What is the treatment for a chemical burn?

Treatment for Chemical Burns

Chemical burns should be immediately irrigated with copious amounts of clean running water for at least 15-20 minutes to remove the chemical and minimize tissue damage. 1, 2

Immediate First Aid for Chemical Burns

Initial Management

• Remove the chemical source and any contaminated clothing or jewelry to prevent further exposure 2
• For dry chemicals: Brush off powder before irrigation to avoid spreading contaminant 2
• For liquid chemicals: Begin immediate irrigation with clean running water 1
• Irrigation technique:
  • Use copious amounts of clean water
  • Keep eyelids open during irrigation if eyes are affected
  • Direct water flow from inner corner outward to prevent contamination of unaffected areas 2
  • Continue irrigation for 15-20 minutes 1, 3

Special Considerations

• For chemical eye injuries, irrigation should continue for at least 15-30 minutes 2
• For specific chemicals like hydrofluoric acid, additional treatments beyond water irrigation may be needed - contact poison control for guidance 2
• Monitor children for signs of hypothermia during cooling with water 1

Post-Irrigation Care

Wound Management

• After irrigation, apply a clean, non-adherent dressing to the burn area 1
• For small partial-thickness burns managed at home, consider applying:
  • Petrolatum
  • Petrolatum-based antibiotic ointment
  • Honey
  • Aloe vera 1
• For more severe burns, silver sulfadiazine cream may be applied to a thickness of approximately 1/16 inch once to twice daily 4

Pain Management

• Over-the-counter pain medications (acetaminophen or NSAIDs) are appropriate for pain control 1

When to Seek Medical Attention

Activate emergency medical services immediately if:

• Burns involve face, hands, feet, or genitalia
• Burns cover >10% body surface area (>5% in children)
• Full-thickness burns are suspected
• Respiratory symptoms are present
• Systemic symptoms develop 1, 2

Common Pitfalls to Avoid

• Delaying irrigation - immediate irrigation is critical to minimize tissue damage
• Stopping irrigation too early - chemical residues may continue causing damage
• Using pressure or rubbing the eye during irrigation - can cause further damage
• Applying eye patches or bandages before medical evaluation
• Using topical anesthetics outside of medical supervision 2

Evidence Quality and Considerations

The recommendation for immediate irrigation with water is supported by Class I, Level B evidence from the American Heart Association 1. Continuous water irrigation has been shown to be more effective than other methods like wet packs, and even surgical debridement has not been shown to achieve faster recovery than proper irrigation 3.

While some specific chemicals may require specialized treatments, water irrigation remains the cornerstone of first aid for chemical burns and should be initiated as quickly as possible to minimize tissue damage and improve outcomes 1, 2, 3.