Is it OK to treat a burn at home?
You burn your hand on the stove. You wonder – can I treat it at home or should I go to the emergency room? Well, it really depends.
Determining burn severity can be a little tricky if you don’t deal with burns all the time. I usually explain it this way:
- First degree burns: These burns are basically like a sun burn where the skin turns red and it hurts but it doesn’t blister and it doesn’t peel.
- Second degree burns: This type of burn blisters and sometimes can even peel on its own revealing pink, juicy skin. They are more painful than first degree burns.
- Third degree burns: These burns can blister and peel but the skin underneath looks white and dry. These burns can be very painful but if the nerve is damaged, they may not hurt at all.
Even before you figure out the type of burn, the first thing you’ll want to do is stop the burning process by running cold water over the burn. Avoid using ice to cool the burn as extreme cold can damage the tissue. Don’t put butter on it either. The fat content in butter may actually deepen the injury if you haven’t cooled it thoroughly. If the clothing is involved, remove it.
Once you’ve cooled the area, assess how serious the burn is and treat it accordingly:
First degree burns
If it’s a first degree burn, you can typically take care of it at home. First degree burns don’t actually need anything. We usually treat them for comfort with an over-the-counter anti-inflammatory medication such as acetaminophen, aspirin, ibuprofen or naproxen. If you’d like, you can apply aloe vera or vitamin E. It won’t hurt the burn but there’s no scientific evidence it helps.
Second degree burns
Second degree burns can be serious, especially if they cover a large area of the body. If the second degree burn involves more than 20 percent of the body in adults or more than 10 percent of the body in children or the elderly, you’ll definitely want to seek medical care.
Second degree burns need more wound care. Don’t break the blister. If it does break, clean the area and apply an antibiotic ointment and cover loosely with a sterile bandage. You can take an over-the-counter anti-inflammatory medication, if needed.
In healthy people, second degree burns should eventually heal without the need for skin grafting. It’s hit or miss if they are going to leave a scar. What we often see is some color mismatch where the affected area doesn’t perfectly match the surrounding skin. For most people, that’s as bad as it gets.
Third degree burns
Third degree burns are the ones we worry about because they are more likely to need a skin graft. Any third degree burn should be seen in a burn center to see if it might heal with careful wound care or will require surgery.
With third degree burns, there’s almost always going to be scarring. The scar severity is going to vary from person to person. The two things that impact scarring are how much inflammation is associated with the wound, which is related to how long it’s open, and the other thing is genetics.
A healthy 20 year old is going to heal a burn wound differently from a 60 year old with heart disease and diabetes.
Chronic medical conditions: People who are medically complicated may have issues with wound healing or how well they do. Any medical condition that may compromise blood flow can impact wound healing, including vascular disease, heart disease and diabetes. Steroids or immunosuppression medications also pose risks. People with chronic medical conditions should receive care for a burn injury from a burn center.
Specialty areas of the body: You want to be seen at a burn center if the burn is on a specialty area of the body, such as the hands, feet, face or across joints. While the care of a specialist in burn healing is important, it is also important to be seen by our other team members such as an occupational therapist to help you maintain function. Our goal is always to help people have a full recovery from a burn injury.
Amalia Cochran is the director of the Burn Center at The Ohio State University Wexner Medical Center.