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Burns and scalds

Burns and scalds are damage to the skin caused by heat. Both are treated in the same way.

Burns and scalds are damage to the skin caused by heat. Both are treated in the same way.

A burn is caused by dry heat – by an iron or fire, for example. A scald is caused by something wet, such as hot water or steam.

Burns can be very painful and may cause:

  • red or peeling skin
  • blisters 
  • swelling
  • white or charred skin

The amount of pain you feel isn't always related to how serious the burn is. Even a very serious burn may be relatively painless.

Treating burns and scalds

To treat a burn, follow the first aid advice below:

  • immediately get the person away from the heat source to stop the burning
  • cool the burn with cool or lukewarm running water for 20 minutes – don't use ice, iced water, or any creams or greasy substances such as butter
  • remove any clothing or jewellery that's near the burnt area of skin, including babies' nappies - but don't move anything that's stuck to the skin
  • make sure the person keeps warm – by using a blanket, for example, but take care not to rub it against the burnt area
  • cover the burn by placing a layer of cling film over it – a clean plastic bag could also be used for burns on your hand
  • use painkillers such as paracetamol or ibuprofen to treat any pain
  • if the face or eyes are burnt, sit up as much as possible, rather than lying down - this helps to reduce swelling

The British Red Cross website has a video about first aid for burns.

Read more about treating burns and scalds.

When to get medical attention

Depending on how serious a burn is, it may be possible to treat it at home. For minor burns, keep the burn clean and don't burst any blisters that form.

More serious burns require professional medical attention. You should go to a hospital A&E department for:

  • all chemical and electrical burns
  • large or deep burns – any burn bigger than your hand
  • burns that cause white or charred skin – any size
  • burns on the face, hands, arms, feet, legs or genitals that cause blisters

If someone has breathed in smoke or fumes, they should also seek medical attention. Some symptoms may be delayed and can include:

  • coughing
  • a sore throat
  • difficulty breathing
  • facial burns

People at greater risk from the effects of burns, such as children under five years old and pregnant women, should also get medical attention after a burn or scald.

The size and depth of the burn will be assessed and the affected area cleaned before a dressing is applied. In severe cases, skin graft surgery may be recommended.

Read more about:

Types of burn

Burns are assessed by how seriously your skin is damaged and which layers of skin are affected. Your skin has three layers:

  • the epidermis – the outer layer of skin
  • the dermis – the layer of tissue just beneath, which contains blood capillaries, nerve endings, sweat glands and hair follicles 
  • the subcutaneous fat, or subcutis – the deeper layer of fat and tissue

There are four main types of burn, which tend to have a different appearance and different symptoms:

  • superficial epidermal burn – where the epidermis is damaged; your skin will be red, slightly swollen and painful, but not blistered
  • superficial dermal burn – where the epidermis and part of the dermis are damaged; your skin will be pale pink and painful, and there may be small blisters
  • deep dermal or partial thickness burn – where the epidermis and the dermis are damaged: this type of burn makes your skin turn red and blotchy; your skin may be dry or moist, and become swollen and blistered, and it may be very painful or painless
  • full thickness burn – where all three layers of skin (the epidermis, dermis and subcutis) are damaged; the skin is often burnt away and the tissue underneath may appear pale or blackened, while the remaining skin will be dry and white, brown or black with no blisters, and the texture of the skin may also be leathery or waxy

Preventing burns and scalds

Many severe burns and scalds affect babies and young children. Examples of things you can do to help reduce the likelihood of your child having a serious accident at home include:

  • keeping your child out of the kitchen whenever possible
  • testing the temperature of bath water using your elbow before you put your baby or toddler in the bath
  • keeping matches, lighters and lit candles out of young children's sight and reach
  • keeping hot drinks well away from young children

Read more about preventing burns and scalds.

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Burns and scalds

Appropriate first aid must be used to treat any burns or scalds as soon as possible. This will limit the amount of damage to your skin.

Appropriate first aid must be used to treat any burns or scalds as soon as possible. This will limit the amount of damage to your skin.

You can apply the following first aid techniques to yourself or another person who has been burnt.

First aid for burns

  • Stop the burning process as soon as possible. This may mean removing the person from the area, dousing flames with water, or smothering flames with a blanket. Don't put yourself at risk of getting burnt as well.
  • Remove any clothing or jewellery near the burnt area of skin, including babies' nappies. However, don't try to remove anything that's stuck to the burnt skin as this could cause more damage.
  • Cool the burn with cool or lukewarm running water for 20 minutes, as soon as possible after the injury. Never use ice, iced water, or any creams or greasy substances such as butter.
  • Keep yourself or the person warm. Use a blanket or layers of clothing, but avoid putting them on the injured area. Keeping warm will prevent hypothermia, where a person's body temperature drops below 35C (95F). This is a risk if you are cooling a large burnt area, particularly in young children and elderly people.
  • Cover the burn with cling film. Put the cling film in a layer over the burn, rather than wrapping it around a limb. A clean clear plastic bag can be used for burns on your hand.
  • Treat the pain from a burn with paracetamol or ibuprofen. Always check the manufacturer's instructions when using over-the-counter medication. Children under 16 years of age should not be given aspirin.
  • Sit upright as much as possible if the face or eyes are burnt. Avoid lying down for as long as possible as this will help to reduce swelling.

When to go to hospital

Once you have taken these steps, you'll need to decide whether further medical treatment is necessary. Go to a hospital accident and emergency (A&E) department for:

  • large or deep burns – bigger than the affected person's hand
  • burns of any size that cause white or charred skin
  • burns on the face, hands, arms, feet, legs or genitals that cause blisters
  • all chemical and electrical burns

Also get medical help straight away if the person with the burn:

  • has other injuries that need treating
  • is going into shock – signs include cold, clammy skin, sweating, rapid, shallow breathing, and weakness or dizziness
  • is pregnant
  • is over the age of 60
  • is under the age of five
  • has a medical condition such as heart, lung or liver disease, or diabetes
  • has a weakened immune system (the body's defence system) – for example, because of HIV or AIDS, or because they're having chemotherapy for cancer

If someone has breathed in smoke or fumes, they should also seek medical attention. Some symptoms may be delayed, and can include:

  • coughing
  • a sore throat
  • difficulty breathing
  • singed nasal hair
  • facial burns

See recovering from burns and scalds for information on how serious burns are treated.

Electrical burns

Electrical burns may not look serious, but they can be very damaging. Someone who has an electrical burn should seek immediate medical attention at an A&E department.

If the person has been injured by a low-voltage source (up to 220-240 volts) such as a domestic electricity supply, safely switch off the power supply or remove the person from the electrical source using a material that doesn't conduct electricity, such as a wooden stick or a wooden chair.

Don't approach a person who is connected to a high-voltage source (1,000 volts or more).

Chemical burns

Chemical burns can be very damaging and require immediate medical attention at an A&E department. If possible, find out what chemical caused the burn and tell the healthcare professionals at A&E.

If you're helping someone else, put on appropriate protective clothing and then:

  • remove any contaminated clothing on the person
  • if the chemical is dry, brush it off their skin
  • use running water to remove any traces of the chemical from the burnt area

Sunburn

In cases of sunburn, follow the advice below:

  • If you notice any signs of sunburn, such as hot, red and painful skin, move into the shade or preferably inside.
  • Take a cool bath or shower to cool down the burnt area of skin.
  • Apply aftersun lotion to the affected area to moisturise, cool and soothe it. Don't use greasy or oily products.
  • If you have any pain, paracetamol or ibuprofen should help relieve it. Always read the manufacturer's instructions and do not give aspirin to children under the age of 16.
  • Stay hydrated by drinking plenty of water.
  • Watch out for signs of heat exhaustion or heatstroke, where the temperature inside your body rises to 37-40C (98.6-104F) or above. Symptoms include dizziness, a rapid pulse or vomiting.

If a person with heat exhaustion is taken to a cool place quickly, given water to drink and has their clothing loosened, they should start to feel better within half an hour.

If they don't, they could develop heatstroke. This is a medical emergency and you'll need to call 999 for an ambulance.

Read more about what to do if someone has heat exhaustion or heatstroke.

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Burns and scalds

How long it takes to recover from a burn or scald depends on how serious it is and how it is treated.

How long it takes to recover from a burn or scald depends on how serious it is and how it's treated. If the wound becomes infected, seek further medical attention.

Burns that don't need medical attention

If your burn or scald is mild and treated at home, it normally heals without the need for further treatment. Read more about first aid for burns and scalds.

While the skin heals, keep the area clean and don't apply any creams or greasy substances. Don't burst any blisters as this can lead to infection.

If you've scalded the inside of your mouth by drinking something hot, try to avoid things that can irritate the scalded area, such as hot and spicy food, alcohol and smoking, until the area heals.

Mild burns or scalds that only affect the uppermost layer of skin (superficial epidermal burns) usually heal in about a week without any scarring.

Burns that need medical attention

If you have a burn or scald that requires medical treatment, it will be assessed to determine the level of care required.

The healthcare professional treating you will:

  • assess the size and depth of the burn by examining the area
  • clean the burn, being careful not to burst any blisters
  • cover the burn with a sterile dressing – usually a pad and a gauze bandage to hold it in place
  • offer you pain relief if necessary – usually paracetamol or ibuprofen

Depending on how the burn happened, you may be advised to have an injection to prevent tetanus, a condition caused by bacteria entering a wound. For example, a tetanus injection may be recommended if there's a chance soil got into the wound.

Your dressing will be checked after 24 hours to make sure there are no signs of infection. It will be changed after 48 hours, and then every three to five days until it's completely healed.

Minor burns affecting the outer layer of skin and some of the underlying layer of tissue (superficial dermal burns) normally heal in around 14 days, leaving minimal scarring.

If the burn is severe, you may be referred to a specialist. In some cases, it may be necessary to have surgery to remove the burnt area of skin and replace it with a skin graft taken from another part of your body. See plastic surgery techniques for more information about this.

More severe and deeper burns can take months or even years to fully heal, and usually leave some visible scarring.

Blisters

Expert opinion is divided over the management of blisters that are caused by burns. However, it's recommended that you shouldn't burst any blisters yourself.

If your burn has caused a blister, you should seek medical attention. The blister will probably remain intact, although some burns units at hospitals follow a policy of deroofing blisters. Deroofing means removing the top layer of skin from the blister.

In some cases, a needle may be used to make a small hole in the blister to drain the fluid out. This is known as aspiration and may be carried out on large blisters or blisters that are likely to burst.

Your healthcare professional will advise you about the best way to care for your blister and what type of dressing you should use.

Exposure to the sun

During the first few years after a burn, you should try to avoid exposing the damaged skin to direct sunlight as this may cause it to blister. It's especially sensitive during the first year after the injury. This also applies to a new area of skin after a skin graft.

It's important to keep the area covered with cotton clothing. If the burn or scald is on your face, wear a peaked cap or wide-brimmed hat when you're out in the sun. Total sun block – for example, one with a sun protection factor (SPF) of 50 – should be used on all affected areas.

The area can be exposed to sunshine again around three years after the injury, but it's still very important to apply a high-factor sun cream (SPF 25 or above) and stay out of the midday sun.

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Burns and scalds

Burns and scalds can sometimes lead to further problems, including shock, heat exhaustion, infection and scarring.

Burns and scalds can sometimes lead to further problems, including shock, heat exhaustion, infection and scarring.

Shock

After a serious injury, it's possible to go into shock. Shock is a life-threatening condition that occurs when there's an insufficient supply of oxygen to the body. It's possible to go into shock after a serious burn.

Signs and symptoms of shock include:

  • a pale face
  • cold or clammy skin
  • a rapid pulse
  • fast, shallow breathing
  • yawning
  • unconsciousness

Dial 999 and ask for an ambulance if you think that someone who has been seriously injured is going into shock.

While you wait for the ambulance:

  • lay the person down (if their injuries allow it) and raise and support their legs
  • use a coat or blanket to keep them warm, but don't cover their face or the burnt area
  • don't give them anything to eat or drink

Heat exhaustion and heatstroke

Heat exhaustion and heatstroke are two heat-related health conditions that happen when the temperature inside your body rises to 37-40C (98.6-104F) or above.

Both heat exhaustion and heatstroke can be very serious. They're often caused by being exposed to too much sunlight or heat.

Symptoms of heat exhaustion and heatstroke include:

  • extreme tiredness and lack of energy
  • dizziness or fainting
  • feeling sick or vomiting
  • rapid pulse
  • headache
  • muscle pain
  • irritability
  • confusion

If a person with heat exhaustion is taken quickly to a cool place, given water to drink and has their clothing loosened, they should start to feel better within half an hour. If they don't, they could develop heatstroke. This is a medical emergency and you'll need to call 999 for an ambulance.

Read more about what to do if someone has heat exhaustion or heatstroke

Infection

Wounds can become infected if bacteria get into them. If your burn or scald has a blister that has burst, it may become infected if it's not kept clean. Seek medical attention for any burn that causes a blister.

Your wound may be infected if:

  • it's uncomfortable, painful or smelly
  • you have a high temperature of 38C (100.4F) or higher 
  • you have signs of cellulitis, a bacterial infection that causes redness and swelling of the skin

Seek immediate medical attention if you think your burn has become infected. An infection can usually be treated with antibiotics and painkilling medication, if necessary.

In rare cases, an infected burn can cause blood poisoning (sepsis) or toxic shock syndrome. These serious conditions can be fatal if not treated.

Signs of sepsis and toxic shock syndrome include:

  • a high temperature
  • dizziness
  • vomiting

Scarring

scar is a patch or line of tissue that remains after a wound has healed. Most minor burns only leave minimal scarring. You can try to reduce the risk of scarring after the wound has healed by:

  • applying an emollient, such as aqueous cream or emulsifying ointment, two or three times a day
  • using sunscreen with a high sun protection factor (SPF) to protect the healing area from the sun when you are outside
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Burns and scalds

Many severe burns and scalds affect babies and young children. The following advice can help reduce the chances of your child having a serious accident.

Many severe burns and scalds affect babies and young children. The following advice can help reduce the likelihood of your child having a serious accident.

In the kitchen

  • it's best to keep your toddler out of the kitchen, well away from kettles, saucepans and hot oven doors – you could put a safety gate across the doorway to stop them getting in
  • use a kettle with a short or curly cord to stop it hanging over the edge of the work surface, where it could be grabbed
  • when cooking, use the rings at the back of the cooker and turn saucepan handles towards the back so your child can't grab them

In the bathroom

  • never leave a child under five alone in the bath, even for a moment
  • fit a thermostatic mixing valve to your bath's hot tap to control the temperature
  • put cold water into the bath first, then add the hot water – use your elbow to test the temperature of the water before you put your baby or toddler in the bath

Throughout the home

  • put your iron, hair straighteners or curling tongs out of reach while they cool down after you've finished using them
  • fit fireguards to all fires and heaters
  • keep matches, lighters and lit candles out of young children's sight and reach

Hot drinks

  • keep hot drinks well away from young children – a hot drink can still scald 20 minutes after it was made
  • put hot drinks down before you hold your baby
  • after warming a bottle of milk, shake the bottle well and test the temperature of the milk by placing a few drops on the inside of your wrist before feeding – it should feel lukewarm, not hot
  • don't let your child drink a hot drink through a straw

Preventing sunburn

  • encourage your child to play in the shade – under trees, for example – especially between 11am and 3pm, when the sun is at its strongest
  • keep babies under the age of six months out of direct sunlight, especially around midday
  • cover your child up in loose, baggy cotton clothes, such as an oversized T-shirt with sleeves
  • get your child to wear a floppy hat with a wide brim that shades their face and neck
  • cover exposed parts of your child's skin with sunscreen, even on cloudy or overcast days – use a sunscreen that has a sun protection factor (SPF) of 15 or above and is effective against UVA and UVB
  • reapply sunscreen often throughout the day – even water-resistant sunscreens should be reapplied after you come out of the water

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