What is the recommended treatment for a mild burn?

Treatment of Mild Burns

For mild burns, the recommended treatment is to apply cold tap water (15-25°C) for up to 30 minutes as soon as possible after injury until pain is relieved, followed by appropriate dressing based on burn severity. 1

Initial Management

1. Cooling the burn:

   • Apply cold tap water (15-25°C) for up to 30 minutes or until pain subsides 1
   • Do not apply ice directly to burns as it can cause tissue ischemia 1
   • Research confirms that tap water at 12-18°C is effective, while ice water (1-8°C) can actually increase tissue damage 2

2. Blister management:

   • Leave burn blisters intact and cover loosely with a sterile dressing to improve healing and reduce pain 1
   • For larger blisters, decompress by piercing with a sterile needle to release fluid while leaving the blister roof intact as a biological dressing 1

Dressing Selection

Based on burn depth:

1. Very superficial burns (first-degree):

   • Apply a greasy emollient (50% white soft paraffin with 50% liquid paraffin) 1
   • Non-adherent dressings for painful eroded areas (e.g., Mepitel or Atrauman) 1

2. Partial-thickness burns (second-degree):

   • Apply a thin layer (approximately 1/16 inch) of 1% silver sulfadiazine cream 1, 3
   • Reapply once to twice daily or whenever the cream has been removed by patient activity 3
   • Dressings are not required with silver sulfadiazine but may be used if necessary 3

Ongoing Care

• Monitor for signs of infection: increasing pain, redness, swelling, discharge, fever or systemic symptoms 1
• Do not administer systemic antibiotics prophylactically 1
• Only use antibiotics when there are clinical signs of infection 1
• Provide appropriate pain management using validated pain assessment tools 1

When to Seek Medical Attention

Immediate medical attention is required for burns that:

• Involve face, hands, feet, or genitalia
• Are full-thickness (third-degree)
• Cover >10% total body surface area (TBSA) in children
• Cover >20% TBSA in adults 1

Important Considerations

• Silver sulfadiazine has been traditionally used but recent evidence suggests it may be associated with increased rates of burn wound infection compared to modern dressings/skin substitutes 4
• For very superficial burns, application of an emollient may be sufficient to limit inflammation, pain, and prevent desiccation 5
• The primary goal of treatment is to control pain, prevent infection, and promote healing 1, 3