From the Guidelines
Management for a flash burn to the face requires immediate first aid with cooling of the burn using running water, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. The first step in managing a flash burn to the face is to remove the person from the heat source and cool the burn with cool running water for 10-15 minutes, as this has been shown to decrease the need for subsequent care in patients with thermal burns 1.
- Key considerations in the management of flash burns to the face include:
- Cooling the burn with running water to reduce the risk of further tissue damage
- Giving over-the-counter pain medications, such as acetaminophen or ibuprofen, for pain relief, as they are well-tolerated and generally recommended for burn pain 1
- Applying a topical treatment, such as petrolatum, petrolatum-based antibiotic ointment, honey, or aloe vera, to promote healing and prevent infection, although the evidence for short-term use in the first aid setting is limited 1
- Covering the burn with a clean, non-stick bandage to protect the wound and promote healing
- Seeking medical attention promptly, especially for facial burns, as they can affect the eyes, airways, and may lead to significant scarring, and may require surgical intervention to prevent permanent disability 1
- It is also important to be aware of the potential for inhalation injury, especially if there are signs such as facial burns, difficulty breathing, singed nasal hairs, or soot around the nose or mouth, and to activate EMS immediately if suspected 1. The American Burn Association recommends that patients with second- or third-degree burns involving the face, hands, feet, and genitals, and those involving >10% body surface area, be treated in a specialized burn center due to the likely need for intravenous fluid resuscitation, surgery, and other specialized treatments 1.
From the FDA Drug Label
Prompt institution of appropriate regimens for care of the burned patient is of prime importance and includes the control of shock and pain. The burn wounds are then cleansed and debrided; silver sulfadiazine cream, USP 1% is then applied under sterile conditions. The management for a flash burn to the face includes:
- Control of shock and pain
- Cleansing and debridement of the burn wounds
- Application of silver sulfadiazine cream, USP 1% under sterile conditions
- Covering the burn areas with silver sulfadiazine cream, USP 1% at all times
- Reapplying the cream once to twice daily to a thickness of approximately one sixteenth of an inch
- Reapplying the cream immediately after hydrotherapy 2
From the Research
Management of Flash Burns to the Face
The management of flash burns to the face involves several key considerations, including:
- Resuscitation and airway maintenance, as facial and inhalational burns can compromise airways and pose difficulties in pre-hospital resuscitation 3
- Clinical treatment of facial injuries, which can be compounded if the victim is a child 3
- Surgical treatment, which has been shown to minimize complications and duration of recovery 3
Treatment Options
Several treatment options are available for flash burns to the face, including:
- Aloe vera cream, which has been shown to increase re-epithelialization and reduce wound size in burn wounds 4, 5, 6
- Silver sulfadiazine cream, which is commonly used to treat burn wounds but may not be as effective as aloe vera cream in promoting healing and reducing itching and pain 4, 5, 6
Diagnosis and Assessment
Diagnosis and assessment of flash burns to the face involve evaluating the severity of the burn and the presence of any inhalational injury, which can be indicated by signs such as singed nasal hair, carbonaceous sputum, and facial burns 7
- However, these physical findings have been shown to be unreliable indicators of inhalation injury and should be interpreted as one component of the history and physical 7
Key Considerations
Key considerations in the management of flash burns to the face include: