Definition & Overview

Any burn that affects only the topmost layer of the skin is classified as a first-degree burn. Considered as the mildest type of burn, first-degree burns can usually heal on their own and only require first aid treatment to encourage proper healing of the skin and prevent any complications.

Who Should Undergo and Expected Results

Most first-degree burn patients are treated on an outpatient basis with the goals to ensure proper healing of the skin and prevent the development of complications such as infection and scarring.

First-degree burns can cause the following symptoms:

  • Redness, similar to a sunburn
  • Pain when the area is touched, usually lasting up to 72 hours after the injury occurred
  • Minor inflammation
  • Dry skin
  • Peeling skin, which may occur within 24 to 48 hours after the injury


Although first-degree burns can heal without treatment, prompt first aid management can minimise possible long-term damage and scarring. Also, patients are encouraged to seek medical attention if they suffer from:

  • Burns on the face
  • Burns over a major joint, such as the shoulder or the knee
  • Burns on the hands or feet
  • Burns on the genitals
  • Burns that cover areas of skin that are larger than 2 to 3 inches in diameter


Patients who are unsure as to how to treat a first-degree burn should have it treated by a medical professional.

How is the Procedure Performed?

Contrary to popular practice, the proper initial treatment for first-degree burns does not involve applying ice directly on the burned skin. In fact, doing so can cause more damage. There are also several known home remedies, such as applying powder, butter, or grease. However, there are no definitive studies that support such claims, and applying anything on an injured part of the skin may only increase the patient’s risk of developing a skin infection.

The proper treatment for first-degree burns, which can be performed either at home or by primary care physicians and emergency personnel, should follow the steps below:

  • Remove the skin from the source of the burn.
  • Remove clothing from the said area.
  • Soak the affected area in cool water for five minutes to reduce swelling. This effectively pulls the heat away from the burned skin. The sooner the skin comes into contact with cool water, the less injury it will suffer. If cool water is not available, any kind of drinkable liquid, as long as it is cool, may be used.
  • Press a clean cold compress against the burned area for 3-5 minutes repeatedly, especially if the patient is on the way to getting medical help.
  • The only approved ointments for first-degree burns are topical creams containing aloe vera or honey, which are known to have good lipid components.
  • Put a dry sterile gauze bandage loosely over the burn to protect it as it heals.


If the burn is initially treated by a medical professional, the treatment may involve cleaning the injured skin of any debris and thoroughly evaluating the wound to determine the extent of damage to the skin. The doctor can then prescribe the correct ointment to use that may need to be applied to the affected area three times a day.

It is normal for patients to experience some pain and swelling as the burn heals. If the pain is severe, acetaminophen or ibuprofen can be taken. Topical corticosteroids, however, should be avoided, as studies show that they do not have any effect on superficial first-degree burns.

The burn can be expected to significantly improve within the first ten days following the injury.

Possible Risks and Complications

Any burn, including first-degree ones, can leave lasting damage to a patient’s skin especially when not properly managed. Even so, patients still face the risks of:

  • Skin infection
  • Pruritus or severe itching of the skin
  • Neuropathic pain


Post-burn pruritus can be managed using cetirizine or doxepin. In severe cases, patients may be advised to undergo pulsed dye laser therapy.

References:

  • Kelby MC. “First degree burn symptoms and treatment.” http://www.empowher.com/burns/content/first-degree-burn-symptoms-and-treatment?page=0,1

  • Lloyd ECO, Rodgers BC, Michener M, Williams M. “Outpatient burns: Prevention and care.” Am Fam Physician. 2012 Jan 1;85(1): 25-32. http://www.aafp.org/afp/2012/0101/p25.html

  • Sheridan RL. “Initial evaluation and management of the burn patient.” Medscape. http://emedicine.medscape.com/article/435402-overview#a3

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