Responding to a burn or scald depends on the cause, severity and duration of heat exposure. Some burns can be treated at home, while others require immediate medical attention. And to confuse things even further, the pain you feel doesn’t always correlate to how serious the burn is. In fact, severe third–degree burns are often painless because the pain receptors themselves have been destroyed. So what do you do? Fortunately, the initial steps for treating burns and scalds are basically the same: stop the burn, cool the burn and treat the pain. You can go to Urgent Care for first–degree burns and most second–degree burns, but third–degree burns should be treated in the Emergency Room.

First Steps:

  1. Remove the person from the heat source, or the heat source from the person—whichever is easier.
  2. Cool the burn, ideally by running cool (but not cold) running water for up to 20 minutes. Resist the urge to run for ice cubes; ice is too cold and can lead to tissue damage. Also avoid using Vaseline, lotions and oils, which can trap heat in the skin. 
  3. Remove clothing and jewelry near the burn area. If clothing is stuck to the skin, leave it and seek medical help.
  4. Cover the burn with cellophane, a plastic bag or a non–stick gauze (anything that doesn’t adhere to the skin).
  5. Take a painkiller like ibuprofen or Tylenol to treat the pain.

What are Burns and Scalds?

Burns and scalds arise from heat damage to the skin. Burns are caused by dry heat sources, such as flames and hot irons. Scalds are caused by wet heat (typically hot liquids and steam) or hot oils and greases. Chemical and electrical burns require different response measures, such as chemical neutralization, and are often very serious. But the most important factor is always severity, which determines how you respond to a burn or scald.

First Degree Burn

First–degree burns, or “minor burns,” affect only the top layer of the skin known as the epidermis. These burns are often caused by exposure to the sun (a sunburn) or a short physical interaction with a heat source (like a hot pan). The affected skin will turn red, and the burn will feel irritated, swollen and mildly painful. No blisters will arise. First–degree burns can be treated at home and should heal on their own.

Second Degree Burn

Second–degree burns affect the dermis, which is the layer just beneath the outer skin. Hotter liquids like grease, oil and soup are more likely to cause these burns than sun exposure or hot objects. These burns can damage capillaries, nerves and hair follicles, and are typically quite painful. The skin will appear pale pink, blistered, and white when pressed. In deeper dermal burns, known as deep partial–thickness burns, the skin turns a deeper red and may appear blotchy or spotted. Medical attention is recommended for all second–degree burns.

Third Degree Burn

Third–degree burns are the most severe and can lead to permanent tissue and nerve damage. Usually caused by fire, steam, hot liquids, chemicals or electricity, these burns always require immediate medical attention. The burn area will appear leathery and hard, usually blackened through, and the skin will not blanche when pressed. Call 911 immediately and cover the burn area as well as possible. Do not soak in water, as it could lead to infection.

When in Doubt

No matter the kind of burn, it’s always a good idea to seek medical attention if you’re not sure what to do—especially if a minor burn hasn’t healed on its own. Urgent Care is a good option for non–life threatening emergencies, or you can go to the Emergency Room if the burn is more serious.