The first step is to safely stop the electrical current causing the injury. Turn off the stimulation device at the power source or remove the battery to ensure no further current passes through the skin. Quickly and gently remove the electrode pads and any jewelry or clothing from the affected area, unless the material is stuck to the burn.
Once the current has stopped, prioritize cooling the burn to limit tissue damage. Hold the burned area under cool—not cold or icy—running water for a minimum of 10 to 20 minutes. This helps dissipate built-up heat energy, reducing pain and swelling.
After cooling, gently clean the wound with mild soap and water to remove debris or residue. Avoid scrubbing the area or breaking any blisters, as the blister roof protects against infection. Apply a protective layer using a sterile, non-adhesive dressing to shield the wound.
Secure the dressing loosely with gauze to prevent air exposure and reduce pain. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can be taken for pain relief. Monitor the burn closely over the next 24 to 48 hours for increasing pain or changes in appearance, which may suggest infection.
Indicators of Serious Injury and When to Seek Medical Attention
Although many electrical stimulation burns appear superficial, all electrical injuries carry the risk of deeper, unseen tissue damage to muscles, nerves, or blood vessels. A professional evaluation is prudent, even if the surface burn appears minor. Determining the burn depth is a factor in deciding medical care, as burns are classified by the layers of skin affected.
First-degree burns cause redness and mild pain without blistering, affecting only the epidermis, and are often managed at home. Second-degree (partial thickness) burns involve blistering, significant pain, and redness, damaging the epidermis and part of the dermis. Third-degree (full thickness) burns destroy all skin layers, potentially appearing white, charred, or leathery, and may be numb due to nerve destruction.
Seek immediate medical attention if the burn is larger than the injured person’s palm (roughly one percent of the total body surface area). Emergency care is also necessary for any burn on sensitive areas, which are at higher risk for functional impairment and scarring:
- The face
- The hands
- The feet
- The genitals
- Over a major joint
Systemic symptoms also indicate a serious injury, regardless of the surface appearance. Seek immediate medical attention if there are signs of shock, such as cold, clammy skin, a weak pulse, or shallow breathing. Other red flags include numbness, tingling, or weakness in the affected limb, suggesting damage to underlying nerves or muscle tissue. If the person experiences confusion, difficulty breathing, or an irregular heart rhythm, contact emergency services immediately.
Clinical Treatment and Long-Term Healing
Upon arrival at a medical facility, clinical treatment begins with a professional assessment to determine the burn’s depth and extent. The healthcare provider examines the wound and may order tests, such as blood work or imaging scans, to check for internal injury or muscle damage. This initial evaluation dictates the subsequent course of action, ranging from simple wound care to surgical procedures.
For less severe burns, treatment includes applying specialized medical dressings, often with antimicrobial agents like silver sulfadiazine, to prevent infection and promote healing. If dead tissue (eschar) is present, debridement may be performed to surgically remove it, allowing healthy tissue to regenerate. Extensive full-thickness burns may require surgical excision and skin grafting for wound closure and functional recovery.
Long-term care focuses on monitoring the wound for infection and managing potential scarring. Signs of infection include:
- Increasing redness extending from the wound
- Warmth
- Swelling
- Pus-like drainage
- A persistent fever
Patients are instructed on proper dressing changes and wound hygiene to minimize bacterial contamination.
Scar management is important, especially for deeper burns. This may involve using pressure garments, silicone sheets, or massage therapy to flatten and soften developing scar tissue. Follow-up appointments with burn specialists or physical therapists monitor healing progress, ensure full range of motion, and address long-term cosmetic or functional concerns.