How to treat burns and scalds – a doctor’s first aid tips

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Burns and scalds are damage to the skin caused by heat. They can be painful and frightening, though the majority of burns are mild and can be treated at home or with the help of a pharmacist or doctor.

‘The difference between burns and scalds is that scalds are caused by wet things like boiling water in a kettle, and burns are caused by dry heat, like from an iron or flame,’ explains Dr Nikki Ramskill, a Livi GP. They’re both treated the same way.

What should I do if I have a burn?

  • Get away from the heat source. Move as quickly and as safely as possible
  • Remove any clothing or jewellery near the burnt skin. Don’t remove anything that’s stuck to the skin, as this could cause more damage
  • Cool the burn. Hold it under cool, running water for at least 20 minutes
  • If the burn is large, keep warm. Wrap up in a blanket while you’re cooling the burn to prevent hypothermia. Go to A&E if the burn is larger than your hand
  • If your face or eyes are burnt, sit up for as long as possible. This helps reduce swelling. Go to A&E for any burns to the eyes and face
  • Relieve pain if necessary. Use paracetamol or ibuprofen

There are a few other points to remember:

  • Never use ice or ice-cold water to cool a burn. Burning your skin may expose deeper layers that are more sensitive to cold temperatures. If you’ve had a large or severe burn, ice can lower your body temperature too far and potentially cause hypothermia.
  • Avoid creams or ointments. Covering the burn in creams may slow the cooling process.
  • If you have a chemical burn, take a photo of the chemical. Show the doctors the photo in A&E so they know how to treat it.
  • Do not pop any blisters that form.

When should I go to A&E with a burn or scald?

You should also go to A&E if:

  • The burn is larger than your hand
  • Your skin is white or charred
  • The burns are on your face, genitals, hands, arms, feet or legs and cause blisters
  • You’ve had a chemical or electrical burn
  • You have other injuries or have lost blood
  • You’ve inhaled smoke
  • You’re pregnant
  • You’re over the age of 60
  • Your child was burned
  • You have a serious medical condition like HIV, cancer, diabetes, or heart, lung or liver disease

If you or someone else has been burnt and is bleeding, having trouble breathing or is going into shock, call 999.

When should I speak to a doctor about a burn or scald?

Even if you don’t need emergency care after burning yourself, it can be a good idea to make an appointment to see a doctor or nurse if:

  • You need reassurance that it’s OK to treat your burn at home
  • There’s worsening redness on your skin
  • The pain is getting worse
  • There’s pus coming from the burn
  • You need advice on how to treat it

What are the different types of burns?

Superficial (first-degree burn)

A burn that only affects the outer layer of the skin (the epidermis). These look red and feel dry, but don’t form blisters.

Red and painful skin can be scary, but this is usually a sign that the burn hasn’t gone very deep into the tissues.

Superficial partial-thickness (second-degree burn)

A burn that affects the epidermis and extends into the superficial dermis. These burns are usually very painful and typically form blisters within 24 hours.

Deep partial-thickness (second-degree burn)

These burns extend even deeper into the dermis, and they may not be as painful.

Full-thickness (third-degree and fourth-degree burns)

This affects all three layers of the skin, including the deepest layer (the hypodermis). The skin might look white, grey or charred and black.

‘Not being able to feel your burn suggests the deepest layers of your skin have been affected and your nerve endings have been damaged by the heat,’ says Dr Ramskill. This is very serious and always requires urgent medical attention.

Burns can also be categorised based on the cause: thermal burns, radiation burns, chemical burns or electrical burns.

What’s a burn blister?

A burn blister is a separation between layers of your skin that contains a clear fluid called serum. They form over a burnt area of skin to protect it. ‘Don’t pop any blisters,’ says Dr Ramskill. ‘Keep the skin clean and take painkillers as needed.’

Should I cover a burn or let it breathe?

‘Covering the burn keeps the area moist and reduces pain from air blowing over the burn. For mild burns, you can apply a blister plaster,’ says Dr Ramskill. ‘Make sure that any dressings you apply are non-adhesive and suitable for burns.’

As your burn becomes less painful, it doesn’t need to be covered unless you’re worried about catching and bursting a blister. Avoid using any topical cream for burns unless a doctor advises you to.

If you’re given a dressing at a hospital, it will need changing after 48 hours, then every 3 to 5 days or whenever it gets wet.

What are the signs that a burn is infected?

The skin around infected burns or the burn blister may turn increasingly red and become painful. Feeling sweaty, clammy or flu-like can also be signs of a serious infection, and you might notice pus– a sticky, yellow substance – coming from the burn wound.

‘Monitor how the skin looks underneath the dressing regularly,’ says Dr Ramskill. If you notice any signs of infection, seek medical advice.

How long does it take for a burn to heal?

Mild burns: about a week

‘The fluid will usually drain away during the first few days,’ says Dr Ramskill. ‘The roof of the blister will protect the area while a new layer of skin forms underneath, and eventually, the blistered skin will peel away.’

Severe burns: 2 weeks to several months.

‘If your burn is severe enough that you went to hospital and received dressings, it can take longer for the burn to heal,’ says Dr Ramskill. Severe and deep burns can take months or even years to heal and sometimes require skin grafts.

‘It can take time to recover both physically and emotionally from a bad burn,’ says Dr Ramskill. ‘Bad burns in children can sometimes be emotionally scarring for caregivers as well. If you’re struggling, seek help from support groups or go through talking therapy to come to terms with what’s happened.’

You can also talk to a doctoror a psychologist to get help.

This article has been medically reviewed by Dr Nikki Ramskill, a Livi GP

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