From the Guidelines
First-degree burns should be treated by immediately cooling the affected area with cool (not cold) running water for about 10-20 minutes to stop the burning process and reduce pain, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1.
Key Management Steps
- After cooling, gently clean the area with mild soap and water, then apply a thin layer of petroleum jelly or an aloe vera-based moisturizer to keep the skin moist and promote healing.
- Over-the-counter pain relievers such as acetaminophen (Tylenol) at 325-650 mg every 4-6 hours or ibuprofen (Advil, Motrin) at 400-600 mg every 6-8 hours can help manage pain and inflammation, as supported by the guidelines 1.
- Cover the burn loosely with a sterile, non-stick bandage if needed, changing it daily, to protect the wound and reduce pain, as suggested by the guidelines 1.
Important Considerations
- Avoid using ice, butter, or oils directly on burns as these can worsen damage.
- Keep the burn protected from sun exposure during healing.
- First-degree burns typically heal within 7-10 days without scarring.
- If the burn covers a large area, affects sensitive areas like the face or genitals, or shows signs of infection (increasing pain, redness, swelling, or discharge), seek medical attention promptly, as advised by the guidelines 1.
From the Research
First-Degree Burn Management
- First-degree burns are the most common type of burn and can be caused by thermal injury or UV irradiation (sunburn) 2.
- The pathophysiology and therapeutic approach for first-degree burns are similar, regardless of the cause, but the damage follows a different time course for each injury 2.
- Initial treatment for first-degree burns involves cooling with water, followed by the application of aqueous emulsions with small amounts of well-tolerated lipids (O/W emulsions) 2.
- Foam sprays and lotions are ideal for treating first-degree burns due to their ease of application and painless administration 2.
- The use of topical corticosteroids is not recommended for first-degree burns, as their superiority to the vehicle has not been shown 2.
Topical Antimicrobial Agents
- The choice of topical antimicrobial agents for burn patients, including those with first-degree burns, can be challenging 3.
- International guidelines tend to recommend silver-containing dressings over antiseptics or antibiotics, regardless of the depth of the burn 3.
- Silver sulfadiazine is the most recommended topical antimicrobial in low-resource settings 3.
- However, there is currently no ideal topical antimicrobial agent that can be recommended for all clinical scenarios, and more consistent recommendations are warranted to standardize clinical practice 3.