Page header image

Burns: Thermal

What is a burn?

Most burns are scalds from hot water or drinks. A few are from hot grease, heating grates, and cigarettes.

There are three degrees of burns:

  • A first-degree burn is reddened skin without blisters. It does not leave a scar.
  • A second-degree burn has blisters. It also does not leave a scar. Second-degree burns take up to 3 weeks to heal.
  • A third-degree burn is deep and leaves areas of charred or white skin. There are no blisters in third-degree burns. During healing it usually needs a skin graft to prevent bad scarring.

How can I take care of my child?

  • First Aid: Immediately (don't take time to remove clothing) put the burned part in cold tap water or pour cold tap water over it for 10 minutes. If you are outside, the nearest garden hose should be used. This will lessen the depth of the burn and relieve pain. Do not put ice on a burn. Do not use butter or shortening. If the burned area is large, cover it loosely with a clean sheet. You can also use plastic wrap. The covering will keep the burn clean and reduce the pain.
  • Home Care: If the burn is minor, wash the area gently with warm water once a day. Avoid soap unless the burn is dirty. (Soaps can slow healing). Don't open any blisters—the outer skin protects the burn from infection. If the burn is second degree, the blister is broken, and the skin is gone, put an antibiotic ointment on it and cover it with a Band-Aid or sterile gauze dressing. Change the dressing every other day. Use warm water and 1 or 2 gentle wipes with a wet washcloth to remove any dirt or debris on the surface. Then reapply the dressing with antibiotic ointment. Do not put any butter or burn ointments on the burn.

    For pain give acetaminophen every 4 hours or ibuprofen every 6 hours for at least 24 hours. Covering any open burn with ointment also usually greatly reduces the pain.

    Note: Once the blisters break open, the dead skin needs to be wiped off with a wet washcloth or trimmed off with fine scissors. Otherwise, the hidden pockets become an ideal breeding ground for infections.

  • Prevention: Think about how you can prevent similar accidents in the future. Also, install a smoke detector.

When should I call my child's healthcare provider?

Call IMMEDIATELY if:

  • A blister is larger than 2 inches across.
  • The burn is on the face, hands, feet, or genitals.
  • It was an electrical burn.

Call during office hours if:

  • It starts to look infected.
  • It isn't healed within 10 days.
  • You feel your child is getting worse.
  • You have other questions or concerns.
Written by Barton D. Schmitt, MD, author of “My Child Is Sick,” American Academy of Pediatrics Books.
Pediatric Advisor 2018.1 published by Change Healthcare.
Last modified: 2015-06-11
Last reviewed: 2017-06-05
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2018 Barton D. Schmitt, MD FAAP. All rights reserved.
Page footer image