Burns at home
the first few minutes

What really helps, which home remedies make things worse, and the signs that tell you a doctor is needed.

Most burns at home happen in the kitchen and the bathroom — boiling water, hot oil, the oven, a cup of tea. In most cases, the first ten minutes decide how deep the damage will go.

A burn does not stop the moment contact ends. Heat retained in the tissue goes on damaging it for several minutes afterwards. That is why cooling is urgent.

The first few minutes

• Stop contact with the source of heat
• Remove clothing and jewellery from the affected area, unless they are stuck to the skin
• Hold the burn under cool running water for 20 minutes, as soon as possible
• Cover it with a clean, dry, non-fluffy (lint-free) cloth or with cling film laid loosely lengthways over the burn — do not wrap it around a limb, and do not put it on the face
• Take a painkiller if it hurts

Not overly cold water, and not ice

Cool, not ice-cold. Ice and iced water constrict the blood vessels in the damaged skin, reduce its blood supply and can make the injury deeper.

When a large area is affected, excessive cooling can also cause body temperature to drop — especially in children and older people.

What not to put on a burn

• Cooking oil, olive oil, butter or egg — they hold in the heat and create conditions for infection
• Yoghurt, potatoes, tomatoes and other home remedies
• Toothpaste
• Surgical spirit or iodine on fresh blisters
• Cotton wool — the fibres stick to the wound

Do not burst blisters at home. Whether and how they should be treated is for a doctor to decide.

When you must see a doctor

• A burn to the face, neck, hands, feet or genitals
• A burn over or around a joint
• A burn larger than the injured person's palm
• The skin is white, waxy, brown or charred — such burns do not hurt, which is misleading
• An electrical or chemical burn
• The injured person is a child or an older person
• The burn has not healed within two to three weeks
• Redness, pus or a high temperature develops

Why two to three weeks is the limit

Superficial burns heal on their own in about two weeks and usually do not leave a permanent scar.

The depth of a burn, however, is not something you wait three weeks to find out — it is assessed early, at an examination. The three-week mark matters for a different practical reason: a wound that takes longer than 21 days to heal carries a high risk of hypertrophic scarring, and this is also the point at which surgical treatment with a skin graft is discussed.

So a burn that “just won’t heal” should not be left indefinitely.

After the burn has healed

New skin is thin, dry and very sensitive to the sun. It needs full sun protection for at least a year, daily moisturising with a cream or ointment, silicone products if the scar is raised, and compression therapy with elastic bandages or garments.

For burns over joints, rehabilitation is not an optional extra but part of the treatment. A tightening scar restricts movement, and this is far easier to prevent than to correct later.