Treatment for First Degree Burns
First degree burns should be immediately cooled with clean running water for 5-20 minutes, followed by application of a moisturizing agent such as petrolatum, aloe vera, or honey, and covered with a clean, non-adherent dressing if needed. 1
Initial Management
Cooling
- Immediately cool the burn with clean running water 1
- Cool for 5-20 minutes 1
- If clean running water is not available, it may be reasonable to cool superficial burns with ice wrapped in cloth 1
- Monitor children for signs of hypothermia during cooling 1
Pain Management
- Over-the-counter pain medications (acetaminophen or NSAIDs) are recommended for pain relief 1
- Pain medications are generally well-tolerated for burn pain 1
Post-Cooling Care
Topical Treatment Options
After cooling, apply one of the following:
- Petrolatum (plain or with antibiotic) 1
- Aloe vera 1, 2
- Honey 1
- Aqueous emulsions with small amounts of lipids (O/W emulsions) for first-degree burns 2
Dressing
- For first-degree burns, a clean non-adherent dressing may be applied if needed 1
- Foam sprays and lotions are ideal for first-degree burns as they are easy and painless to apply 2
Important Considerations
When to Seek Medical Care
Seek immediate medical attention for:
- Burns involving face, hands, feet, or genitalia 1
- Any full-thickness burns 1
- Signs of inhalation injury (soot around nose/mouth, difficulty breathing) 1
- Large burn surface area (>10% body surface area in children, >20% in adults) 1
Additional Precautions
- Remove jewelry before swelling occurs 1
- Do not use topical corticosteroids (superiority to vehicle has not been demonstrated) 2
- Prophylactic antibiotics are not indicated for outpatient management of burns 3
Long-Term Care
- First-degree burns generally heal without scarring 3
- Monitor for signs of infection (increasing pain, redness, swelling, purulent drainage)
- Continue moisturizing the area to prevent dryness
First-degree burns involve only the epidermal layer of the skin and typically heal well with proper first aid care. The evidence strongly supports immediate cooling with running water as the most effective initial treatment to limit tissue damage and reduce pain 1. This approach is supported by meta-analyses showing decreased need for subsequent care in patients who receive immediate active cooling with clean running water 1.