Hydrogen Peroxide Should Not Be Used on Burns
Hydrogen peroxide should not be applied to burns as it can cause tissue damage, delay healing, and potentially worsen outcomes. 1
Rationale for Avoiding Hydrogen Peroxide on Burns
- Hydrogen peroxide (H₂O₂) is a caustic oxidizing agent that can cause additional tissue damage when applied to already compromised burn tissue 2
- When applied to wounds, hydrogen peroxide causes toxicity via three main mechanisms:
- Corrosive damage to tissues
- Oxygen gas formation which can impair local blood supply
- Lipid peroxidation that exerts direct cytotoxic effects 2
Recommended Burn Management Approach
Initial Management
- For acute burns, cooling with water and covering burns with a fatty substance (e.g., Vaseline) and appropriate dressings is recommended for pain control 3
- Non-pharmacological treatments such as cooling limited burned surfaces can improve pain control without the risks associated with hydrogen peroxide 3
Pain Management
- Multimodal analgesia should be used with medications titrated based on validated comfort and analgesia assessment scales 3
- Titrated intravenous ketamine can be effectively combined with other analgesics to treat severe burn-induced pain 3
- For stable patients, non-pharmacological techniques should be combined with analgesic drugs during dressing changes 3
Scientific Evidence Against Hydrogen Peroxide Use
- A specific caution from the literature states: "Hydrogen peroxide must not be applied to burns that are healing spontaneously" 1
- Hydrogen peroxide can cause:
Special Considerations
- While some recent research has explored hydrogen peroxide's potential in specific wound management contexts 4, 5, these studies do not specifically support its use for acute burn management
- One study did show benefit for hydrogen peroxide in chronic-colonized burn wounds during surgical debridement and grafting procedures, but this was in a controlled surgical setting, not for routine burn care 6
Proper Burn Wound Care
- Burns should be gently cleaned with mild soap and water or saline solution 3
- Covering burns with appropriate dressings helps protect the wound and manage pain 3
- For severe burns, early excision and grafting is the standard treatment approach, rather than application of potentially harmful topical agents 1
When to Seek Medical Attention
- Any burn that is:
- Larger than 3 inches in diameter
- On the face, hands, feet, genitals, or major joints
- Deep or appears white, charred, or leathery
- Accompanied by significant pain or numbness
- Showing signs of infection (increased redness, swelling, warmth, or drainage)
These burns require immediate medical attention rather than home treatment with any agent, including hydrogen peroxide 3