Treatment of Lip Burns
For a simple lip burn, immediately apply white soft paraffin ointment (petroleum jelly) to the lips every 2 hours and clean with warm saline mouthwashes daily. 1, 2
Immediate First Aid Management
Initial Cooling (if applicable)
- Cool the burn with tap water or saline for up to 40 minutes if the burn is fresh and the patient is not in shock 1
- This reduces burn depth progression and provides pain relief 1
- Do not use prolonged external cooling devices as they risk hypothermia 1
Remove Constricting Items
- Remove jewelry or tight items around the lips immediately before swelling develops 1
Primary Wound Care
Essential Lip Protection
- Apply white soft paraffin ointment (petroleum jelly) to the lips every 2 hours 1, 2
- This is the cornerstone of lip burn management recommended by the British Association of Dermatologists 1
- Clean the mouth daily with warm saline mouthwashes or an oral sponge 1, 2
Topical Antimicrobial Options
- For small partial-thickness burns managed at home, apply petrolatum-based antibiotic ointment (such as bacitracin) 1-3 times daily after cooling 1, 3
- Alternatively, honey or aloe vera may be applied to open burn wounds 1
- Clean the affected area before each application 3
- May cover with a sterile, nonadherent bandage 1, 3
Wound Cleaning
- Clean burns with tap water, isotonic saline, or an antiseptic solution before dressing 1
- Perform wound care in a clean environment 1
Pain Management
Oral Analgesics
- Give over-the-counter pain medications such as acetaminophen or ibuprofen (800mg every 6 hours for adults) 1
- These are well-tolerated and generally recommended for burn pain 1
Topical Anti-inflammatory Treatment
- Apply benzydamine hydrochloride oral rinse or spray every 2-4 hours, particularly before eating 1, 2
- This provides local pain relief and reduces inflammation 1, 2
Additional Pain Control
- For inadequate pain control, consider topical anesthetic preparations such as viscous lidocaine 2% under medical supervision 2
- Deep analgesia or general anesthesia may be required for extensive wound care 1
Anti-inflammatory Treatment
Corticosteroid Therapy
- Consider a potent topical corticosteroid mouthwash (betamethasone sodium phosphate) four times daily for significant inflammation 1
- In infants, clobetasol propionate 0.05% cream or ointment may be applied topically to affected lip areas 1
Infection Prevention
Antiseptic Measures
- Use an antiseptic oral rinse containing chlorhexidine twice daily 1, 2
- Routine antibiotic prophylaxis is NOT recommended for burn patients 1
- Topical antibiotics should be reserved for infected wounds only, not first-line treatment 1
Monitoring for Infection
- Take swabs for bacterial and candidal culture from sloughy or crusted areas if infection is suspected 1
- If infection develops, administer appropriate antibiotics for at least 14 days 2
Important Caveats and Pitfalls
Avoid These Common Mistakes
- Do not use alcohol-containing mouthwashes as they cause additional pain and irritation 2
- Avoid silver sulfadiazine for prolonged periods on superficial burns as it delays healing 1
- Do not use petroleum-based products chronically as they promote mucosal dehydration and increase infection risk 4
When to Seek Emergency Care
- Burns involving the face require evaluation by a healthcare professional due to risk of permanent disability 1
- Signs of inhalation injury (facial burns, difficulty breathing, singed nasal hairs, soot around nose/mouth) require immediate EMS activation 1
- Burns with large surface area (>10% body surface area in adults, >5% in children) need specialized burn center care 1
Dressing Considerations
- Cover burns with intact skin or intact blisters loosely with a clean cloth or nonadherent dry dressing while awaiting professional evaluation 1
- For open wounds, nonadherent bandages protect the wound and reduce pain 1
- Re-evaluate dressings daily 1