How to Treat a Burn With First Aid Steps

Understanding Burn Severity and Types

Burns are classified into three main degrees based on how deeply they damage the skin and underlying tissue. Understanding which type of burn you're dealing with helps determine the right treatment approach. According to the American Burn Association, approximately 486,000 people seek medical care for burns each year in the United States, with most being minor burns that people treat at home.

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First-degree burns affect only the outer layer of skin, called the epidermis. These burns appear red and may feel slightly swollen and painful, similar to a typical sunburn. The skin usually returns to normal within a few days without scarring. Second-degree burns, also called partial-thickness burns, extend into the layer beneath the skin called the dermis. These burns cause blistering, severe redness, and significant pain. The affected area may appear wet or shiny. Second-degree burns take longer to heal, typically 2-3 weeks, and may result in scarring. Third-degree burns, the most severe type, penetrate through all layers of skin and into the tissue below. These burns appear white, charred, or leathery and may not hurt as much because nerve endings are damaged. Third-degree burns always require professional medical treatment and often result in permanent scarring.

Burns can also be categorized by their cause: thermal burns from fire, hot liquids, or steam; chemical burns from contact with corrosive substances; electrical burns from contact with electrical current; and friction burns from contact with rough surfaces. Each type may require specific treatment considerations.

Practical Takeaway: Before treating any burn, assess how deep and extensive it is. If you can see charring, blistering that covers a large area, or the burn is on the face, hands, feet, joints, or genitals, seek medical care rather than treating it yourself.

Immediate Steps for Cooling and Stopping the Burn

The first few minutes after a burn occurs are critical. Your immediate goal is to stop the burning process and reduce pain. The most important action is to cool the burned area with cool (not cold) running water. This should be done as soon as possible after the injury. According to burn specialists, cooling the area within three minutes of injury can significantly reduce the depth of the burn and improve healing outcomes. Run cool water over the burn for 10-20 minutes, or until the pain decreases noticeably. The water should feel cool to the touch but not painfully cold, as ice can actually damage tissue further.

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If the burn is from a chemical substance, rinse with water for at least 15-20 minutes to dilute and remove the chemical. For dry chemicals, brush off any powder or particles before rinsing, as adding water to some dry chemicals can cause dangerous reactions. If you're unsure whether a chemical is safe to rinse with water, contact poison control. For electrical burns, make sure the person is no longer in contact with the electrical source before providing treatment. Do not touch someone who is still in contact with electricity, as you could be injured too.

Remove any tight items like rings, bracelets, or constrictive clothing from the burned area before it starts to swell. Swelling can begin within minutes, and removing items now prevents circulation problems later. However, do not remove anything that is stuck to the skin, as this can cause further injury. If the person's clothing is on fire, have them stop, drop to the ground, and roll to smother the flames. Do not run, as this makes the fire burn hotter.

Practical Takeaway: Keep cool running water available at the first sign of a burn. Set a timer for 10-20 minutes to ensure adequate cooling time. This single action can prevent the burn from becoming more severe.

Cleaning and Protecting the Burned Area

After cooling the burn, the next step is gentle cleaning to prevent infection. Wash the burned area with mild soap and cool water using a clean, soft cloth. Be gentle—do not scrub or rub the area, as burned skin is fragile. If blisters have formed, do not pop them, even though this might seem appealing. Blisters protect the underlying skin and help it heal. Popping them increases infection risk significantly. A study in the Journal of Burn Care & Research found that intact blisters are associated with better healing outcomes and less scarring compared to blisters that rupture or are deliberately opened.

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Once the area is clean and dry, you may apply a thin layer of antibiotic ointment such as neomycin or bacitracin. This helps prevent bacterial infection. Some people prefer using antibiotic ointment while others use petroleum jelly, which also protects the wound. Avoid using butter, oil, ice, or toothpaste on burns, as these can trap heat and make the injury worse. Do not use cotton balls on burns, as fibers can stick to the wound and cause problems during healing.

Cover the burn with a sterile, non-stick bandage or dressing. For small burns, a simple adhesive bandage works fine. For larger burns, use sterile gauze or a specialized burn dressing that won't stick to the wound. Keep the dressing clean and dry. Change the dressing once or twice daily, or whenever it becomes soiled or wet. When changing the dressing, wash the area gently with cool water and reapply ointment before putting on a fresh bandage. Leave the dressing off periodically to allow the area to air out slightly, which can support healing.

Practical Takeaway: Keep an antibiotic ointment and sterile non-stick bandages in your first aid kit. After cooling a burn, cleaning and covering it properly takes just a few minutes but significantly reduces infection risk and supports healing.

Managing Pain and Reducing Swelling

Burn pain can be intense, and managing it is an important part of recovery. Over-the-counter pain relievers such as ibuprofen or acetaminophen can help reduce pain and, in the case of ibuprofen, also reduce swelling. Follow the dosage instructions on the package based on age and weight. Ibuprofen is particularly useful for burns because it reduces inflammation as well as pain. Take the pain reliever with food to prevent stomach upset. If the burn is causing severe pain that doesn't respond to over-the-counter medication, contact a healthcare provider.

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Swelling is a natural part of the body's response to injury and typically peaks 24-48 hours after the burn. To manage swelling, elevate the burned area above heart level when possible. If the burn is on your hand or arm, prop it up on pillows while sitting or lying down. Elevation helps reduce fluid accumulation in the tissue. Avoid applying pressure to the burned area, and don't wrap bandages too tightly, as this restricts circulation and increases swelling.

Cool compresses can provide additional pain relief. After the initial 10-20 minute cooling period with running water, you can apply a cool (not cold) compress for short periods, about 5-10 minutes at a time, several times throughout the day. Make sure the compress is clean to avoid introducing bacteria to the wound. Stop using cool compresses if they cause shivering or severe discomfort, as you don't want to lower overall body temperature.

Keep the burned area at a comfortable temperature. Exposure to cold air can increase pain in burned tissue, so keep it covered. Loose, soft clothing that doesn't rub against the burn helps. Some people find that keeping a burn exposed to room temperature air, rather than covered, is more comfortable once the initial healing phase begins.

Practical Takeaway: Start pain management within the first hour after a burn. Combine over-the-counter pain relief with elevation and cool compresses for the most effective pain control during the first few days.

Recognizing When to Seek Medical Care

While many minor burns can be managed at home, certain situations require professional medical evaluation. Seek medical care immediately for any burn that covers more than 3% of the body surface. For perspective, the palm of your hand is roughly 1% of your body surface area. Burns larger than this—roughly the size of three of your palms—need professional assessment. Additionally, all third-degree burns require medical treatment, even if they seem small, because they involve deep tissue damage.

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Seek medical care for any second-degree burn on sensitive areas including the face, hands, feet, genitals, joints, or anywhere on the body that's critical for daily function. Burns