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Main Line Pediatrics

Are You Sick?

Burn

Is this your symptom?

  • Burns or scalds to the skin
  • A burn can be caused by moist or dry heat, chemicals, electricity, or extreme cold
  • Sunburn and Frostbite are covered in other care guides

Causes of Burns

  • Hot Liquids. Hot liquids (such as coffee) are the most common cause of burns. They cause a scald. Steam acts the same way.
  • Hot Surfaces. Examples are ovens, stoves, space heaters and curling irons.
  • Chemical Burns (serious). Examples are acids or lye splashed on the skin or in the eye. They continue to damage the tissues until they are removed. It is important to keep washing the area until all the chemical is removed. Unless the area is very small, you should call 911. Washing of the area can continue on the way to ER.
  • Electrical Burns (serious). They can be much deeper than they first appear. They can affect the tendons and muscles under the surface of the skin. They can also cause an abnormal heartbeat, so it is best to get checked out at the hospital.
  • Flame Burns (serious). Flammable liquids that ignite cause burns. These are sometimes seen in people trying to start barbecues or light a fire. House fires can also cause flame burns.
  • Friction Burns. Treadmill burns are a common example.
  • Sunburn is not covered here. See the Sunburn care guide.

Degrees of Burns

  • There are 3 layers to the skin:
    • The epidermis is the surface layer.
    • The dermis is the tissue just beneath the surface. It contains blood vessels, nerve endings, sweat glands and hair follicles.
    • The subcutaneous layer sits underneath the dermis and is made up of fat and other tissue.
  • The degree of burn is based upon how deep the burn goes and which layers of skin are affected.
    • 1st degree. Red skin without blisters. The burn affects the epidermis only. These burns often don't need to be seen.
    • 2nd degree. Red skin with blisters. The burn affects the epidermis and part or all of the dermis. These burns are painful. They heal from the bottom up, not from the edges. Takes 2 to 3 weeks. Small closed blisters decrease pain and act as a natural bandage.
    • 3rd degree. Deep burns with white or charred skin. The burn affects all three layers of the skin. There are no blisters. Skin feeling is lost. Heals in from the edges. Grafts are often needed if it is larger than a quarter in size. These are burns larger than 1 inch or 2.5 cm. Skin grafts help limit scarring.

Burn Care and Healing

  • As burns heal, there is a risk of the burn getting infected. It is important to keep the burn clean and dry. Dressings must be changed every 1-2 days at first, then every 3-5 days as they heal.
  • Deep burns, or infected burns, are at higher risk for scarring or loss of function. Always seek medical care for burns in areas that may be hard to keep clean. These areas include: face, hands, arms, feet, legs or genitals.
  • Facial Burns: sleeping or resting in a sitting position will help limit the amount of swelling.

When to Call for Burn

When to Call for Burn

Call 911 Now

  • A painful or painless burn covering a large area of the body
  • Trouble breathing or a painful throat after a burn to the face
  • Trouble breathing or a painful throat after being near fire, smoke or fumes
  • A chemical burn affecting the eyes
  • Hard to wake up; acts or talks confused
  • An electrical burn and you have palpitations, chest pain or feel like you are going to pass out
  • You think you have a life-threatening emergency

Call Doctor or Seek Care Now

  • Burn that causes blisters to the face, eyes or eyelids, hands, arms, feet, legs or genitals
  • Burn goes all the way around an arm or leg
  • Center of the burn is white or charred
  • Electrical or chemical burn
  • Explosion or gun powder caused the burn
  • Coughing or soot in the nostrils after being near fire and smoke
  • House fire burn
  • Blister from burn and no past tetanus shots
  • Severe pain and not better 2 hours after taking pain medicine
  • You think you have a serious burn
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Blister is present. Exception: small, closed blister less than ½ inch (12 mm) in size
  • Minor burn and last tetanus shot more than 5 years ago
  • Burn looks infected (redness, swelling, or tender to the touch)
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Burn not healed after 10 days
  • You have other questions or concerns

Self Care at Home

  • Minor heat or chemical burn
  • Blisters less than ½ inch (12 mm) size

Call 911 Now

  • A painful or painless burn covering a large area of the body
  • Trouble breathing or a painful throat after a burn to the face
  • Trouble breathing or a painful throat after being near fire, smoke or fumes
  • A chemical burn affecting the eyes
  • Hard to wake up; acts or talks confused
  • An electrical burn and you have palpitations, chest pain or feel like you are going to pass out
  • You think you have a life-threatening emergency

Call Doctor or Seek Care Now

  • Burn that causes blisters to the face, eyes or eyelids, hands, arms, feet, legs or genitals
  • Burn goes all the way around an arm or leg
  • Center of the burn is white or charred
  • Electrical or chemical burn
  • Explosion or gun powder caused the burn
  • Coughing or soot in the nostrils after being near fire and smoke
  • House fire burn
  • Blister from burn and no past tetanus shots
  • Severe pain and not better 2 hours after taking pain medicine
  • You think you have a serious burn
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Blister is present. Exception: small, closed blister less than ½ inch (12 mm) in size
  • Minor burn and last tetanus shot more than 5 years ago
  • Burn looks infected (redness, swelling, or tender to the touch)
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Burn not healed after 10 days
  • You have other questions or concerns

Self Care at Home

  • Minor heat or chemical burn
  • Blisters less than ½ inch (12 mm) size

Care Advice

  1. What You Should Know About Burns:
    • Burns can be very painful. They may cause red and peeling skin, blisters, swelling and white or charred skin.
    • The amount of pain is not always a sign of how serious the burn is. Very deep burns may be painless because the nerve endings have been destroyed.
    • Minor burns can be treated at home.
    • This includes some small blisters.
    • Here is some care advice that should help.
  2. Cooling the Burn:
    • Move the person away from the heat source right away to stop the burning.
    • Cool the burn with cool or lukewarm running water for 20 minutes. Do not use ice or put on creams or greasy substances like butter.
    • Remove any clothing that is near the burn, unless it is stuck to the skin.
    • Remove other items of clothing or jewelry further down the limb. They can become tight if swelling of the area occurs.
    • Keep the person warm.
    • For large burns, cover the area with plastic wrap or with a clean plastic bag, but do not wrap tightly around a limb.
    • Do not use dressings which will stick to the burn, such as gauze.
  3. Cold Pack for Pain:
    • For small but painful burns, put a cold wet washcloth on the burn.
    • Repeat as needed.
  4. Pain Medicine:
    • To help with the pain, take an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil). Ibuprofen works well for this type of pain.
    • Use as needed, but do not take more than the maximum recommended dose.
    • If you are not sure what to take, ask a pharmacist.
  5. Clean the Burn:
    • Wash the burn gently with warm water.
    • Do not use soap unless the burn is dirty. Reason: soaps can slow healing.
  6. Closed Blisters - Don't Open:
    • Don't open any small, closed blisters.
    • The outer skin protects the burn from infection.
  7. Antibiotic Ointment for Open Blisters:
    • For any broken blisters, use an antibiotic ointment (such as Polysporin). No prescription is needed.
    • Then cover it with a bandage. Change the dressing every other day.
    • Each time, clean the area. Use warm water and 1 or 2 gentle wipes with a wet washcloth.
  8. What to Expect:
    • Most often, small burns hurt for about 2 days.
    • They will peel like a sunburn in about a week.
    • First- and second-degree burns don't leave scars.
  9. Call Your Doctor If:
    • Severe pain lasts more than 2 hours after taking pain medicine
    • Burn starts to look infected (spreading redness, pus)
    • Burn not healed after 10 days
    • You think you need to be seen
    • Your symptoms get worse

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Copyright 2023 Schmitt Decision Logic, LLC

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