Treatment of First-Degree Burn (6x3 cm Blanching Erythema)
Immediately cool the burn with clean running water for 5-20 minutes, then apply petrolatum or aloe vera with a clean non-adherent dressing, and use over-the-counter pain medications as needed. 1, 2
Immediate Cooling (First Priority)
- Cool the burn immediately with clean running water for 5-20 minutes to limit burn progression and reduce pain 1, 2
- If clean running water is unavailable, you may use ice wrapped in cloth for this superficial burn with intact skin 1, 2
- Monitor for hypothermia during cooling, particularly if treating a child 1, 2
- Remove any jewelry from the affected area before swelling occurs to prevent vascular compromise 2
The 2024 American Heart Association guidelines provide the strongest evidence for immediate water cooling, demonstrating decreased need for subsequent care in patients receiving this intervention 1. The cooling duration of 5-20 minutes represents a reasonable balance between therapeutic benefit and hypothermia risk 1.
Pain Management
This is a reasonable intervention supported by current guidelines for managing discomfort from thermal burns 1.
Post-Cooling Wound Care
- After cooling, apply petrolatum, petrolatum-based antibiotic ointment, honey, or aloe vera to the burn surface 1, 2
- Cover with a clean non-adherent dressing loosely applied 1, 2
- Aqueous emulsions with small amounts of lipids (oil-in-water emulsions) are particularly well-suited, as water evaporation provides cooling while lipids accelerate barrier repair 3
- Foam sprays and lotions are ideal because they are easy and painless to apply 3
The American Heart Association guidelines specifically recommend these topical agents for small burns managed at home 1. First-degree burns generally heal without scarring and have low infection risk, making simple topical care appropriate 1, 2.
What NOT to Do (Common Pitfalls)
- Do not use topical corticosteroids - superiority to vehicle has not been demonstrated for first-degree burns 3
- Do not apply ice directly to the burn surface, as this can cause further tissue damage 2, 4
- Do not use prophylactic antibiotics - they are not indicated and may increase bacterial resistance 5
When This Simple Approach Is Sufficient
This 6x3 cm (18 cm²) first-degree burn with blanching erythema represents a superficial injury involving only the epidermis 1, 5. The size is well below thresholds requiring specialized care, and the blanching characteristic confirms superficial depth 1.
No medical referral is needed for this burn unless it involves the face, hands, feet, or genitalia 1, 2. First-degree burns heal with simple first-aid techniques and over-the-counter pain relievers 5.