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Burn

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Definition

  • Burns to the skin
  • A burn is a heat, chemical or electrical injury to the skin

Causes of Burns

  • Hot Liquids. Hot liquids (such as coffee) are the most common cause of burns. They cause a scald.
  • Hot Surfaces. Examples are ovens, stoves, space heaters and curling irons.
  • Chemical Burns (Serious). Examples are acids or lye splashed on the skin. They continue to damage the skin until they are removed.
  • Electrical Burns (Serious). They can be much deeper than they first appear.
  • Flame Burns (Serious). Flammable liquid burns are mainly seen in teen boys.
  • Friction Burns. Treadmill burns are a common example.
  • Sunburn is not covered here. See the Sunburn care guide.

Degrees of Burns

  • 1st degree. Red skin without blisters. These burns don't need to be seen.
  • 2nd degree. Red skin with blisters. Heals 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. 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 over 1 inch or 2.5 cm. Skin grafts help limit scarring.
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When To Call

Call 911 Now

  • 2nd or 3rd degree burn covers a large area
  • Trouble breathing with burn to the face
  • Trouble breathing after being near fire, smoke or fumes
  • Hard to wake up
  • Acts or talks confused
  • You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

  • Eye or eyelid burn
  • Burn goes all the way around an arm or leg
  • Blistered burn and No past tetanus shots. Note: tetanus is the "T" in DTaP, TdaP, or Td vaccines.
  • Center of the burn is white or charred
  • Electrical burn
  • Explosion or gun powder caused the burn
  • Chemical burn (such as acid)
  • Coughing after being near fire and smoke
  • House fire burn
  • Severe pain and not better 2 hours after taking pain medicine
  • Burn looks infected (spreading redness, red streaks, swelling, or tender to the touch)
  • You think your child has a serious burn
  • You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Blister is present. Exception: small closed blister less than ½ inch or 12 mm size.
  • Minor burn and last tetanus shot more than 10 years ago
  • Burn looks dirty or is hard to clean and last tetanus shot more than 5 years ago
  • You think your child needs 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
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Care Advice

  1. What You Should Know About Burns :
    • Minor burns can be treated at home.
    • This includes some small blisters.
    • Here is some care advice that should help.
  2. Cold Pack for Pain:
    • For pain, put a cold wet washcloth on the burn.
    • Repeat as needed.
  3. Pain Medicine:
    • To help with the pain, give an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil).
    • Use as needed.
  4. Clean the Burn:
    • Wash the burn gently with warm water.
    • Do not use soap unless the burn is dirty. Reason: soaps can slow healing.
  5. Closed Blisters - Don't Open:
    • Don't open any small closed blisters.
    • The outer skin protects the burn from infection.
  6. 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 (such as Band-Aid). Change the dressing every other day.
    • Each time, clean the area. Use warm water and 1 or 2 gentle wipes with a wet washcloth.
  7. What to Expect:
    • Most often, burns hurt for about 2 days.
    • It will peel like a sunburn in about a week.
    • First- and second-degree burns don't leave scars.
  8. Call Your Doctor If:
    • Severe pain lasts over 2 hours after taking pain medicine
    • Burn starts to look infected (spreading redness, pus)
    • Burn not healed after 10 days
    • You think your child needs to be seen
    • Your child becomes worse

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

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Photos

First Aid - Burn - Thermal

  • Right away, put the burned part in cold tap water or pour cool water over it for 20 minutes. Reason: lessen the depth of the burn and relieve the pain.
  • For burns on the face, apply a cold wet washcloth.
  • Do this right away. Don't take time to remove clothing.

Note: a thermal burn is any burn caused by heat.

Source: Self Care Decisions, LLC
Used with Permission from Schmitt Pediatric Guidelines LLC.

Burn - First Degree

The photo shows a 6 inch (15 cm) wide area of mild redness without blistering on the forearm. This thermal burn was caused by spilled hot water.

First Aid Care Advice:

  • Put the burned part in cold tap water right away or pour cold water over it for 10 minutes or cover with a cold wet washcloth.
  • Reason: this lessens the depth of the burn and relieves pain.

Source: Self Care Decisions, LLC
Used with Permission from Schmitt Pediatric Guidelines LLC.

Burn - Second Degree

This shows a second degree burn that is caused by heat. The burn area is swollen and bulging with blisters.

First Aid Care Advice:

  • Right away, put the burned part in cold tap water or pour cold water over it for 10 minutes. Reason: this lessens the depth of the burn and relieves pain.
  • Cover with a cold wet washcloth and seek emergency care.

Source: Self Care Decisions, LLC
From the Dr. William Weston Collection of Pediatric Dermatology. Used with permission.

Barton Schmitt MD, FAAP
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
Copyright 2000-2022. Schmitt Pediatric Guidelines LLC.
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