Immediate Treatment for Partial Thickness Burns on the Face
Partial thickness burns on the face should be immediately cooled with clean running water for 5-20 minutes to limit tissue damage and reduce pain. 1, 2
Initial Assessment and Management
- Immediately cool the burn with clean running water for 5-20 minutes to limit tissue damage and reduce pain 1, 2
- Remove any jewelry from the affected area before swelling occurs to prevent constriction and vascular ischemia 3, 2
- Monitor for signs of inhalation injury such as facial burns, difficulty breathing, singed nasal hairs, or soot around the nose/mouth, which requires immediate emergency medical services activation 1, 3
- Administer over-the-counter pain medications such as acetaminophen or NSAIDs for pain management 1, 4
Wound Care After Cooling
- After cooling, loosely cover the burn with a clean, non-adherent dry dressing or clean cloth while awaiting evaluation by healthcare professionals 1, 2
- Do not apply ice directly to burns as this can cause further tissue damage 2, 5
- Do not apply butter, oil, or other home remedies to burns 2
- Do not break blisters, as this increases infection risk 2
Referral Criteria for Facial Burns
- All partial-thickness burns involving the face require evaluation at a specialized burn center due to high risk of functional and cosmetic disability 1, 6
- The American Burn Association recommends that patients with partial-thickness burns involving the face be treated in a specialized burn center regardless of size 1, 3
- Immediate medical attention is required for burns that show signs of inhalation injury (soot around nose/mouth, difficulty breathing) 1, 2
Medication Management
- For pain control, acetaminophen is the first-line treatment for pain associated with minor burns 4
- If the patient will be managed as an outpatient initially, silver sulfadiazine cream may be applied to a thickness of approximately 1/16 inch once to twice daily 7
- The cream should be reapplied to any areas from which it has been removed by patient activity 7
Special Considerations for Facial Burns
- Facial burns require special attention due to the risk of airway compromise from swelling 1, 3
- Even small partial-thickness burns on the face require specialized care to optimize cosmetic outcomes 3, 6
- Monitor closely for signs of infection, which may include increasing pain, redness, swelling, or purulent discharge 4, 8
Common Pitfalls to Avoid
- Delaying cooling of the burn (benefits still seen with cooling up to 3 hours post-injury, but immediate is best) 9
- Using ice directly on burns instead of cool running water (ice can cause further tissue damage) 2, 5
- Failing to recognize the need for specialized burn care for facial burns regardless of size 1, 6
- Applying home remedies such as butter or oils to burns 2
- Underestimating the risk of airway compromise with facial burns 1, 3