How to treat a burn blister

Most burns are not medical emergencies and can be treated easily. Burns that cause the skin to be red, painful and swell are called superficial burns. Usually they are caused by heat, such as fire, steam, hot surfaces or a hot liquid.

The treatment for superficial burns caused by heat:

1) Stop the burning! Get the person away from the source of the burn.

2) Use plenty of cold running water to help control pain.

3) Cover the burn loosely with sterile dressing. This is not like bandaging for bleeding – keep it loose.

Most of the time, it’s that simple. But sometimes a burn is more severe.

Call 911 or get to a hospital immediately for these conditions:

1) Skin that is burned to a brown or black color or if the tissue underneath appears to be white.

2) Burns to the airway. Burns around the mouth or nose can be very serious. It may be accompanied by trouble breathing.

3) Burns from electricity and explosions. These types of burns carry additional risks such as airway and cardiac damage.

For chemical burns, run an excessive amount of water over the burned area. The idea is to flush the chemical off the skin. However, if you have any doubt about your ability to treat a chemical burn, call 911 or seek professional medical help immediately.

Burns that cause open weeping blisters can be treated at home if the burned area is very small. The general rule is that if the burn is bigger than a quarter on a child and bigger than a silver dollar on an adult, seek medical help.

Additional considerations for burns:

  • Burns to the hands, feet, genitals, head and neck are the most serious.
  • Children younger than 5 and people over 60 are more susceptible to the affects of burns.
  • If a burn blisters, don’t try to drain the blister. This increases your chance for infection.
  • Do not try to remove clothes that are burned into the skin.
  • There is no need to put ointments on a burn unless a healthcare provider tells you to do so.
  • You can apply ice to a small superficial burn to cool the area for pain management, but do not put the ice directly on the skin. Use a barrier between the ice and your skin. Do not use ice for more than 10 minutes continuously. Skin tissue can be damaged with excessive treatment with ice. It is also possible to lower a person’s body temperature too much with excessive ice treatment.
  • Do not put butter on a burn. It’s an old home remedy that is a bad idea. Yes, it can reduce pain because the burn isn’t exposed to air, but the salt desiccates the burned tissues. Butter also retains heat in tissues and can make the burn worse.
  • Consider taking an American Heart Association or Red Cross first aid class to learn more about burns and to have a chance to practice treating burns.

About The Author:

Chris Schlesinger’s company In Home CPR teaches on-site safety classes at homes and businesses throughout the San Francisco Bay Area, serving Alameda, Contra Costa, Marin, Napa, Sonoma, San Mateo, Santa Clara and Solano counties.  He offers certifications through the American Heart Association and American Red Cross in CPR, BLS, AED, standard first aid and pediatric first aid.  Visit his websites at CPR Certification San Francisco or CPR Class San Mateo.

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Second Degree Burn

  • Results in damage extending beyond the top layer of skin
  • The skin will blister and become extremely red and sore
  • Should be assessed by a doctor for risk of infection
  • If over-the-counter pain relief is not sufficient, a prescription medication may be required
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Third Degree Burn

  • Burn extends through every level of skin
  • One of the most severe burns
  • If extensive nerve damage has occurred, there may not be any pain
  • Common signs of a third-degree burn include:
    • Bleeding
    • Appearing a bit black
    • Skin appearing dry or leathery
    • If your burn is bleeding, looks a little bit black, or your skin appears dry or leathery
  • Seek emergency medical care immediately

Fourth Degree Burn

  • This is the most serious type of burn
  • Fourth-degree burns penetrate deeply beneath the skin
  • There is potential for nerve damage and injury to deeper tissues including muscles, tendons, and bones
  • Due to nerve damage, there may not be any pain
  • Burns may appear white, brown, yellow, or blackened
  • Seek emergency medical care immediately

 

First Aid for Burns

In the case of a burn, regardless of the degree of burn, there are three steps you should follow to minimize injury and maximize chances of recovery:

  • Step 1: Prevent shock
  • Step 2: Relieve pain/discomfort
  • Step 3: Reduce the risk of infection

Depending on the degree of burn, the specific tasks within each step will differ. Outlined below are the actions to be taken based on the type of burn you received or are treating:

First Degree Burn Treatment

  • Usually treated with home care
  • Soak burns in cold water asap; healing time can be reduced by treating burns quickly
  • Soak burn for at least five minutes
  • Apply aloe vera to soothe the skin
  • Acetaminophen or ibuprofen can be taken for pain relief
  • Skin may peel as it heals
  • A full recovery should take three weeks
  • A doctor should be consulted if there are any signs of infection or if pain worsens

Second Degree Burn Treatment

  • Run burn under cold water for at least 15 minutes
  • Keep burn clean to prevent infection
  • Consult a doctor for wound assessment, tetanus shot administration, and prescription pain medication if required
  • Burns should heal in three weeks without scarring
  • Changes in pigment to affected skin may occur
  • A doctor should be consulted if there are any signs of infection or if pain worsens after initial assessment.

Third and Fourth Degree Burn Treatment

  • Call 911 immediately; do not self-treat
  • These burns carry a high risk of complications and will likely require surgery
  • Remove constrictive clothing or jewelry close to the burn site asap (burns swell quickly)
  • Loosely cover the burned area with material that won’t leave lint in the wound (but preferably a sterile, non-stick bandage)
  • Elevate burn area above heart level
  • Check pulse and monitor until emergency help arrives
  • Victims can suffer from long-term effects requiring ongoing medical treatment, rehabilitation, and mental health counselling
  • Some victims suffer from blood loss, hypothermia, or bacterial infections such as tetanus
  • These types of burns can sometimes be fatal

Treatment for Burns to the Hands

Unfortunately, burns to the hands can be very serious and sometimes are not easy to treat. The palm of your hand is only 1% of your body’s surface area but a burn to that area can lead to serious short- or long-term disability. If you are helping someone tend to a hand burn or have burned your own hand, below are some tips to increase your chances of a speedy recovery.

  • Elevate your hand  above heart level to prevent the formation of an edema
  • Check that airways are clear and there are no breathing concerns
    • Burns often result in shock and may lead to changes in or loss of pulse
    • If the pulse is lost, techniques such as incisions in the arm may be required
  • For burns resulting in blisters, consult a doctor as breaking blisters and leaving them intact are both viable options
  • Daily care is extensive
    • Burned hands need to be cleaned twice a day with a mixture of water and antiseptics
    • Dressings are available for treating partial thickness burns to the hand
    • Burned hands must be positioned for proper wrist extension and joint form
  • A burn to the hands may require substantial adjustments to your daily life and routines
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Serious hand burns can lead to time off work and even permanent disability. This is why burn prevention is so essential.

Types of burns

Burns are categorized according to their severity:

First degree burns: These are the types of burns that most people experience at some time. They are minor burns that affect just the outer later of skin, called the epidermis. They can be painful, causing redness to the skin and some swelling. Mild sunburns are a common type of first degree burn.

Second degree burns: These burns are deeper than first degree burns, affecting the epidermis and the second layer of the skin, called the dermis. If the burn is small, less than two to three inches wide, it is considered minor, but larger second degree burns are treated as major burns. Second degree burns are also considered to be major if they are on the face, hands, feet, a major joint, groin/genitals, or buttocks.

Second degree burns are usually painful and cause redness and swelling. They may cause blistering and breaks in the skin, so the increase your risk of developing an infection. Sunburns that blister and are very painful are considered to be second degree burns.

Third-degree burns: These are serious burns, even if they are small. They can be life-threatening. These burns go through the layers of the skin to the fat below. There may be no pain in the area, because the nerves may be destroyed, although there will likely be pain around the area, where the burns are not as deep.

People with third degree burns are at particular risk for dehydration, infection, and sepsis.

Burns on your face

Burns on your face, regardless of the severity, may also cause internal burns in your airway, which can be life threatening. Facial burns can happen as part of a larger burn, but your face can get burned if you are too close to the flame when you light a barbecue or pilot light, or even if you suddenly release steam from a pot, for example. If you have burns in your airway, you may experience:

  • Burns on your lips and mouth
  • Coughing
  • Difficulty breathing
  • Changes in your voice
  • Wheezing

Treating burns

Major burns must be treated as medical emergencies. Seek emergency help or call 9-1-1 if you have a third-degree burn or a second-degree burn that covers more than two to three inches in width, or is on your face, hands, feet, a major joint, your groin or genitals, or buttocks.

Do not:

  • Soak the burn in water
  • Put ice on the burn
  • Apply any ointments or creams to the burn
  • Remove any clothing or fabric that is stuck to the burn

If the burn is caused by a chemical, rinse the area with clean running or poured water to try to flush the chemical away. By running or pouring water over the burn, the chemical may be pushed off and away from the skin. If possible, loosely cover the burn with a clean or sterile cloth or bandage.

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Treatment for severe burns may include:

  • Intravenous (IV) fluids to keep you hydrated
  • Medications, particularly for pain
  • Burn creams and ointments, and special burn dressings
  • Antibiotics to treat infections

Care for less serious burns

First degree and smaller second degree burns are usually managed well at home. First aid may include soaking the burned area in cool (not cold) water for a few minutes to stop the burning process, and then drying gently. Pat to dry, do not rub. Creams, such as aloe vera or burn ointments may help relieve some of the pain or discomfort. Keep the burns clean and loosely covered, and monitor for breaks in the skin and signs of infection. Do not break any blisters that may form.

If you show any of the following signs of infection, contact your doctor or go to an urgent care clinic, so your burn can be evaluated and treated:

  • Pus or discharge from the burn site
  • Increase in pain
  • Change of color around the burned area
  • Fever

If you suspect sepsis, call 9-1-1 or go to a hospital and tell your medical professional, “I AM CONCERNED ABOUT SEPSIS.” 

Related article:

  • Summer Fun: Staying Safe, Reducing Infection Risk

Would you like to share your story about sepsis or read about others who have had sepsis? Please visit Faces of Sepsis, where you will find hundreds of stories from survivors and tributes to those who died from sepsis.

Updated December 13, 2017

Burn Degrees: What Are First, Second, and Third-Degree Burns?

  • first-degree burn only affects the most superficial layer of skin, called the epidermis. The skin may be pink in color, warm to the touch, and slightly swollen. The burn site will be tender and sensitive to the touch.
  • second-degree burn penetrates into the dermis, a thick layer of living tissue just beneath the surface of your skin. Severe second-degree burns may extend deeper into the tissue below the dermis. With a second-degree burn, you may see blistering, deep-hued red skin, or even yellow and white patches. Pain from a second-degree burn is moderate to severe.
  • Third-degree burns sear the epidermis, the dermis, and below. These severe burns do not produce blistering because the tissue that blisters will be destroyed. Contrary to popular belief, third-degree burns produce minimal pain because the nerves will be too damaged to transmit feeling. The burn may be white, yellowed, or visibly charred.
  • fourth-degree burn refers to an extremely severe burn that extends into the muscles, bones, ligaments, and tendons. These tissues may be visible, and the surrounding will likely be blackened.

Next, think about these burn factors.

  • How large is the burn?
  • Where is the burn located?
  • How old is victim? Small children may be more affected by burn injuries.
  • Have any additional injuries been sustained as the result of the burn?

RELATED: Burn Awareness: Flame Burns

These types of burns should be treated by a doctor.

  • Any second-degree burn larger than two inches in diameter should be checked out by a doctor. In addition, burns on the face, genitals, or joints should be treated by a doctor, as they may require additional treatment to heal without scarring.
  • Burns caused by chemicals or electricity should be evaluated by a doctor, while only first- and second-degree sunburns or burns caused by high temperatures should be treated at home.

For more information about burn treatment, visit the UPMC Mercy Burn Center website. To find immediate care near you, visit UPMC CareFinder.

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