From the Guidelines
Management of a first degree burn involves cooling the burn immediately with running water, cleaning and drying the area, applying a moisturizer, and using over-the-counter pain relievers as needed. The first step in managing a first degree burn is to cool the burn immediately by running cool water over the affected area for about 10-20 minutes to reduce pain and prevent further tissue damage, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. It is essential to avoid using ice, as this can worsen the injury. After cooling, the area should be gently cleaned with mild soap and water, then patted dry with a clean towel. A thin layer of petroleum jelly or an aloe vera-based moisturizer can be applied to keep the skin moist and promote healing, as suggested by the guidelines 1. Over-the-counter pain relievers such as acetaminophen (Tylenol) at 325-650 mg every 4-6 hours or ibuprofen (Advil, Motrin) at 200-400 mg every 4-6 hours can help manage pain and reduce inflammation, as recommended by the guidelines 1. Some key points to consider when managing a first degree burn include:
- Cooling the burn immediately with running water
- Cleaning and drying the area
- Applying a moisturizer to keep the skin moist
- Using over-the-counter pain relievers as needed
- Covering the burn with a sterile, non-stick bandage and changing it daily
- Avoiding breaking any blisters that may form to prevent infection
- Keeping the burn protected from sun exposure during healing If the burn covers a large area, affects sensitive areas like the face or genitals, or shows signs of infection (increasing pain, redness, swelling, or discharge), it is crucial to seek medical attention promptly, as indicated by the guidelines 1. First degree burns typically heal within 7-10 days without scarring. It is also important to note that burns involving the face, hands, feet, and genitals may require surgical intervention to prevent permanent disability, and those with a large surface area can lead to significant fluid loss and multisystem organ failure, as highlighted by the 2024 American Heart Association and American Red Cross guidelines for first aid 1.
From the Research
First Degree Burn Management
- First-degree burns are the most common type of burn and can be caused by thermal injury or UV irradiation (sunburn) 2
- The pathophysiology and therapeutic approach for first-degree burns are similar, regardless of the cause, although the damage follows a different time course for each injury 2
Treatment Steps
- Initial cooling with water is recommended for first-degree burns 2, 3
- Aqueous emulsions with small amounts of well-tolerated lipids (O/W emulsions) are best suited for treating first-degree burns or sunburn, as they produce cooling, reduce inflammation, and accelerate the repair of the damaged skin barrier 2
- Foam sprays and lotions are ideal because they are easy and painless to apply 2
- The use of topical corticosteroids is not recommended, as superiority to the vehicle has not been shown 2
- Cold running tap water (between 2 and 15 degrees C) is recommended for first aid treatment of burn injuries, rather than ice or alternative plant therapies 3
Topical Antimicrobial Agents
- Topical antimicrobial agents have been shown to decrease wound-related infections and morbidity in burn wounds when used appropriately 4
- The goal of topical antimicrobial therapy is to control microbial colonization, thus preventing development of invasive infections 4
- Topical antimicrobials of choice include bacitracin, neomycin, silver sulfadiazine, and mafenide 4
- The development of effective topical antimicrobial agents for wound care was a major advance in the care of burn patients, but research on optimal topical treatment continues 5