Burns: How to Treat Burns

Posted by Dr. Ben Kim on Feb 17, 2007

You can get burned by a number of different sources, the most common of which are hot liquids, hot objects, chemicals, steam, electricity, the sun, and fire.

For diagnostic and treatment purposes, burns are generally categorized into the following three classifications:

First-degree burns

A first-degree burn is the least serious type of burn that you can suffer, and involves only the outermost layer of your skin, called your epidermis.

Your skin will likely be reddened and painful. It can also be swollen.

In general, if a first-degree burn does not cover a significant portion of your body, it can be treated at home.

Second-degree burns

A second-degree burn is one in which the second layer of your skin (called your hypodermis) is also burned. In this type of burn, your skin will be extremely red with a spotted or blotchy appearance, and you will probably have blisters in the area of the burn.

A second-degree burn typically causes severe pain and swelling.

If you suffer a small and localized second-degree burn - no more than a few inches in diameter - you might be able to treat it effectively at home. If the burned region is larger than this, or has occurred on your face, hands, feet, groin, buttocks, or a major joint, it is best to go to your doctor or local hospital for professional care.

Third-degree burns

A third-degree burn involves all layers of your skin, and possibly structures that are below your skin as well. Some areas of a third-degree burn are often charred black. You may experience severe pain, but if a nerve has been damaged by the burn, it is possible that you will feel little to no pain. All third-degree burns require immediate emergency medical care.

How to Treat a Minor Burn at Home

The first step that you should take to treat a minor burn is to hold it under cold, running water for 10 to 15 minutes. If cold, running water is not available, immerse the burn in cold water or cover it with cold compresses. Be sure not to put ice directly against the burn; direct contact with ice can cause frostbite and more damage.
Do not apply butter to the burn. Butter will trap heat in the damaged tissues, which can potentially cause more damage and increase your chance of developing an infection.
Once the burn has cooled via cold water or compress exposure, apply lotion to the area. Lotion may soothe any discomfort that you feel, and will also prevent dryness.
Once the burn is moisturized, cover it with a sterile gauze bandage. Just be sure to wrap the burn loosely to avoid putting too much pressure on the wound.
Sometimes, in order to prevent infection, your body will produce fluid-filled blisters. Do not break these blisters - they will resolve on their own. If they break on their own, you can wash the area with water and plain soap, dry it, then apply an antibiotic ointment and a loosely wrapped sterile gauze bandage. It is fine to trim off dead skin from popped blisters.
If needed, you can use an over-the-counter pain reliever like acetaminophen until the pain is tolerable.

How to Treat Major Burns

For all major burns, seek medical care as soon as possible.
Be sure that the cause of the burn has been eliminated, but do not remove burned clothing that has adhered to your skin.
Until you receive emergency medical treatment, cover the burned region with a dry, sterile bandage or a clean cloth. Use a cotton bed sheet for large areas. Do not use blankets or towels, as both have a tendency to stick to burns.
Do not apply ointments or try to break blisters.

Notes on Treating Chemical Burns

Use cold, running water to completely flush chemicals off your body. If the chemical is a powder, such as lime, use a brush to remove it from the skin before flushing with water.

Be sure to remove any jewelry or clothing that has been in contact with the chemical.

If there continues to be a burning sensation after washing the area with cold water, flush the area for another several minutes with cold, running water.

Wrap the burned region with a clean cloth or a dry, sterile gauze bandage.

If a chemical comes into contact with your eyes, flush your eyes with water immediately. Do not worry about finding sterile water; the most critical objective is to begin flushing as soon as possible. Flush your eyes with water for at least 20 minutes. After washing, close your eyelids and cover them with loose, moist dressings before seeking medical care with someone's assistance.

Notes on Treating Electrical Burns

All electrical burns should be evaluated by a physician for two reasons:

Even though the burn may appear to be a minor one, damage may have occurred deep into the underlying tissues.
Electrical burns can sometimes result in an irregular heart beat.

References:

Littin, Scott C. Mayo Clinic Family Health Book. New York: HarperCollins, 2003

Sanders, Mick J. Mosby's Paramedic Textbook. St. Louis, Missouri: Mosby-Year Book, Inc., 1994

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Comments

burns

Submitted by Jerrie Parkin on February 19, 2007 - 15:35

First I would like to thank you for your very informative news letters. I look forward to, and enjoy reading every one.

Regarding burns, I have found that there are two very fast ways to releive the pain of a burn and heal the skin rapidly. One is to pour liquid chlorophyll over the burn site as soon as posible. This will turn the skin green for a short period and needs to be reapplied two or three times every 5 - 10 minutes or so. The second and my favorite is to clip a leaf from my aloe vera plant and squeeze the juice onto the burn. The pain leaves almost instantly, the skin will not blister and heals very rapidly. On a minor burn, the skin doesn't even turn red. This works very well when I burn the inside of my wrist on a very hot oven rack. Liquid Chlorophyll may be purchased at almost any health food store. An aloe vera plant can be purchased at almost any lawn and garden store. It is very easy to grow and can become a beautiful addition to the rest of your house plants.

Burns

Submitted by Steven Gerth on February 19, 2007 - 16:34

Hi Dr. Kim,
I enjoy receiving your news letters. This one on burns is of interest since I have had some experience with burns. My son got a 3rd degree burn the size of a quarter on his leg when he left a heating pad on it over night. There was a crater left where the skin had been. We went to the Doctor and had it cleaned up and I had some solution to clean it with daily and redress the area. At the time I used the Aloe plant method and would cut a section of a leaf and skin the one side to apply it directly on the wound and taped it onto his leg so that the tape sealed the area and the juice from the leaf would not escape from the dressing.
This took some month or more to effect the healing of this wound but it worked.

Since then I have had the occassional burn and I now use Noni. On a first degree burn I will apply a few drops of Noni Juice and the pain of the burn goes away with-in a few minutes and does not return. Repeated application of the Noni Juice also helps the burn to heal rapidly. Much faster than the Aloe plant. I have also found that the Noni Juice works to relieve the itching from bug bites since it has a natural antihitimine in it. When I had a sun burn I also used the Noni and got rapid relief.

Thanks

Steven Gerth

Noni and sunburns/sun reaction

Submitted by Ed Ponist on April 10, 2008 - 20:13

Recently, my wife and I visited Rarotonga in the Cook Islands. We were very careful with sun exposure. Despite this caution, my wife Laurel developed a sun reaction on her arms. A local person applied Noni fruit on Laurel's arms and the sun reaction, burning and bumps vanished in two hours. We picked up Noni cream at the market on Saturday and it was very effective. The fruit itself is very powerful. Noni is quite an amazing fruit and has many other uses as well.

Burn from heating pad

Submitted by Amanda on April 8, 2014 - 09:42

Hi Steven I came across your post when I was looking up ways to treat a burn from a heating pad. Unfourtantly instead of leaving one on my leg like your son had done I fell asleep with one on my chest and received a serious burn from it. To me it looks like a second degree burn and it feels and looks terrible. If you don't mind me asking does your son have a scar from his burn? I'm using the same method like you used for your son I've been applying aloe Vera on my burn two times every other day and the redness and pain has gone down, but it has left this hideous scar on my chest and I was wondering if you would know how to reduce the appearance of a burn scar?

Third degree burn..

Submitted by Corwynn Valencia on April 25, 2016 - 11:17

Hi Steven,, my name is corwynn,, and I am 20 years old and do not use drugs or drink or smoke.. I don't have any diseases or anything of that sort.. Your son's burn is vary alike to mine..

I have a third degree burn exactly the same size as a quarter on my right ankle from a four wheeler tire.. I got my leg stuck in between the foot peg and the tire,, and so the friction burned my ankle.. Again it is the size of a quarter (25 cent piece).. My family thinks I should have a skin graft done on it but I am terrified of the thought of surgery.. I did go to the hospital and they gave me supplies to dress it and antibiotic ointment cream to prevent infection and to promote healing for it.. I know you don't know me at all but in your personal opinion,, should I go threw with the skin graft surgery and will it heal on its own with the supplies the hospital gave me..

Thank you in advance..
Corwynn

burns

Submitted by Gail on February 19, 2007 - 16:58

Re: using antibiotic ointment
recently I used Neosporin on a large rosethorn scratch. I developed itching and redness for weeks as it caused allergic skin reaction. It turns out a large percentage of people are allergic to one of the 3 antibiotics in the ointment. You might wish to warn people away from Neosporin.

Herbal ointments are the best

Submitted by pantea on March 1, 2007 - 00:28

Herbal ointments are the best kind to utilize in case of burn, cut or such. I have found calendula gel or crean to be very helpful. For cleasing, witch hazel is great.
The pharmecuetical brand ointments are harmful and will create sensitivity to skin if not more. Further more, it will delay the process of healing, even making it worse.
Funny thing about it though, is that in some individuals, it helps for few times.....as we are all different. But over all it is harmful rater than helpful.

Something else not to use on burns

Submitted by Dianne Sahakian on February 19, 2007 - 17:53

Another thing NEVER to use on burns of any type of burn is Vaseline (petroleum jelly) as it will make any burns much worse. Never use any kind of oil either. Any kind of burn your not sure of it would be best to go to the nearest hospital emergency room. Learned by experience.

I suffered a blistery burn

Submitted by Anonymous on June 19, 2013 - 18:35

I suffered a blistery burn from my steristrips after surgery. It was way worse than recovering from my procedure. The dr. told me to use an ointment on it. But that made it worse. Then I tried a mild silver colloidal first aid gel and it took all the itching and discomfort away. Even the OTC allergy gel didn't work very well. Once the blisters are gone, I'll probably switch to the emu oil to help with scarring.

re treating burns

Submitted by beryl vangou on February 21, 2007 - 06:43

I was surprised that no-one has mentioned treating small burns with honey. Whenever I have had a burn from the stove, etc. I have immediately dabbed honey on the burn and in no time the stinging stopped and healing began. Honey has been known as being used in Egypt at the time the pyramids were being built and grains and other seeds etc. covered in honey at the time have remained in a perfect state up until recent times when discovered.

THANKS A LOT!!

Submitted by marija magdalena on May 11, 2010 - 00:26

Thanks for the advice for using honey... it helps a lot.All other advices were about using Aloe vera.. wich I couldn't find at midnight and I didn't have it at home. But the honey helped me and I have no pain any more... its true.. there is a magic in it!:) Thanks again..

Honey treatment for burns and other wounds

Submitted by Keith Taylor on January 7, 2013 - 22:33

http://www.wikihow.com/Treat-a-Burn-Using-Honey

Chemical Burn from Glycolic Acid

Submitted by Staya on February 26, 2007 - 16:46

A few days ago, I applied 40% glycolic acid to my skin for a peel.
Unfortuanately the instructions didn't specify to ONLY apply to the skin for 30 seconds, and then rinse off.

I applied for about 6 minutes. After 30 seconds the acid was making my nose red, and I applied liquid soap (as recommended in the instructions) to slow down the burn. I also neutralized the acid with a weak baking soda and water solution as recommended. However, the damage had already been done.

After completing my facial, I looked in the mirror and realized I ended up with some burns on my nose and a spot on my cheeks to my horror. My skin got more sensitive as the night went on and had difficulty with the burning sensation that occured for a full 18 hours. I woke up a few times and applied cold compresses, and even an ice cube. I also harvested leaves from my aloe plant and taped them to my face. The next morning, horrified at the burning sensation, I went to the acid pros from the essential day spa skin care board.

The guidance from one of the memebers who was a consultant, was to apply emu oil first and then aloe vera gel every hour, and not to apply anything else to the skin, including makeup etc.

Users reported that the scabs fell off and no scar resulted. My skin is olive toned and every pimple stains my skin. However, this morning one of the 2 cheeck scars fell off (and I've been doing the emu oil and aloe vera gel every hour for 2 days). NO SCARRING! The skin was slightly pink but no inflammation.

I'd say emu oil is an exception to the oil guidance.

Semi Icy Water Saved My Hand

Submitted by L Reyna on August 17, 2007 - 20:21

Yesterday afternoon I took the cap off my car’s radiator and 2 seconds later boiling hot water shot out of the radiator completely engulfing my left hand. I was in instant agony. Fortunately, my wife was able to get a large enough bowl of water filled with SOME (not a lot) ice and I kept my hand submerged in the semi icy water. The icy water kept me from going crazy with pain and soothed the searing heat. We then drove immediately to the Emergency Room, and all the while I kept putting more ice in the bowl. The icy water didn’t stop all the pain but it sure did keep it from getting worse. As soon as I was seen all the doctors and nurses wanted me to keep my hand out of the icy water! They wanted to put some burn cream on my hand, which I found out only prevents infection, and wrap it in gauze. Every time I tried to do this the pain came screaming back and I could see water blisters starting to form. So they gave me a big shot of Morphine but that didn’t even touch the pain. The only thing that worked was the semi icy water. Finally I let them apply the cream and wrap it but within seconds the pain became overwhelming. So I took off the bandage and put my hand back into the icy water and left the Emergency Room. From 4pm yesterday afternoon till 10- pm last night I kept it in icy water. I then took my hand out quickly dried it and then smeared a thick coat of Desitin (diaper rash cream that has 40% Zinc Oxide) all over my hand. Zinc Oxide is known to help sooth minor burns! So I then put my hand back in the semi icy water until 3 am when the pain in my hand finally subsided. To my joy I formed no blisters!!!!! The skin on my hand feels really tight because it has swelled some put that’s it!!!!! I think Doctor should study why this worked better than smearing antibiotic cream and gauze on my hand. Ice is used to keep swelling down, and I know that the semi icy water kept my burn from getting much worse. Can anyone tell me why the Doctors and nurses were so hell bent against using semi icy water? I had no brken skin or charred skin. And even if I did i could have used icy water with a teaspoon of bleach to kill any bacteria and prevent infection?! It seemd the Doctors and Nurses were actually clueless about the benefits of using the icy water! WHY!!! And why would they be soooooo CRUEL and let me and others suffer?

Because the ice water keeps

Submitted by Lily on June 20, 2008 - 06:53

Because the ice water keeps the burn inside the skin, so the pain lasts longer. Best method is just cool water or cold water. I'm guessing because you left it in cold water with ice that the pain lasted longer than it should've.

The reason that you're

Submitted by Rachel on June 24, 2009 - 23:15

The reason that you're discouraged from putting ice or icy water on a burn is that extreme cold can cause tissue damage (similar to frostbite) in addition to the burn, and also that in the case of more severe burns where shock is an issue the cold can make the shock worse. It may have made your hand *feel* better than the antibiotic cream, but the purpose of the antibiotic cream was to prevent infection, not reduce the pain. Some kind of anti-inflammatory, like Advil is usually the best for pain relief.

So, while ice or icy water is a bad idea, cool water is actually an excellent idea and is usually recommended.

raw honey for burns

Submitted by darla flores on May 10, 2010 - 22:36

I just placed my hand on the burner and my skin on my 4 fingers turned white. .I put my hand in cold water immediately it made it feel better and i looked in the freezer for a icepak. there was just popcicles. i used them up and it hurt after i took it offf. i have raw honey with the comb and i put that on. i didnt take effect immedietaly, but now the pain is gone and i have the honey on there and it really works.if u dont believe me. try it!

The honey is great

Submitted by Thankful on February 11, 2011 - 11:27

The honey is great. I also applied a cold wet tea towel to the arm (above the burn on the hand). Maybe it slowed blood flow or focused my attention from the oil burns on the hand).
Thanks to all of you for your input. It was very valuable.

Heating Pad 3rd Degree Burn/Surgery !

Submitted by kathy on February 28, 2011 - 00:34

My sister accidentally went to sleep on her heating pad which was on high. It was between her outer thigh and the sofa. The heat had no where to escape except into her leg. After a week of swelling, she went to the doctor and told him what happened. He told her that the infection from her toothache traveled to her leg, as heat does that, and it caused the infection. He gave her a prescription and sent her home. Well, 6 days later it was really bad, went to hospital emergency, was immediately admitted for 2 days, doctor took needle and sucked out most of the 'stuff' but not all of it, sent her home with more pills. The first doctor totally misdiagnosed her. Another week goes by, really bad now, and was in hospital for 3 days, saw a surgeon and he could not believe that the doctor from the previous week did not call in a surgeon to do surgery on her leg. He did surgery on her the next morning. Now there is a big hole in her leg that is healing, but there may be other parts of her leg with dead flesh inside that will probably need surgery again this week. DO NOT take the word of the first doctor. See another one and MAKE SURE you see a surgeon if you are burned and are "swelling". DON'T WAIT !! This is so very stressful. We are praying for everything to be ok with her.

bleach?!! your burned skin is

Submitted by Anonymous on June 28, 2011 - 03:24

bleach?!! your burned skin is so sensitive - be careful! and maybe ask the doctors why they are "hell-bent" against something that you feel is right next time you are in the hospital. they probably would have given you the answer (cannot prevent healing circulation or risk freezing sensitive dying skin).

Very cold water helped my burn

Submitted by Surplus_Profiterole on June 25, 2013 - 22:05

I burned a couple of fingers and submerging them in very cold water in a bowl was the only way I could cope with the pain. I found after twenty minutes or so that the water had warmed from the body heat in my fingers and so I had to replace it with cold again (and again) - so maybe your ice cubes were doing the job of maintaining the coldness of your water? I think the original poster meant do not use an ice cube directly on a burn.

Why on earth would you put

Submitted by Anonymous on August 1, 2013 - 14:14

Why on earth would you put bleach in water where you may have an open wound? Seems to me that you need some education before you bash medical professionals.

oven burns

Submitted by Teresa on October 31, 2016 - 19:35

I have gotten burnt on my elbow on the inner part of my arm. I have had a few days and it still hurts bad. What can I do.

Oven Burn

Submitted by Colleen on November 1, 2016 - 03:31

Hi Teresa,

For a minor burn, you can follow the recommendations above. Burns can still hurt for a few days after they have initially happened. If you feel this is a more major burn than first degree or a small second degree burn, please seek medical attention.

Sincerely,
Colleen
Client Care Manager