What to give for a burn inside the mouth?

Treatment for Mouth Burns

For thermal burns inside the mouth, immediately cool the area with cold tap water (15-25°C) for 5-20 minutes, then apply petrolatum or aloe vera to open wounds, cover with a non-adherent dressing, and give oral acetaminophen or NSAIDs for pain relief. 1, 2

Immediate First Aid

• Cool the burn immediately with clean running tap water at 15-25°C as soon as possible and continue for 5-20 minutes until pain is relieved 1, 2
• Monitor for signs of hypothermia during cooling, especially in children, as prolonged cooling can cause complications 1, 2
• If clean running water is unavailable and the burn has intact skin, ice wrapped in cloth may be used as an alternative, though direct ice application should be avoided 1, 2

The cooling intervention is critical because it limits burn depth progression and reduces pain by affecting the inflammatory cascade. Evidence from over 11,000 patients demonstrates that immediate cooling with running water decreases the need for subsequent specialized care. 1

Topical Treatment After Cooling

For open wounds (including unroofed blisters):

• Apply a thin layer of petrolatum (Vaseline) or petrolatum-based antibiotic ointment without sulfonamides (such as polymyxin B or bacitracin) 2, 3
• Aloe vera gel or medical-grade honey are effective alternatives that promote healing and reduce pain 1, 2, 3

For intact skin or intact blisters:

• Loosely cover with a clean, non-adherent dressing or clean cloth 1, 2, 3
• Leave blisters intact as this improves healing and reduces pain 2

Important caveat: Avoid silver sulfadiazine for superficial burns as it is associated with prolonged healing when used long-term. 1

Pain Management

• Administer over-the-counter oral analgesics such as acetaminophen or NSAIDs (ibuprofen) for pain relief 1, 2, 3
• Consider multimodal analgesia combining both acetaminophen and NSAIDs if pain is significant 2, 3
• For severe pain with burning sensation (oral dysesthesia), viscous lidocaine can be applied topically, or gabapentin may be considered for moderate to severe cases 1

The cooling itself provides substantial pain relief by reducing the inflammatory response. 2

Wound Care

• Thoroughly irrigate the wound with warm or room temperature potable water to clean the area 2
• Apply dressings in a clean environment 1
• Cover treated burns with a clean, non-adherent dressing to promote healing and reduce infection risk 1, 2, 3

When to Seek Emergency Medical Attention

Activate EMS immediately for:

• Burns involving the face, hands, feet, or genitals 1, 2, 3
• Burns covering >10% body surface area in adults or >5% in children 1, 2, 3
• Signs of inhalation injury including difficulty breathing, soot around nose or mouth, singed nasal hairs, or facial burns 1, 2, 3
• Signs of infection or worsening condition 2, 3
• Severe pain unresponsive to first-line treatments 2, 3

Inhalation injury can rapidly lead to airway loss due to swelling and may indicate carbon monoxide poisoning, making this a life-threatening emergency. 1

Critical Pitfalls to Avoid

• Do not apply ice directly to burns as it can cause tissue ischemia 1
• Avoid prolonged cold exposure to prevent hypothermia and further tissue injury 1
• Do not use external cooling devices (like Water-Jel dressings) for prolonged periods due to hypothermia risk 1
• Remove jewelry from the affected area before swelling occurs to prevent vascular compromise 1, 2
• Avoid topical antibiotics as first-line treatment; reserve them for infected wounds only 1