What is the treatment for a chemical burn to the skin?

Treatment for Chemical Burns to the Skin

Immediate irrigation with copious amounts of running water for at least 15 minutes is the recommended first-line treatment for chemical burns to the skin. 1, 2

Initial Management

• Remove all contaminated clothing, shoes, and jewelry immediately to prevent chemicals from being trapped against the skin 2, 3
• For dry chemicals (like sodium hydroxide, elemental sodium, or potassium), brush off as much powder as possible before irrigation to prevent reaction with water 1, 2
• Irrigate the affected area with copious amounts of running water for at least 15 minutes 1, 2
• Use personal protective equipment when providing first aid to avoid contaminating yourself or others 1
• Do not apply ice directly to burns as this can cause additional tissue damage 2, 3
• Do not apply butter, oil, or other home remedies to burns 2, 4

Special Chemical Considerations

• Certain chemicals require specific treatments beyond water irrigation:
  • Hydrofluoric acid and phenol require decontamination with substances other than water 1, 5
  • Commercial decontamination solutions may be more effective than water for some exposures 1
• Contact a regional poison control center for chemical-specific treatment recommendations 1, 2

Post-Irrigation Care

• After thorough irrigation, loosely cover the burn with a clean cloth or non-adherent dry dressing 3
• For small partial-thickness burns being managed at home, consider applying petrolatum or petrolatum-based antibiotic ointment 3
• Leave blisters intact to improve healing and reduce infection risk 3
• For pain management, over-the-counter medications such as acetaminophen or NSAIDs can be used 3

When to Seek Medical Attention

Seek immediate medical attention if:

• Burns involve the face, hands, feet, or genitals 2, 3
• Burns have blisters or broken skin 2
• Partial-thickness burns cover more than 10% of body surface area (5% in children) 2, 4
• Full-thickness (third-degree) burns are present 2
• The burn appears infected or is very painful 2
• Difficulty breathing or other systemic symptoms develop 2, 3

Hospital Treatment

• For more severe burns, silver sulfadiazine cream 1% may be applied once to twice daily to a thickness of approximately 1/16 inch after the burn is cleansed and debrided 6
• Reapply silver sulfadiazine immediately after hydrotherapy 6
• Treatment should continue until satisfactory healing occurs or until the burn site is ready for grafting 6

Common Pitfalls to Avoid

• Delaying irrigation - immediate decontamination is crucial to minimize tissue damage 1, 7
• Breaking blisters, which increases infection risk 3
• Using ice, which can cause tissue ischemia 3
• Applying home remedies like butter or oil 2
• Failing to remove contaminated clothing and jewelry 1, 3
• Neglecting to seek medical attention for burns with blisters or broken skin 2

Remember that the extent of chemical burn injury depends on the concentration of the chemical, depth of penetration, volume of exposure, body site involved, and duration of exposure 1. Prompt and appropriate first aid significantly improves outcomes.