What is the proper aftercare for a burn caused by touching hot metal?

First Aid Treatment for Burns from Hot Metal Contact

For burns caused by touching hot metal, immediate cooling with clean running water for 5-20 minutes is the most effective first aid treatment to reduce tissue damage and improve outcomes. 1

Initial Assessment and Management

• Immediately cool the burn with clean running water for 5-20 minutes to limit tissue damage and reduce pain 1
• Remove any jewelry from the affected area before swelling occurs to prevent constriction and vascular ischemia 1
• Monitor children closely for signs of hypothermia during cooling, especially with larger burns 1, 2
• If clean running water is not available, cooling superficial burns (with intact skin) using ice wrapped in cloth may be reasonable 1

Treatment Based on Burn Severity

For Superficial (First-Degree) Burns:

• These burns only affect the epidermis, generally heal without scarring, and have low infection risk 1
• After cooling, it's reasonable to administer over-the-counter pain medications like acetaminophen or NSAIDs 1, 2
• For small burns being managed at home, apply petrolatum, petrolatum-based antibiotic ointment, honey, or aloe vera 1
• Cover with a clean, non-adherent dressing 1, 2

For Partial-Thickness (Second-Degree) Burns:

• These burns involve destruction of the epidermis and injury to deeper layers 1
• After cooling, loosely cover with a clean cloth or non-adherent dry dressing 1, 2
• Seek medical attention if the burn:
  • Involves the face, hands, feet, or genitalia
  • Covers more than 10% body surface area (5% in children)
  • Shows signs of infection
  • Is very painful or concerning 1, 2

For Full-Thickness (Third-Degree) Burns:

• All full-thickness burns require immediate medical attention 1
• After cooling, cover with a clean, dry, non-adherent dressing while awaiting medical care 1, 2

Evidence on Cooling Duration

• Meta-analysis shows that cooling burns with running water decreases the need for subsequent care 1, 3
• Research suggests that cooling for 5-20 minutes is beneficial 1, 4
• Even delayed cooling (up to 60 minutes after injury) can still be effective compared to no cooling 5
• The optimal temperature for cooling is around 15°C (cold tap water), with evidence showing that ice should not be used directly on burns 6

Common Pitfalls to Avoid

• Do not apply ice directly to burns as this can cause further tissue damage 2, 6
• Do not apply butter, oil, or other home remedies to burns 1, 2
• Do not delay seeking medical attention for:
  • Burns with blistering or broken skin
  • Burns causing difficulty breathing
  • Burns on the face, hands, feet, or genitals
  • Burns covering large surface areas 1, 2
• Do not break blisters, as this increases infection risk 2

When to Seek Medical Attention

• Seek immediate medical care for burns that:
  • Show signs of inhalation injury (soot around nose/mouth, difficulty breathing)
  • Involve the face, hands, feet, or genitals
  • Are partial-thickness and cover >10% body surface area (>5% in children)
  • Are full-thickness (third-degree) burns
  • Appear infected or are very painful 1, 2