Wound Care for Superficial Burns
Immediately cool superficial burns with clean running water for 5-20 minutes, then apply petrolatum-based ointment or honey, and cover with a clean non-adherent dressing. 1, 2
Immediate Cooling (First Priority)
Active cooling must be initiated immediately to limit tissue damage, reduce burn depth, and decrease pain. 1
- Apply clean running water directly to the burn for 5-20 minutes 1, 2
- This intervention reduces hospital admission rates (from 64.4% to 35.8%) and decreases burn depth progression 1
- Monitor preadolescent children closely for hypothermia during cooling, especially with larger burns 1, 2
- If clean running water is unavailable, ice wrapped in cloth may be used for superficial burns with intact skin 1
- Never apply ice directly to burns as this causes additional tissue damage 2, 3
The 2024 American Heart Association guidelines prioritize running water cooling as a Class 1 recommendation based on meta-analysis of 11,383 patients showing clear benefit. 1 The 2015 International Consensus found that adequate cooling (≥10 minutes) was associated with reduced need for subsequent care. 1
Remove Constricting Items
- Remove all jewelry from the affected area before swelling occurs to prevent vascular compromise 1, 2
Topical Treatment After Cooling
For superficial (first-degree) burns being managed at home:
Apply one of the following topical agents: 1, 2
- Petrolatum or petrolatum-based antibiotic ointment (preferred for ease of application)
- Honey (evidence shows benefit for infection prevention) 1
- Aloe vera
The 2024 AHA guidelines give this a Class 2, Level C-EO recommendation, acknowledging limited direct evidence but established clinical practice. 1 Notably, silver sulfadiazine should be avoided for superficial burns as it may prolong healing when used long-term. 2, 4
Dressing Application
- Cover with a clean, non-adherent dressing after applying topical agent 1, 2
- The dressing protects against contamination while allowing the wound to heal 2
- Re-evaluate dressings daily to monitor for signs of infection 2
Pain Management
- Administer over-the-counter pain medications (acetaminophen or NSAIDs) for pain control 1, 2
- This is a Class 2, Level B-R recommendation from the AHA based on established analgesic efficacy 1
Critical Pitfalls to Avoid
Do not apply the following: 2, 3
- Butter, oil, or other home remedies
- Ice directly to the burn
- Silver sulfadiazine for superficial burns (associated with prolonged healing) 2, 4
Do not break blisters as this increases infection risk 2, 5
When to Seek Medical Attention
Superficial burns generally heal without scarring and have low infection risk, but seek immediate medical care if: 1, 2
- Burns involve the face, hands, feet, or genitals
- Signs of infection develop (increased pain, redness, swelling, or discharge)
- Signs of inhalation injury present (soot around nose/mouth, difficulty breathing)
- The burn is very painful or not improving with home care