The immediate reaction to a burn is often to reach for ice, believing that extreme cold will quickly counteract the heat and stop the pain. A burn is tissue damage caused by heat, electricity, chemicals, or friction. While the instinct to cool the injury is correct, applying ice or ice water is a dangerous mistake that can worsen the initial injury. This measure introduces a new, serious threat to the already compromised tissue.
The Risk of Causing Further Tissue Damage
Applying ice or very cold water to a burn is counterproductive because it causes rapid narrowing of the blood vessels, a process known as vasoconstriction. This reduction immediately decreases blood flow to the injured area. Adequate blood flow is necessary to deliver oxygen and nutrients vital for tissue survival and to remove cellular waste.
By constricting the blood vessels, ice deprives the damaged tissue of the circulation needed to heal and prevent cell death. Furthermore, the extreme cold can cause a secondary injury, such as frostnip, on top of the thermal burn. Since the burn has already damaged nerve endings, the victim may not feel that the ice is making the skin too cold, leading to compounded damage. This combination of thermal and cold injury can deepen the wound, potentially turning a less severe burn into a complex injury.
The Correct Immediate First Aid
The safest first aid for a burn is to use cool, not freezing, running water. The goal is to gently reduce the skin’s temperature and stop the burning process without causing the damaging vasoconstriction that ice induces. The injured area should be held under cool or lukewarm running water for at least 10 to 20 minutes immediately after the injury.
This sustained cooling minimizes swelling and reduces pain effectively. After the burn has been thoroughly cooled, cover it loosely with a clean, non-fluffy dressing, such as plastic cling film. This covering protects the wound from infection and prevents air from reaching exposed nerve endings, which dramatically reduces pain.
Identifying When a Burn Requires Medical Attention
Not all burns can be treated at home, so assessing the severity is important after initial cooling. Superficial (first-degree) burns affect only the outer layer of skin (epidermis), resulting in redness and pain, much like a mild sunburn. Partial thickness (second-degree) burns extend deeper into the second layer (dermis), characterized by intense pain and blisters. Full thickness (third-degree) burns damage all layers and sometimes underlying tissue, often appearing white, charred, or leathery. These may surprisingly cause little pain due to nerve damage.
Immediate medical attention is required for any third-degree burn, regardless of size. Professional help is also necessary for second-degree burns larger than the patient’s palm. Burns located on sensitive areas, such as the face, hands, feet, genitals, or over a major joint, warrant an emergency room visit. These locations have a higher risk of complications and may require specialized care to prevent permanent loss of function or scarring.