Burns and scalds - Recovery 

Recovering from burns and scalds 

Hot drinks harm

Two children a day are brought into Frenchay Hospital with major burns caused by hot drinks. Burns injuries from tea or coffee account for 60 per cent of admissions to the South West UK Children's Burn Centre at Frenchay. The hospital's burns team wanted to raise awareness about the dangers of leaving hot drinks around small children, who can easily pull them from tables or kitchen counters.

Media last reviewed: 14/04/2014

Next review due: 14/04/2016

When to seek further medical advice

Whether your burn required medical attention or not, you should seek medical advice if:

  • the wound becomes painful or smelly
  • you develop a high temperature of 38°C (100.4°F) or higher
  • the dressing becomes soaked with fluid leaking from the wound
  • the wound has not healed after two weeks

How long it takes to recover from a burn or scald depends on how serious it is and how it is treated. If the wound becomes infected, seek further medical attention.

Burns that don't need medical attention

If your burn or scald is mild and treated at home, it will normally heal without the need for further treatment. Read more about first aid for burns and scalds.

While the skin heals, keep the area clean and do not apply any creams or greasy substances. Do not burst any blisters because this can lead to infection.

If you have scalded the inside of your mouth by drinking something hot, try to avoid things that can irritate the scalded area, such as hot and spicy food, alcohol and smoking, until the area heals.

Mild burns or scalds that only affect the uppermost layer of skin (superficial epidermal burns) will usually heal in about a week without any scarring.

Burns that need medical attention

If you have a burn or scald that requires medical treatment, it will be assessed to determine the level of care required.

The healthcare professional treating you will:

  • assess the size and depth of the burn by examining the area
  • clean the burn, being careful not to burst any blisters
  • cover the burn with a sterile dressing, usually a pad and a gauze bandage to hold it in place
  • offer you pain relief if necessary (usually paracetamol or ibuprofen)

Depending on how the burn happened, you may be advised to have an injection to prevent tetanus (a condition caused by bacteria entering a wound). For example, a tetanus injection may be recommended if there is a chance that soil has got into the wound.

Your dressing will be checked after 24 hours to make sure there are no signs of infection. It will be changed after 48 hours, and then every three to five days until it is completely healed.

Minor burns affecting the outer layer of skin and some of the underlying layer of tissue (superficial dermal burns) will normally heal in around 14 days, leaving minimal scarring.

If the burn is severe, you may be referred to a specialist. In some cases, it may be necessary to have surgery to remove the burnt area of skin and replace it with a skin graft taken from another part of your body. See plastic surgery techniques for more information about this.

More severe and deeper burns can take months or even years to fully heal, and will usually leave some visible scarring.

Blisters

Expert opinion is divided over the management of blisters that are caused by burns. However, it is recommended that you should not burst any blisters yourself.

If your burn has caused a blister, you should seek medical attention. The blister will probably remain intact, although some burns units at hospitals follow a policy of deroofing blisters. Deroofing means removing the top layer of skin from the blister.

In some cases, a needle may be used to make a small hole in the blister to drain the fluid out. This is known as aspiration and may be carried out on large blisters or blisters that are likely to burst.

Your healthcare professional will advise you about the best way to care for your blister and what type of dressing you should use.

Exposure to the sun

During the first few years after a burn, you should try to avoid exposing the damaged skin to direct sunlight as this may cause it to blister. It is especially sensitive during the first year after the injury. This also applies to a new area of skin after a skin graft.

It is important to keep the area covered with cotton clothing. If the burn or scald is on your face, wear a peaked cap or wide-brimmed hat when you're out in the sun. Total sun block – for example, one with a sun protection factor (SPF) of 50 – should be used on all affected areas.

The area can be exposed to sunshine again around three years after the injury, but it is still very important to apply a high-factor sun cream (SPF 25 or above) and stay out of the midday sun.

Page last reviewed: 03/12/2013

Next review due: 03/12/2015

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Comments

The 1 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Burns Surgeon said on 26 September 2009

Except for some specialist antimicrobial dressings, burns wounds must have their dressings changed at least every other day or when the wound exudate has leaked to the outer surface of the dressing - whichever is soonest. Failure to do this significantly escalates the risk of infection.
Keep dressings clean and dry, but when dressings are changed, wash the burn with soap an water.
Blisters should always be removed except smaller blisters on the palms and soles of the feet. If skin blisters from a burn, the skin of the blister is dead and cannot recover. If it stays in place it does however make an excellent food source for bacteria, and they are protected from te body's natural defences (antibodies) because the blister fluid separates it from the circulation (which is how the antibodies get where they are needed).
Sterile gauze should not be used straight on top of a raw burn wound - a non-stick dressing is needed first, and preferably an antibacterial dressing.
Antibiotics are not the mainstay of treating burn wound infections, instead it is regular wound cleaning (soap and water), daily dressing changes and antibacterial dressings. By keeping to these principles from the outset, most burn infections can be prevented and will result in less scarring.
If you develop any problem scarring (thickened or painful), ask your GP to consider referring you to a Burns Specialist. However note that burns will often remain reddened for several weeks or months after injury even though it has healed - this is normal.
After a burn injury, the burned area can react differently to getting a sun-tan - any tan can become permanent in the burned area. This lasts for several months, so it is a good idea to cover the burn with clothes or sun block until the burn has matured and no redness remains.

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