Burn care: Keep it clean and cool and dry

Sometimes what seems like the right thing to do is the worst thing to do. That’s the way it is with burn care. The usual treatment for cuts, scrapes and wounds is antibacterial ointment and a bandage—but that’s not so for burns.

Because the skin is the body’s natural source of protection from infection, burned skin requires special treatment.

Dos and don’ts of burn first aid

Our natural instinct is to slather a burn with an ointment, but that’s the wrong thing to do, said Anna Myers, MD, a pediatrician on the medical staff of Baylor Scott & White McLane Children’s Medical Center. Instead, for minor burns, follow these steps:

1. Wash gently with soap and water.
2. Apply a cool compress, such as wet sterile gauze or a washcloth.
3. Cover the burn with a clean, dry bandage.
4. Take acetaminophen or ibuprofen for the pain, if needed and recommended by your child’s doctor.

Flushing a burn immediately with cool water stops the burning process and lowers the skin temperature, reducing the pain and halting or decreasing swelling that comes with a burn, she said.

And remember: never apply over-the-counter ointment, oils or butter on any burn.

“They trap the heat inside the burn without providing any additional protection against infection,” Dr. Myers said. “You should avoid ointments or creams unless prescribed by a physician.”

Follow-up care

Check the dressing daily, and if the burn seeps, run cool water over it again to clean it and cover it again with a dry bandage.

“If there are blisters, don’t pop them,” Dr. Myers said. “The blisters provide a layer of protection against infection. If the blisters pop on their own, trim them, so they stay clean and continue serving their purpose of natural infection protection.”

Practice burn safety at home

The most frequent causes of burns at home are scalds from fluids and contact burns from everyday household items. Protect yourself and your family from common burn mistakes with the following safety precautions:

To avoid scalding

• Reduce the temperature of your water heater to 125 degrees.
• Let soup and other hot liquids cool before serving.
• Don’t drink hot coffee or tea while holding an infant or small child.
• Never leave food unattended on the stove.
• Take care when frying with hot grease so that it doesn’t spatter.

To avoid contact burns

• Keep curling irons and straighteners unplugged and out of reach of children.
• Turn the handles of pots and pans on the stove inward toward the wall.
• Prohibit play near barbecue grills, fireplaces and fire pits.

How serious is your burn?

It is essential to understand the severity of any burn to ensure you get the help you need. There are three classifications of burns, noted by degrees, said Dr. Myers.

First-degree burns

First-degree burns are marked by reddened skin without blisters and leave no scarring. They will be tender and sore. These outer-layer burns are the least severe and can be treated at home.

Second-degree burns

Second-degree burns, or partial-thickness burns, damage the top two layers of the skin. They will have moist blisters that may ooze. These painful burns may result in scarring and often take weeks to heal.

Third-degree burns

Sometimes called a “full-thickness” injury, third-degree burns are the most serious.  These burns may not hurt right away because of damage to the nerve endings. You may experience severe pain as nerves and tissues regenerate during the healing process.

Third-degree burns, and burns to the face, joints and genitalia, require immediate professional care in an emergency department.

“Any burn you suspect is a third-degree or any large burn needs to be treated right away by professionals,” Dr. Myers said. “You should wrap the burn in a clean sheet and call 911 or go directly to the emergency department.”

Most large burns require hospitalization and sometimes plastic surgery if the damage is extensive or on the hands, feet or face.

If you are unsure if the burn is second or third degree, seek emergency care.

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