Burns or Scalds

With over one million cases of burn injuries in the US each year, burns and scalds are some of the most common injuries, especially with toddlers and young children who may not have the hazard …

Burned arm, Scalds
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With over one million cases of burn injuries in the US each year, burns and scalds are some of the most common injuries, especially with toddlers and young children who may not have the hazard awareness to avoid heat sources. Pediatric burns occur more commonly in the home (84 percent) when children are unsupervised (80 percent).

Both burns and scalds are types of heat damage caused to the skin, but the difference is that burns result from dry heat (hot objects, fire) while scalds are caused by wet heat (steam, hot water).

This guide covers the different types of burns and scalds and their varying severity. It will also look at the treatment required for different degrees of injury and offer suggestions for preventing your child from suffering burns.

Types of burns

Burns can differ in nature and severity depending on the source of heat. It’s important to classify the type of burn in order to properly treat it. Burns are classified based on how deeply they penetrate the skin.

First-degree burn

A first-degree burn affects only the top layer of skin or the epidermis. These burns are painful and dry, and blanch when pressed (turning from red to white). First-degree burns are also called superficial burns and they do not blister or scar. They generally heal within 6 days. An example of a superficial burn is a non-blistering sunburn.

Second-degree burn

Second-degree burns are also known as partial-thickness burns and involve the top 2 layers of skin. They are usually more painful than first-degree burns and also blanch when pressed. They can form blisters and leak discharge and can take between 1 and 3 weeks to heal. Once healed, second-degree burns can leave a scar or can leave the skin permanently lighter or darker in color.

Third-degree burns

Third-degree burns are also called full-thickness burns and penetrate all layers of skin, destroying it completely. They damage hair follicles, fat, and nerve-endings, meaning that these types of burns do not hurt. This is the most serious type of burn, requiring emergency treatment and skin grafts. Third-degree burns range in color from black and dark red to white and do not change color when pressed.


Treatment for burns is determined by their size, depth, and severity.

Only first- and second-degree burns can be treated at home, while third-degree burns cannot heal on their own and need emergency treatment. Moderate burn injury may require admission to a hospital but not to a burn center, severe burn injury must be treated at a designated burn center. The most important step for treating burns is cooling down the skin as soon as possible to stop the burning process.

Steps for treating burns

Cool the skin

The burning process will continue to damage the skin until the area is cooled down. Cooling the skin with a cold compress or soaking it in cool (not icy) water will ease the pain and save the skin from further damage [4]. Although it seems counterintuitive, you should not place ice directly on the burnt skin as this can damage the tissue even more.

Clean the burn

Cleaning the burnt skin will help to prevent infection and aid the healing process. Remove any clothing from the burn, but do not forcibly remove fabric that is stuck to the skin as this should only be dealt with by a medical professional. Only clean the skin with cold water and gentle soap and avoid potential irritants such as alcohol or disinfectant.

Prevent infection

Like any other wound, burnt skin will be vulnerable to infection. For second-and third-degree burns, you can apply a thin layer of an antibacterial cream along with a non-stick bandage to prevent infection. This dressing should be changed once or twice a day. Do not apply any natural or homemade remedies such as essential oils, egg whites, or mustard.

Monitor the burn

Regularly check the burn to make sure it is healing properly.  If the burn becomes more red or painful or appears to be infected, see a doctor as soon as possible. Although it can be irritating, itching is a sign that the skin is healing. Avoid scratching the burn while it heals.


In the average home, there are many different sources that can cause burns and scalds. These include electrical outlets, stovetops, hot irons, boiling water, open fires, and cleaning chemicals. 

Adventurous toddlers tend to be curious about everything around them without yet understanding the potential dangers. Keep hazardous objects or substances securely covered and out of reach/sight to protect your child from burns and other injuries.

When to see a doctor

While burns can often be treated at home, you should seek medical attention if:

  • The burn is on the face, fingers, hands, feet, or genitals.
  • The burn is on or near a joint.
  • The burn is encircling a body part, such as an arm, leg, or chest.
  • The burn is particularly large or deep. As a guide, you should see a doctor if the burn is larger than an orange. When in doubt about what is too large or deep, see a doctor.
  • The child is younger than 5.
  • There are signs of infection, or the child has a fever (100.4˚F).
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  2. Peck MD, Kruger GE, van der Merwe AE, et al. Burns and fires from non-electric domestic appliances in low and middle income countries Part I. The scope of the problem. Burns 2008; 34:303.
  3. World Health Organization. The Global Burden of Disease: 2004 Update. World Health Organization, Geneva 2008. www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf (Accessed on April 02, 2010).
  4. Pruitt BA, Wolf SE, Mason AD. Epidemiological, demographic, and outcome characteristics of burn injury. In: Total Burn Care, 3rd edition, Herndon DN (Ed), Saunders Elsevier, Philadelphia 2007. p.14.
  5. Fabia R, Groner JI. Advances in the care of children with burns. Adv Pediatr 2009; 56:219.
  6. Nguyen NL, Gun RT, Sparnon AL, Ryan P. The importance of initial management: a case series of childhood burns in Vietnam. Burns 2002; 28:167.
  7. Turner C, Spinks A, McClure R, Nixon J. Community-based interventions for the prevention of burns and scalds in children. Cochrane Database Syst Rev 2004; :CD004335.
  8. American Burn Association White Paper. Surgical management of the burn wound and use of skin substitutes. Copyright 2009. www.ameriburn.or (Accessed on January 04, 2010).

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