Medically reviewed by Dr. A.M. van Coevorden, dermatologist
BurnsCool first, assess after.
A burn is caused by heat, hot liquid, steam, fire, chemicals, electricity or the sun. The single most important thing is to cool immediately: hold the wound under lukewarm, gently running water for ten to twenty minutes. How deep a burn is determines how it heals; superficial burns clear by themselves, deeper and larger burns belong with a doctor. For a large burn or breathing difficulty: call the emergency number.
What are burns?
Burns are classified by depth. With a first-degree burn the skin is red, dry and painful, but not broken, as with mild sunburn. With a second-degree burn the skin is moist and red and blisters form; this often hurts a lot. With a third-degree burn the skin is yellowish-white, brown or black and feels stiff; because the nerves are destroyed, you actually feel little or no pain. The larger and deeper the wound, the greater the risk of fluid loss and infection.
What should you do immediately?
Cool the burn immediately for ten to twenty minutes with lukewarm, gently running water; not with ice or ice-cold water. Meanwhile remove clothing, a nappy and jewellery near the wound, but do not pull off fabric that is stuck to the skin. Then cover an open wound or blisters loosely with cling film or a clean, lint-free cloth. Apply nothing to a fresh burn: no ointment, toothpaste or butter. Keep the body warm to prevent hypothermia, and take paracetamol for the pain if needed.
Please note
Do not pierce blisters: the blister protects the skin beneath it against infection. Do not pull off clothing stuck to the wound, but cut around it if needed.
What can you do yourself for a small burn?
A small first-degree burn needs no further treatment after cooling; the skin recovers by itself within a few days. Wash your hands before touching the wound and keep it clean. A healing burn and the new, pink skin are vulnerable to the sun: keep the area out of full sun or cover it for a year, otherwise a lasting colour change can develop. Keep an eye on the wound in the first days for signs of infection.
When to see a doctor?
Call the emergency number for a very large burn, or for hoarseness, wheezing, breathlessness or drowsiness; cool first or let someone else call while you cool. Call your GP or the out-of-hours service for blisters or a moist, red wound on the face, hands or feet, at a joint or on the genitals, for a wound larger than half your hand, for a deep wound that does not hurt, or for a burn from chemicals or electricity. Also make contact if the wound becomes redder, more painful or yellow-green after a few days. An online consultation is not the channel for a fresh burn: that needs cooling and often immediate assessment. For aftercare, scars or pigment questions afterwards, a dermatologist can review with you.
Please note
Call the emergency number for a very large burn or for hoarseness, wheezing, breathlessness or drowsiness. Cool first, or let someone else call while you cool.
Frequently asked questions
How long should I cool a burn?
Ten to twenty minutes with lukewarm, gently running water, as soon as possible after it happens. Do not use ice or ice-cold water; that damages the skin further and can cause hypothermia. Cooling is the most important first step for any burn.
Can I pierce a burn blister?
Preferably not. A blister protects the vulnerable skin beneath it against infection. Leave it intact; only for a large, painful blister might a doctor decide to open it sterilely. Never pierce it yourself with an unsterilised needle.
What should I not put on a burn?
Do not apply ointment, toothpaste, butter or oil to a fresh burn; it does not help and makes assessment harder. Do not use ice, do not pull off stuck clothing and do not pierce blisters. Cooling with lukewarm water and covering loosely is enough until the wound can be assessed.
When should I see the GP about a burn?
For blisters or a moist, red wound on the face, hands or feet, at a joint or on the genitals; for a wound larger than half your hand; for a deep wound that does not hurt; and for burns from chemicals or electricity. Call the emergency number for a very large burn or for breathlessness.
Do burns leave scars?
First-degree and superficial second-degree burns usually heal without a scar. Deeper burns can leave scars or a lasting colour change. Protect the healing skin from the sun for a year; for scars or pigment questions, a dermatologist can review with you.
Sources and more information
- Ik heb me verbrand (thuisarts.nl)
- Eerste hulp bij brandwonden (brandwondenstichting.nl)