Many people instinctively reach for ice when they suffer a burn, believing it will soothe the pain and prevent further damage. This common reaction, however, can actually worsen the injury and complicate the healing process. Understanding why ice is detrimental and knowing the correct first aid steps is important for effective burn care.
The Science Behind Burn Injuries
A burn is tissue damage from exposure to heat, chemicals, electricity, or radiation. When skin tissue encounters a harmful source, cells are damaged, and the body initiates an inflammatory response. This response releases mediators like histamine, increasing blood vessel permeability. This causes fluid to leak into surrounding tissues, leading to swelling (edema).
The immediate aftermath of a burn can also involve fluid shifts from the intravascular space into the interstitial space, potentially leading to a decrease in circulating blood volume. Severe burns can trigger a systemic inflammatory response affecting multiple organ systems, with changes in metabolism that can persist for years after the injury. The extent of tissue damage and the body’s response are directly proportional to the burn’s size and depth.
Why Ice is Harmful for Burns
Applying ice to a burn causes vasoconstriction, narrowing blood vessels. This constriction reduces blood flow to injured tissue, potentially extending damage and delaying healing. When cells are deprived of blood and oxygen, they can suffer further injury or even die.
Using ice also carries the risk of inducing hypothermia, a dangerous drop in core body temperature, especially with larger burns or in vulnerable populations like infants and the elderly. Direct contact with ice can cause additional cold-related injury, such as frostbite. This secondary damage complicates treatment and prolongs recovery. While ice may temporarily numb the area, it can mask the true severity of the burn, making accurate assessment difficult.
Effective First Aid for Burns
For minor burns, cool the affected area with cool, running water. Hold the burn under cool, not cold, running water for 10 to 20 minutes. This dissipates thermal energy, stabilizes blood vessels, and reduces pro-inflammatory chemicals, minimizing tissue damage and providing pain relief. This cooling is most effective if performed within 20 minutes of the injury.
After cooling, gently remove any rings, watches, or tight clothing from the burned area before swelling begins. Then, loosely cover it with a clean, non-stick dressing or sterile gauze to protect from infection. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can be taken to manage pain if needed.
Knowing When to Seek Professional Care
Determining when a burn requires medical attention is important. Seek immediate medical care for deep burns, those with dry, leathery, charred, white, brown, or black skin. Burns over 3 inches (8 centimeters) in diameter, or those covering sensitive areas like hands, feet, face, groin, buttocks, or major joints, also need professional assessment.
Medical attention is necessary for chemical or electrical burns, as these can cause internal damage not immediately visible. Signs of infection, such as increased redness, swelling, warmth, pus, or fever, indicate a doctor’s visit. Additionally, infants, older adults, or individuals with underlying medical conditions like diabetes should seek medical advice for even minor burns due to increased complication risk.