What is the recommended wound care for superficial burns?

Wound Care for Superficial Burns

For superficial burns, immediately cool the burn with clean running water for 5-20 minutes, then apply petrolatum, petrolatum-based antibiotic ointment, honey, or aloe vera, and cover with a clean, non-adherent dressing. 1

Immediate Cooling (First Priority)

Active cooling is strongly recommended and should be initiated as soon as possible to limit tissue damage, reduce pain, and decrease burn depth. 2

• Cool the burn with clean running water for 5-20 minutes 1
• Cooling can be effective even when delayed up to 60 minutes post-injury 3
• The 2015 International Consensus on First Aid Science found that adequate cooling (defined as 10 minutes or more) was associated with reduced hospital admissions (RR 0.55) and decreased burn depth (RR 0.68) 2
• Remove jewelry from the affected area before swelling occurs to prevent constriction 1

Critical Cooling Caveats:

• Do NOT apply ice directly to burns as this causes further tissue damage 1, 4
• Monitor for hypothermia, especially in children and with burns covering large surface areas 1
• For adults with burns <20% TBSA and children with <10% TBSA, cooling should be performed in the absence of shock 1

Wound Care After Cooling

Once cooling is complete, superficial (first-degree) burns require straightforward topical management:

• Apply petrolatum, petrolatum-based antibiotic ointment, honey, or aloe vera to the cooled burn 1, 5
• Cover with a clean, non-adherent dressing 1
• The evidence shows honey demonstrated benefit over silver sulfadiazine for infection resolution (RR 12.40) in superficial burns 2

Pain Management

• Administer over-the-counter pain medications such as acetaminophen or NSAIDs for pain control 1, 6
• Pain management should be initiated early as part of the overall burn care strategy 1

What NOT to Do (Common Pitfalls)

• Do NOT apply butter, oil, or other home remedies to burns 1, 6, 4
• Do NOT break blisters as this significantly increases infection risk 1, 6, 4
• Do NOT use routine antibiotic prophylaxis - antibiotics should only be used for confirmed infected wounds 1, 4
• Avoid prolonged use of silver sulfadiazine on superficial burns as it may prolong healing time 1, 4
• A 2013 Cochrane review found silver sulfadiazine was consistently associated with poorer healing outcomes compared to biosynthetic dressings, silver-containing dressings, and silicon-coated dressings 7

Dressing Management

• Re-evaluate dressings daily for optimal monitoring 1, 4
• Burn wound care should be performed in a clean environment 1
• When applying dressings on limbs, prevent bandages from creating a tourniquet effect 1

When to Seek Medical Attention

Superficial burns typically heal without specialized care, but seek immediate medical attention if:

• Burns involve the face, hands, feet, or genitals 1, 6
• Signs of infection develop (increasing redness, warmth, purulent drainage, fever) 1, 4
• Burns are very painful or pain is not controlled by over-the-counter medications 1, 4
• The burn shows signs of being deeper than initially assessed 1