Treatment for Curling Iron Burns
Immediately cool the burn with clean running water (approximately 15°C/cool tap water) for at least 10-20 minutes, then apply a petrolatum-based ointment or antibiotic ointment and cover with a clean, non-adherent dressing. 1, 2, 3
Immediate First Aid (First 20 Minutes)
- Cool the burn immediately with clean running water for 10-20 minutes as soon as possible after injury 1, 2
- Use cool or cold tap water (approximately 15°C), which has been shown to limit tissue damage, reduce pain, speed healing, and may reduce the need for skin grafting 1, 4
- Never apply ice directly to the burn, as this causes tissue ischemia and worsens injury 1, 2
- Remove any jewelry or tight clothing from the affected area before swelling occurs to prevent vascular compromise 2, 3
Important Cooling Considerations:
- If running water is unavailable, a clean cool (not freezing) compress can be used as a substitute 1
- Monitor for hypothermia during cooling, especially in children or if the burn covers a large area 1, 2
- The evidence shows that 15°C water for 20 minutes provides optimal outcomes in terms of reepithelialization and scar appearance 4
Post-Cooling Treatment
For Most Curling Iron Burns (Typically First or Second-Degree):
- After cooling, apply petrolatum, petrolatum-based antibiotic ointment, honey, or aloe vera to the burn 2, 3
- Cover loosely with a clean, non-adherent dressing such as sterile gauze 1, 2
- Over-the-counter pain medications (acetaminophen or NSAIDs) are appropriate for pain control 2, 3
Wound Care Specifics:
- Clean the wound with tap water, isotonic saline, or antiseptic solution before applying dressing 1, 2
- Apply a thin layer of petrolatum-based antibiotic ointment for partial-thickness burns 2
- Avoid silver sulfadiazine for superficial burns, as it is associated with prolonged healing when used long-term on these injuries 1, 5
Critical Pitfalls to Avoid
- Do not apply butter, oil, or other home remedies to burns 2, 3
- Do not break blisters, as intact blisters improve healing and reduce pain 1, 2
- Do not use ice directly on the burn surface 1, 2
- Do not apply topical antibiotics as first-line prophylaxis; reserve these for infected wounds only 1
When to Seek Medical Attention
Seek immediate medical care if the burn involves: 1, 2, 3
- The face, hands, feet, or genitals
- Blistering or broken skin
- Difficulty breathing
- Burns covering >10% body surface area in adults (>5% in children)
- Signs of infection (increasing pain, redness, swelling, or drainage)
Special Note on Curling Iron Burns:
Curling iron injuries account for approximately 82,151 ED visits over a five-year period, with 97% being thermal burns 6. In children under 4 years, 56% occur by grabbing or touching the device, while in those ≥10 years, 69% of burns affect the cornea from contact during use 6. Any eye involvement requires immediate ophthalmologic evaluation 6.
Pain Management
- Start with over-the-counter acetaminophen or NSAIDs for mild to moderate pain 2, 3
- For severe pain, multimodal analgesia with titrated medications based on validated pain scales is recommended 1
- Short-acting opioids and ketamine are most effective for severe burn-induced pain if medical evaluation is obtained 1