Initial Treatment for a 1st Degree Burn
The initial treatment for a 1st degree burn should include immediate cooling with cool or cold potable water (15-25°C) for at least 10 minutes, followed by application of a thin layer of antibiotic ointment and covering with a sterile, non-adherent dressing. 1
Immediate Cooling
- Cool the burn immediately using cool or cold potable water (15-25°C) for at least 10 minutes
- If cool water is not available, use a clean, cool or cold compress
- Avoid direct application of ice as this can cause tissue ischemia 1
- Avoid prolonged cooling of large areas to prevent hypothermia, especially in children and elderly patients 1
Research supports this approach, with studies showing that cooling with tap water at 12-18°C is effective in minimizing burn damage 2. One study demonstrated that burns treated with cool running water showed consistent improvement in wound recovery compared to other methods like wet towels or water spray 3.
Pain Management
- Administer over-the-counter analgesics such as acetaminophen or NSAIDs for pain control 1
- For more severe pain, consider stronger analgesics if available
- Use age-appropriate analgesics based on validated pain assessment scales 1
Wound Care
- Leave burn blisters intact to improve healing and reduce pain 1
- Apply a thin layer of antibiotic ointment (such as bacitracin) to the superficial burn if no known allergies exist 1, 4
- Cover the burn with a sterile, non-adherent dressing applied loosely 1
- Protect intact blisters with a loose sterile dressing to prevent accidental rupture 1
Important Cautions
- Avoid home remedies or butter on burns 1
- Do not apply ice directly to the burn 1, 2
- Avoid topical corticosteroids, as research has not shown superiority to vehicle alone 5
- Monitor for signs of infection (increased redness, warmth, swelling, discharge, or fever) 1
When to Seek Medical Attention
Immediate medical attention is recommended for burns that:
- Affect hands, face, feet, or genitals
- Are full-thickness
- Show signs of infection
- Cover extensive areas (>10% TBSA in children, >20% TBSA in adults) 1
Clinical Pearls
- Aqueous emulsions with small amounts of well-tolerated lipids (O/W emulsions) are well-suited for treating first-degree burns 5
- Foam sprays and lotions are ideal because they are easy and painless to apply 5
- The temperature of the coolant is crucial - tap water (12-18°C) has been shown to be more effective than ice water, which can actually increase tissue damage 2
- Even delayed cooling (within 30 minutes) can still provide beneficial effects 2