What is a burn or scald?

Burns are damage to the tissue of your body caused by heat, too much sun, chemicals or electricity. Scalds are caused by hot water or steam.

Burns and scalds can range from being a minor injury to a life-threatening emergency. It depends how deep and how large they are.

What are the symptoms of a burn or scald?

A superficial burn, also known as a first-degree burn, affects the outer or top layer of skin only. It may be blistered, red and painful.

A partial thickness burn (second-degree burn) damages the first and second skin layers. It may be mottled red and white, dark red or pale yellow. It will be painful and is often blistered.

A full thickness burn (third-degree burn) reaches as far as the fat underneath the skin. It may look brown, black or white, and feel dry and leathery. A full thickness burn can destroy nerves, so you may not feel the pain.

What causes burns and scalds?

The most common causes of burns are:

• scalds from hot drinks such as cups of tea or coffee, hot water or steam from kettles or pots, or hot water taps in the kitchen or bathroom
• contact with flames
• contact with hot objects such as stoves, irons, hair straighteners or hot coals
• contact with winter items such as hot water bottles, electric blankets and heat packs
• chemical burns from swallowing things, such as drain cleaner or button batteries, or from spilling chemicals such as bleach, oven cleaner or concrete onto the skin
• electrical burns

When should I call an ambulance?

Call an ambulance or go straight to your nearest emergency department if:

• the burn is deep, even if the person doesn't feel any pain
• the burn is larger than a 20 cent piece
• the burn involves the airway, face, hands or genitals
• the skin looks leathery, or there are patches of brown, black or white
• the burn was caused by chemicals or electricity
• the person is having trouble breathing

What should I do while waiting for an ambulance?

First, remove the source of the burn:

• If the person is on fire, drop them to the ground and roll them or cover them in a blanket to put out the flames.
• If there is an electrical current, turn off the electricity.
• If it's a chemical burn, take off any contaminated clothing and wash the affected area of skin with plenty of water, continuing for up to 60 minutes. For dry chemicals, brush off the chemicals before putting the burnt area under water.

As soon as possible, put the burnt area under cool running water for at least 20 minutes:

• Don't use ice (only apply water to the burnt area).
• Remove any clothing or jewellery near the burn unless they are stuck to the burn.
• Don't remove anything that is stuck to the burn.

Cover the burn:

• Use a light, loose, non-stick dressing. Use non-fluffy material. Plastic cling film is a good choice.
• If the burn is to an arm or leg, raise it whenever possible to reduce swelling.

Some things to avoid:

• Don't touch the burn or apply ice.
• Don't put a child with burns into a bath full of cold water.
• If blisters develop don't pop them — see your doctor who will examine them and decide how best to treat.
• Don't use any ointments, creams, lotions or fat on a burn. They seal heat in and cause more damage.

How should I treat burns and scalds?

Most small burns will heal themselves in 10 to 12 days. If the burn does not have any blisters or broken skin, such as sunburn, a simple moisturiser such as sorbolene is the best treatment. For all other burns seek medical treatment for appropriate dressings.

The treatment for serious burns includes:

• pain relief medicine
• dressings
• possible admission to hospital
• in some situations, surgery

If the wound gets worse, or if you are not up to date with tetanus injections, see your doctor.

Can burns and scalds be prevented?

In the kitchen:

You can prevent burns and scalds by being careful when cooking:

• Make sure all hot liquids are out of the reach of children and turn pot handles inwards on the stove.
• Be careful not to give children food that is too hot — test it first.

• Always supervise children in the kitchen and install a safety gate if possible, to keep toddlers out while you are cooking.

In the bathroom:

• Fill a bath with cold water first, then add the hot water to get to the correct temperature.
• Always test the water temperature before your child gets into a shower or bath.
• Make sure your water is below 50°C to prevent scalds.

Around your home:

• Take care with all electrical items. Unplug them when they're not in use.
• Always have working smoke detectors in the house and keep a fire extinguisher handy. All adults who live in or regularly visit your home (for example, babysitters) should know where you keep the fire extinguisher.
• If you are using chemicals, always wear protective clothing and eyewear.

Complications of burns and scalds

Large or deep burns and scalds can become infected. This can lead to infection of the blood (sepsis).

Serious burns cause a loss of fluid from the body. They can also lead to dangerously low body temperature.

After a serious burn or scald heals, there may be scarring. This can also cause problems with bones and joints.

Resources and support

• The Royal Children's Hospital has advice on how to prevent burns and first aid treatment of burns.
• St John Ambulance provides a guide and a fact sheet on how to treat burns and scalds.
• Call healthdirect on 1800 022 222 at any time to speak to a registered nurse (known as NURSE-ON-CALL in Victoria) for more information and advice.