How to Treat a Burn

When it comes to treating a burn, what you do will depend on how serious of a burn you have suffered. Most minor burns — they are called either first-degree or superficial burns — will heal on their own.

“Treatment is easy because there is no major treatment,” says Dr. James P. Phillips, a physician in the Department of Emergency Medicine at Beth Israel Deaconess Medical Center.

Such burns are typically caused by exposure to the sun or a tanning bed, scalding water, or a brief a gasoline vapor flash. These types of burns are painful and result in reddening of the skin, but no blisters, according to Dr. Phillips.

Running cool water over the burn or covering it with a cool compress can help with the pain. However, very cold water or ice should not be used.

A gauze dressing may be applied to prevent contact with the burned area and over-the-counter pain relievers, such as Tylenol or Ibuprofen, may be taken for pain. A topical lotion such as aloe vera or bacitracin may also be applied to provide comfort.

Dr. Phillips derides the old household remedy of using butter on the burn. He says that is of no use in helping the burn to heal and could cause problems, such as infection, if the burn were to be deeper than suspected. If the burn results in blisters or weeping, it is likely a second-degree or partial-thickness burn.

“I would not recommend any organic household remedies such as butter or honey,” he says.

Such second-degree or partial thickness burns should be seen by a physician, Dr. Phillips adds, especially if the burn covers an area the size of, or greater than, the palm of your hand.

There is debate over whether blisters should be popped, but “we recommend that patients do not pop burn blisters themselves,” he says. That decision should be left up to a physician. If the burn is bad enough, a physician may perform debridement or remove any dead tissue and cover the area with a dressing.

If there is blistering, Dr. Phillips says people should cool the area by running it under tap water briefly before going to see a doctor or heading to the emergency room. You may cover the area with cool, water-moistened gauze or towels, but do not apply any dressings like paper towels or tissue paper to open or blistered areas.

A third-degree, or full-thickness, burn is one that penetrates the skin and goes deep into subcutaneous tissues. The skin may look gray or white and feel firm. There will be no lasting pain because the burn has killed the nerves in the area. Such burns must be seen by a physician right away as they likely will need surgical treatment.

Third-degree burns result from prolonged exposure to high heat from fire, scalding liquid, electricity or chemicals. While the area of the third-degree burn may no longer be painful, there are likely to be first- and second-degree burns in the area as well, and those will remain painful.

The entire area may be rinsed with cool water before heading to the doctor or emergency room. While first- or mild second-degree burns may or may not need to be seen in the emergency room, there are exceptions, Dr. Phillips notes.

"Pediatric and elderly patients, as well as those with conditions, such as diabetes, that result in difficulty getting wounds to heal, should always been seen by a doctor," he says.

Posted October 2014