From the Guidelines
Immediate treatment for a chemical burn involves removing the chemical by flushing the area with cool running water for at least 20 minutes, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. When treating a chemical burn, it is essential to prioritize removal of the caustic agent to prevent further injury.
- Remove contaminated clothing and jewelry while flushing the area with water to avoid trapping chemicals against the skin.
- After thorough rinsing, gently pat the area dry with a clean cloth and cover with a sterile, non-stick bandage.
- For pain relief, take over-the-counter medications like acetaminophen (Tylenol) or ibuprofen (Advil) as directed.
- Apply a thin layer of petroleum jelly to keep the area moist and aid healing. However, it is crucial to note that some chemicals, such as hydrofluoric acid and phenol, may require special decontamination procedures, and recommendations can be obtained from local protocols, hazardous materials references, and regional poison centers 1. Seek medical attention for chemical burns that are large, deep, on the face, hands, feet, genitals, or major joints, or if you experience severe pain, signs of infection, or if the burn was caused by strong acids, alkalis, or other highly corrosive substances. The severity of chemical burns depends on the concentration of the chemical, duration of contact, and the amount of tissue exposed, and prompt removal of the chemical is crucial to prevent further injury 1.
From the FDA Drug Label
Prompt institution of appropriate regimens for care of the burned patient is of prime importance and includes the control of shock and pain. The burn wounds are then cleansed and debrided; silver sulfadiazine cream, USP 1% is then applied under sterile conditions. The cream should be applied once to twice daily to a thickness of approximately one sixteenth of an inch. Treatment with silver sulfadiazine cream, USP 1% should be continued until satisfactory healing has occurred or until the burn site is ready for grafting.
For the treatment of chemical burns, the following steps should be taken:
- Cleanse and debride the burn wounds
- Apply silver sulfadiazine cream, USP 1% under sterile conditions
- Apply the cream once to twice daily to a thickness of approximately one sixteenth of an inch
- Continue treatment until satisfactory healing has occurred or until the burn site is ready for grafting 2
From the Research
Treatment for Chemical Burns
- Chemical burns can cause deep injury and significant scarring to the skin, and their treatment is distinct from thermal burns 3
- Immediate water lavage for 60 minutes, removal of contaminated clothing, and covering the wound with a sterile dressing are recommended first aid measures for chemical burns to the skin 3
- The early application of cool water irrigation may reduce the length of hospital stay and the extent of scarring 3
Use of Silver Sulfadiazine
- Silver sulfadiazine is an effective antibacterial agent for topical use in burns, with low toxicity and few side effects 4
- It may be used in a variety of conditions beyond burns, and its use is associated with elevated blood, urine, and tissue levels of silver ion 4, 5
- However, silver sulfadiazine can cause side effects such as allergic reactions, silver staining of the treated burn wound, hyperosmolality, methemoglobinemia, and hemolysis due to a congenital lack of glucose-6-phosphate dehydrogenase 6
Efficacy of Silver Sulfadiazine Therapy
- Silver sulfadiazine therapy is effective for second- and third-degree burns, with positive outcomes including enhanced healing, granulation tissue formation, and infection control 7
- However, some studies have noted limited effectiveness, highlighting the need for complementary treatments to optimize results 7
- Silver sulfadiazine therapy is safe and reliable in burn care, with no severe complications associated with its use 7