From the Guidelines
To treat a second-degree sunburn, cooling the skin with running water is the first established and beneficial intervention with little risk of harm, as suggested by the 2024 American Heart Association and American Red Cross guidelines for first aid 1.
Initial Treatment
- Cool the skin with running water for 10-15 minutes to reduce pain and inflammation 1.
- After cooling, it may be reasonable to apply petrolatum, petrolatum-based antibiotic ointment, honey, or aloe vera and a clean nonadherent dressing to open burn wounds 1.
Pain Management
- Over-the-counter pain medications such as acetaminophen or NSAIDs are well tolerated and generally recommended for burn pain 1.
- Take over-the-counter pain relievers like ibuprofen (400-600mg every 6 hours) or acetaminophen (500-1000mg every 6 hours) to manage pain and reduce inflammation.
Wound Care
- Gently pat the skin dry and apply aloe vera gel or a moisturizer containing aloe to soothe the burn.
- For blisters, do not pop them as they protect against infection; let them heal naturally.
- Keep the burned area clean by washing gently with mild soap and water.
- Apply an antibiotic ointment like bacitracin or petroleum jelly to prevent infection, and cover with a non-stick bandage if needed.
General Care
- Stay hydrated by drinking plenty of water, as burns draw fluid to the skin's surface.
- Avoid sun exposure on the burned area until fully healed.
- If the burn covers a large area, affects the face or genitals, shows signs of infection (increased pain, redness, swelling, or pus), or doesn't improve within a few days, seek medical attention immediately 1.
From the FDA Drug Label
Silver sulfadiazine cream, USP 1% is a topical antimicrobial drug indicated as an adjunct for the prevention and treatment of wound sepsis in patients with second and third degree burns. The burn wounds are then cleansed and debrided; silver sulfadiazine cream, USP 1% is then applied under sterile conditions. Treatment with silver sulfadiazine cream, USP 1% should be continued until satisfactory healing has occurred or until the burn site is ready for grafting.
The treatment for second-degree solar burn (sunburn) includes:
- Cleansing and debridement of the burn wound
- Application of silver sulfadiazine cream, USP 1% under sterile conditions
- Reapplication of the cream once to twice daily to a thickness of approximately one sixteenth of an inch
- Continuing treatment until satisfactory healing has occurred 2 2
From the Research
Treatment Options for Second-Degree Solar Burn
- Hydrocolloid dressings, such as Duoderm, have been shown to be effective in the treatment of second-degree burns, with benefits including improved wound healing, repigmentation, and reduced pain 3.
- Aloe vera has been found to expedite wound healing in patients with second-degree burns, with a significant reduction in mean wound-healing time compared to other topicals 4, 5.
- Fufang Xuelian Burn Ointment, a traditional Chinese medicine, has been shown to be effective in treating superficial and deep second-degree burn wounds, with improved healing rates and reduced healing time 6.
- Silver-coated dressings, such as Acticoat, have been found to reduce the incidence of early burn wound cellulitis and associated costs of inpatient treatment 7.
Key Findings
- Aloe vera has been consistently shown to reduce wound-healing time in second-degree burns, with a mean difference of 3.76 days 4 and 4.44 days 5 compared to other treatments.
- Hydrocolloid dressings and Fufang Xuelian Burn Ointment have been found to improve wound healing and reduce healing time, with benefits including improved repigmentation and reduced pain 3, 6.
- Silver-coated dressings have been shown to reduce the incidence of burn wound cellulitis and antibiotic use, with associated cost savings 7.