A burn is tissue damage caused by heat, chemicals, electricity, or radiation. The correct immediate response is vital to limiting the injury’s depth and severity. Heat energy continues to damage underlying tissue even after the source is removed. This ongoing cellular destruction makes the first few minutes after a burn the most important period for intervention. A common instinct is to apply ice, but this practice is a misconception that can worsen the injury.
Why Ice Damages Burned Tissue
Applying ice or ice-cold water to a fresh burn causes damage to the already compromised skin layers. Extreme cold triggers vasoconstriction, causing small blood vessels in the affected area to narrow. This reduction in blood flow prevents the delivery of necessary immune cells and oxygen required for the initial stages of healing. Restricting circulation traps residual heat deeper within the tissue, slowing cooling and potentially deepening the burn.
The severe temperature drop also risks causing a secondary injury, sometimes called a “cold burn” or localized frostbite, on the damaged skin. If ice is applied to a burn covering a large area, there is a risk of inducing systemic hypothermia, particularly in vulnerable populations like young children.
The Recommended Immediate Treatment
The correct first aid action is to immediately cool the burn with cool, not cold or icy, running water for a sustained period. The burn should be held under the stream for at least 10 to 20 minutes to draw the heat away from the wound and prevent the injury from progressing. Running water is superior to soaking the burn because it constantly removes the warmed water, creating a continuous “heat sink” that cools the tissue gently.
After the initial cooling phase, the burn should be gently covered to protect it from infection and reduce pain. A sterile, non-fluffy dressing or a layer of clean cling film is recommended. The film should be placed over the burn rather than wrapped tightly around a limb, which allows for potential swelling. Avoid common household remedies such as butter, oils, toothpaste, or creams, as these can trap heat in the skin and increase the risk of infection.
Assessing Burn Severity and Seeking Care
Burns are categorized by the depth of tissue damage, which determines the necessary medical response. A superficial burn (1st-degree) affects only the outer layer of skin and appears red with minor pain. Partial thickness burns (2nd-degree) are more serious, involving the layer beneath the surface, and typically cause blisters, significant pain, and swelling.
Immediate emergency medical attention is necessary for any full thickness burn (3rd-degree), which may appear white, leathery, or charred and might be surprisingly painless due to nerve damage. Professional care is also required if a burn is larger than the size of the injured person’s palm, regardless of its depth. Burns located on sensitive areas such as the face, hands, feet, joints, or genitals should always be evaluated by a healthcare professional. All chemical and electrical burns require immediate emergency medical care due to the potential for deep tissue damage that is not immediately visible.