Treatment for First Degree Burns
First degree burns should be immediately cooled with clean running water for 5-20 minutes to reduce pain and limit tissue damage. 1
Immediate First Aid Steps
- Cool the burn immediately with clean running water for 5-20 minutes to limit burn progression and reduce pain 1
- If clean running water is not available, superficial burns with intact skin may be cooled with ice wrapped in cloth 1
- Monitor children for signs of hypothermia during cooling, especially preadolescent children 1
- Remove jewelry before swelling occurs to prevent constriction and vascular ischemia 1
Pain Management
- Over-the-counter pain medications such as acetaminophen or NSAIDs are recommended for burn pain 1
- Cooling itself provides significant pain relief by affecting the inflammatory cascade 2, 3
- Despite traditional beliefs, research shows that local cooling with 8°C for 30 minutes may not significantly attenuate hyperalgesia compared to untreated burns 4
Post-Cooling Care
- After cooling, loosely cover the burn with a clean cloth or non-adherent dry dressing 1
- For small burns being managed at home, it may be reasonable to apply petrolatum, petrolatum-based antibiotic ointment, honey, or aloe vera 1
- Aqueous emulsions with small amounts of well-tolerated lipids (O/W emulsions) are well-suited for treating first-degree burns 5
- Foam sprays and lotions are ideal because they are easy and painless to apply 5
Optimal Cooling Method
- Running water is superior to wet towels or water spray for burn treatment 6
- The temperature of the coolant is crucial - tap water (12-18°C) is more effective than ice water (1-8°C), which can actually increase tissue damage 7
- Research supports the 20-minute duration for cooling as optimal, showing statistically significant improvement in burn depth compared to shorter durations 8
When to Seek Medical Attention
- First-degree burns generally heal without scarring and have low risk of infection 1
- Seek medical attention for burns involving the face, hands, feet, or genitals 1
- Burns covering >10% body surface area in adults or >5% in children require medical evaluation 1
- Signs of inhalation injury (soot around nose/mouth, difficulty breathing, singed nasal hairs) require immediate medical attention 1
Application of Topical Agents
- For adults and children 2 years and older, a small amount of bacitracin can be applied to the area 1-3 times daily and may be covered with a sterile bandage 9
- For children under 2 years of age, consult a doctor before applying topical agents 9
- The use of topical corticosteroids is not recommended for first-degree burns 5