From the Guidelines
Don't apply ice directly to a burn, as it can cause tissue ischemia and worsen the injury. When a burn occurs, the skin is already damaged, and applying ice can further reduce blood flow to the affected area, leading to additional tissue damage. Instead, cool the burn with running water at a temperature between 15°C to 25°C for at least 10 minutes to reduce pain, edema, and depth of injury, as recommended by the 2015 American Heart Association and American Red Cross guidelines for first aid 1. The most recent guidelines from 2021 also support the use of cool water for burn cooling, although the optimal duration and technique are still unknown 1. It's essential to monitor for hypothermia, especially when cooling large burns, and to seek medical attention if the burn is severe or covers a large area. Key considerations for burn care include:
- Cooling the burn with cool or cold potable water as soon as possible
- Avoiding the use of ice or freezing temperatures
- Monitoring for hypothermia, especially in young children or when cooling large burns
- Seeking medical attention if the burn is severe or covers a large area
- Loosely covering the burn with a sterile, dry dressing after cooling 1.
From the Research
Adverse Effects of Applying Ice to Thermal Burns
- Applying ice to thermal burns can cause more necrosis than not cooling the wound at all, as seen in a study where ice water of 1-8 degrees C was used 2
- The use of ice water can lead to an increase in tissue damage, whereas cooling with tap water at 12-18 degrees C can minimize damage and promote faster healing 2
- The current recommendations for the first aid treatment of burn injuries suggest using cold running tap water (between 2 and 15 degrees C) on the burn, rather than ice or alternative therapies 3
- There is no mention of using ice as a treatment for minor burns in other studies, which instead recommend irrigation of the burn area with cool water, acetaminophen, or a nonsteroidal anti-inflammatory drug for pain management 4, 5
Optimal Cooling Methods
- Cooling a fresh burn wound with tap water is an effective method of minimizing damage and promoting healing 2
- The ideal temperature of the coolant is between 12-18 degrees C, as seen in a study where tap water was used to cool deep dermal wounds in pigs 2
- Delayed cooling, even for half an hour, can still have beneficial effects in minimizing tissue damage and promoting healing 2