Management of First-Degree Burns
Immediately cool the burn with clean running water for 5–20 minutes, then apply an aqueous oil-in-water emulsion or petrolatum-based product, cover loosely with a clean non-adherent dressing, and provide over-the-counter analgesics for pain control. 1
Immediate Cooling (First Priority)
- Cool the burn promptly with clean running water for 5–20 minutes to reduce pain, limit tissue damage, and decrease the need for subsequent medical care 2, 1
- If clean water is unavailable, apply ice wrapped in a cloth to the burn surface; never place ice directly on the skin as this can cause tissue ischemia and further injury 1
- Monitor pre-adolescent children for signs of hypothermia during active cooling, particularly when larger body surface areas are involved 1
Pain Management
- After cooling, administer over-the-counter analgesics such as acetaminophen or NSAIDs (ibuprofen, naproxen) for pain control 1
Topical Treatment
- Following cooling, apply aqueous oil-in-water emulsions, petrolatum, petrolatum-based antibiotic ointment (such as bacitracin), honey, or aloe vera to the burn surface 1
- These agents provide additional cooling through evaporation and support skin-barrier repair 1, 3
- Foam sprays and lotions are ideal because they are easy and painless to apply to first-degree burns 3
Wound Coverage
- Loosely cover the burn with a clean cloth or non-adherent dry dressing when the skin remains intact 1
- For small burns managed at home, apply the chosen topical agent first, then cover with a clean non-adherent dressing 1
Expected Course and Prognosis
- First-degree burns affect only the epidermal layer and heal without scarring 1, 4
- The risk of infection is low for these superficial injuries 1
- These burns require only simple first-aid techniques with over-the-counter pain relievers 4
Referral and Follow-up
- First-degree burns do not require referral to a specialized burn center or specialist evaluation; they can be managed entirely with home first-aid measures 1
Critical Pitfalls to Avoid
- Never apply ice directly to the burn surface as this produces tissue ischemia and worsens injury 1
- Avoid prolonged cold exposure for larger burns, as this may lead to hypothermia, especially in children 1
- Do not use topical corticosteroids, as superiority to vehicle alone has not been demonstrated for first-degree burns 3