From the Guidelines
Heated seat burns are typically diagnosed as thermal burns, and the most effective treatment involves cooling the area with cool running water for 10-15 minutes, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. The diagnosis of heated seat burns depends on the severity of the burn, which can range from first to third degree.
- First-degree burns are characterized by redness and mild swelling,
- second-degree burns are marked by blisters, severe redness, and pain,
- and third-degree burns are identified by a white or charred appearance and possible numbness. For first-degree burns, treatment involves cooling the area with cool running water for 10-15 minutes, applying aloe vera gel or petroleum jelly, and taking over-the-counter pain relievers like acetaminophen (325-650mg every 4-6 hours) or ibuprofen (400-600mg every 6-8 hours) 1. It is reasonable to give over-the-counter pain medications for pain from thermal burns, as stated in the 2024 American Heart Association and American Red Cross guidelines for first aid 1. Second-degree burns require similar cooling, followed by application of antibiotic ointment like bacitracin or polysporin twice daily, covering with sterile non-stick gauze, and changing dressings daily. Third-degree burns require immediate medical attention. For all burns, it is essential to avoid breaking blisters, not apply ice directly to the skin, and seek medical care if the burn is larger than 3 inches, affects sensitive areas, or shows signs of infection (increasing pain, redness, swelling, oozing, or fever) 1. Burns occur when heated seats transfer enough thermal energy to damage skin proteins and cells, with risk factors including thin clothing, prolonged contact, and conditions affecting temperature sensation like diabetes or neuropathy. The use of written protocols for the management and regular assessment of pain should be encouraged, and titrating drugs is likely to reduce the risk of under- and overdosing 1. Ketamine is an effective drug for burn-induced pain and can limit morphine consumption 1. Non-pharmacological treatments such as cooling limited burned surfaces and covering burns with a fatty substance (e.g., Vaseline and dressings) might improve pain control 1.
From the Research
Diagnosis of Heated Seat Burns on Skin
- The medical term for heated seat burns on the skin is Erythema Ab Igne, a rare condition manifesting in a reticulated, hyperpigmented rash that develops from chronic exposure to direct heat or infrared radiation 2, 3, 4, 5, 6.
- Diagnosis is clinical, with biopsy only required when malignancy is suspected 2, 5.
- The condition can occur with prolonged chronic exposure to normally functioning heated items such as car seats 6.
Treatment of Heated Seat Burns on Skin
- The mainstay of treatment is the removal of heat exposure 2, 3, 4, 5.
- Delays in diagnosis and ongoing heat exposure can result in permanent pigmentation or progression to malignant transformation, leading to Merkel cell carcinoma, basal cell carcinoma, and squamous cell carcinoma 2, 3, 5.
- Although there are no current US Food and Drug Administration-approved therapies for treatment of Erythema Ab Igne hyperpigmentation, the prognosis is excellent because removal of the heat source often will result in spontaneous resolution over time 5.
Prevention of Heated Seat Burns on Skin
- Awareness of thermal-associated skin conditions enables the clinician to establish the appropriate diagnosis based on the associated history of the condition, the morphology of the skin lesion, and, if necessary, correlation with the skin biopsy findings of the cutaneous condition 4.
- Patients are at long-term risk of developing subsequent cutaneous malignant conditions, which include squamous cell and Merkel-cell carcinomas 3, 5.