Cool the burn under running water for at least 20 minutes. That single step, done as soon as possible, is the most effective thing you can do to limit damage and reduce pain from a burn. Everything else, from dressings to pain relief, comes after those 20 minutes. Here’s what to do from start to finish, and how to tell if you need medical help.
Cool the Burn Immediately
Turn on the tap and hold the burned skin under cool (not cold) running water for a full 20 minutes. This sounds like a long time, and most people stop too early. The water isn’t just soothing the surface. Heat continues traveling deeper into your skin even after you’ve pulled away from the source, and 20 minutes of cooling limits how far that damage spreads.
A few things to avoid during this step:
- Ice or ice water. These are too harsh and can further injure already damaged skin.
- Butter, toothpaste, or cooking oil. Greasy substances trap heat against the skin, slowing its release and actually making the burn worse.
- Popping blisters. Intact blisters act as a natural sterile bandage. Breaking them opens the door to infection.
If the burn is on your hand or arm, remove rings, watches, or tight clothing near the area before swelling starts. Once swelling sets in, these can cut off circulation and become very difficult to remove.
How to Tell How Serious Your Burn Is
Burns fall into three categories based on how deep the damage goes, and the depth determines whether you can treat it at home or need professional care.
A first-degree burn affects only the outermost layer of skin. It looks red, feels painful to the touch, and may cause mild swelling, but there are no blisters. A sunburn is the most common example. These heal on their own within a few days to a week.
A second-degree burn goes deeper. You’ll see blisters, the skin may look wet or glossy, and the pain is typically more intense. On average, second-degree burns take one to three weeks to heal. As the skin repairs itself, you’ll notice peeling and flaking at the burn site, which is normal.
A third-degree burn destroys the full thickness of the skin. The area may appear white, brown, or charred, and it can feel surprisingly numb because the nerve endings are damaged. Third-degree burns always require medical treatment.
When You Need Emergency Care
Small first-degree burns and minor second-degree burns (a splash of hot water on your forearm, for instance) can usually be managed at home. But certain burns need professional treatment right away. The American Burn Association recommends immediate medical consultation for:
- Any burn that goes through the full thickness of the skin (third-degree)
- Second-degree burns covering 10% or more of the body (roughly the area of one arm, or one leg from the knee down)
- Burns on the face, hands, feet, genitals, or over joints regardless of size
- Burns with poorly controlled pain that over-the-counter medication can’t manage
- Burns combined with other injuries, such as from a car accident or fall
Children under 10 and adults over 50 have thinner skin and a harder time healing, so the threshold for seeking medical care is lower in those age groups.
Covering and Protecting the Burn
After cooling, gently pat the area dry and cover it with a non-stick dressing. Regular gauze on its own is a poor choice because it sticks to the wound and causes significant pain when you peel it off. Look for non-stick wound pads or fine mesh gauze at any pharmacy.
Second-degree burns tend to ooze a fair amount of fluid as they heal, which is normal. If you’re dealing with a weepy burn, foam-type wound dressings absorb excess moisture and are more comfortable than thin gauze. Change dressings once a day or whenever they become wet or dirty. Each time you change the dressing, gently clean the area with cool water and reapply a thin layer of petroleum jelly or an antimicrobial ointment to keep the wound moist. Keeping a burn moist promotes faster healing and reduces scarring compared to letting it dry out and scab over.
Managing Pain at Home
Burns hurt, sometimes intensely, especially in the first 48 hours. Over-the-counter options like ibuprofen, naproxen, or acetaminophen all work for mild to moderate burn pain. Ibuprofen and naproxen also reduce inflammation, which can help with swelling. Follow the dosing instructions on the package.
Cool (not cold) compresses applied over the dressing can provide additional relief between doses. Elevating the burned area above heart level, when practical, also helps reduce throbbing and swelling.
Watching for Infection
Burned skin has lost its primary barrier against bacteria, so infection is the main complication to watch for during healing. Check the burn daily when you change the dressing. Signs that suggest infection include:
- Increasing redness or red streaks spreading away from the burn
- Pus or cloudy, foul-smelling drainage
- Worsening pain after the first couple of days, rather than gradual improvement
- Fever
If you notice any of these, get the burn evaluated. Oral antibiotics may be needed, but they aren’t used preventively for clean, minor burns.
Tetanus and Burns
Most people don’t think of burns as a tetanus risk, but the CDC classifies burns as “dirty or major wounds” because the damaged tissue creates an environment where tetanus bacteria can thrive. If your last tetanus shot was five or more years ago, or if you’re not sure of your vaccination history, a booster is recommended after a burn injury. If you’ve had a tetanus shot within the past five years and completed the full primary series, no additional dose is needed.
What to Expect as It Heals
First-degree burns typically resolve within a week. The redness fades, the skin may peel lightly (similar to a peeling sunburn), and no scarring occurs.
Second-degree burns follow a longer course of one to three weeks. During the middle phase of healing, you’ll notice the skin peeling and flaking as dead cells shed. Itching is common and can be intense, which is actually a sign that new skin is forming underneath. Resist the urge to scratch, as this can reopen the wound. A fragrance-free moisturizer applied after the wound has fully closed helps with both itching and tightness. Some second-degree burns leave behind discolored skin that gradually fades over months, and deeper ones can produce mild scarring.
Protect healed burn skin from sun exposure for at least a year. New skin is far more sensitive to UV damage and will burn or discolor easily. Use sunscreen with SPF 30 or higher, or keep the area covered with clothing when you’re outdoors.