Burns and Scalds

First aid for burns and scalds

• Cool the burnt area immediately with cool water (preferably running water) for at least 20 minutes. For example, put the burnt area under a running tap. A shower or bath is useful for larger areas. Note: do not use very cold water or ice.
• Remove rings, bracelets, watches, etc, from the affected area. These may cause tightness or constriction if any swelling occurs.
• After cooling, remove clothing from the burnt area. However, do not try to pull off clothing that has stuck to the skin. This may cause damage.
• A cold compress such as a tea towel soaked in cold water may be soothing over the burnt area. You can apply this after the initial cooling under cool water.
• Before going to hospital or to a doctors surgery, cover the burn with cling film or a clean plastic bag and leave it on until seen by a doctor or nurse. Apply cling film in layers rather than round like a bandage to prevent it causing pressure if the burnt area swells.
• Paracetamol or ibuprofen may help to ease pain for small burns.

Do not do the following:

• Prick any blisters.
• Apply creams, ointments, oils, grease, etc. (The exception is for mild sunburn. A moisturiser cream or calamine lotion may help to soothe this.)
• Put on an adhesive, sticky, or fluffy dressing.

Types of burn

• Superficial burns affect the top layer of skin only. The skin looks red and is mildly painful. The top layer of skin may peel a day or so after the burn, but the underlying skin is healthy. It does not usually blister or scar. A good example is mild sunburn.
• Partial thickness burns cause deeper damage. The skin forms blisters and is painful. However, some of the deeper layer of skin (the dermis) is unharmed. This means the skin can usually heal well, sometimes without scarring if the burn is not too deep or extensive.
• Full thickness burns damage all layers of skin. The skin is white or charred black. There may be little or no pain as the nerve endings are destroyed. These often require skin grafting.
• Electrical burns can cause damage inside the body even if there is little damage to the skin.

See a doctor or nurse if you are unsure about what to do after a burn. However, you may be happy to manage small, mild (superficial) burns at home. Mild sunburn, small mild burns, or mild scalds are best left uncovered. They will heal quicker if left to the fresh air. Even a small blister is best left uncovered to heal. If the blister bursts, you can use a dry, non-adhesive, non-fluffy sterile dressing. This will soak up the weeping blister, and stop dirt and germs getting into the wound. However:

• The burn becomes infected. Infection causes a spreading redness from the burn which becomes more painful.
• You are not up to date with tetanus immunisation.
• Blisters occur. You may be happy to deal with a small burn with a small blister. However, a blister means a partial thickness burn, and it may be best to see a doctor or nurse.

• Electrical burns.
• Full thickness burns, even small ones. These are burns that cause white or charred skin.
• Partial thickness burns on the face, hands, arms, feet, legs, or genitals. These are burns that cause blisters.
• Any burn that is larger than the size of the hand of the person affected.
• Cover the burn with cling film or a clean plastic bag before going to casualty.

Common causes of burns

Nearly half of severe burns and scalds occur in children under five years. About half of these accidents to children happen in the kitchen, with scalds from hot liquids being the most common. Many accidents involve the child reaching up and pulling on a mug or cup of hot drink. Other common causes include children falling or climbing into a bath of very hot water, and accidents with kettles, teapots, coffee-pots, pans, irons, cookers, fires and heaters.

Preventing scalds and burns

• Keep young children out of the kitchen unless they are fully supervised.
• The front of the oven, and even the washing machine, can become hot enough to burn a young child. Keep them away.
• Use the back rings of cookers when possible. Turn pan handles towards the back and away from where a child may reach and grab.
• Never drink hot drinks with a baby or child in your lap.
• Never let a child drink a hot drink through a straw.
• Teach older children how to boil kettles and how to use the cooker safely. There is no right age for this. Every child is different. However, it is important to teach them correctly when the time is right rather than let them experiment and find out for themselves.
• Never heat up a baby's milk in a microwave. It may heat the milk unevenly, and some parts may become very hot. Stir baby food well if it is heated in a microwave.
• Put cold water in the bath or sink first, and then bring up the temperature with hot water.
• Do not set the thermostat for hot water too high in case children turn on the hot tap.

Preventing fires

• Fit smoke alarms in every floor of the home and check them regularly.
• Use fireguards for fires and heaters. Do not dry or air clothes on fireguards.
• Shut all doors at night. This prevents any fire from spreading.
• Store matches away from children. Teach older children how to use matches correctly and safely. Do not just let them experiment and find out for themselves.
• Have a fire blanket in the kitchen.
• Do not leave chip pans unattended, and they should never be more than a third full with oil.

• Keep children out of hot sun, particularly between 11am and 3pm.
• When out in the sun remember: Slip, Slap, Slop - slip on a shirt, slap on a hat, and slop on some high protection sunscreen.

© EMIS and PIP 2006   Updated: June 2006   PRODIGY Validated

The authors and editors of this article are employed to create accurate and up to date content reflecting reliable research evidence, guidance and best clinical practice. They are free from any commercial conflicts of interest.

Find out more about updating.