How Do I Treat a Burn? 8 Steps to Avoid Common Mistakes

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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Follow these steps to help heal a burn and avoid making it worse:

  1. Cooling is the first step. Ideally, you can find a cooled saline-soaked gauze but cooled or room temperature water is more practical; this is your starting point. A common mistake people make is putting ice on the burn, don’t do this.
  2. Gentle cleansing with mild soap and water are fine here. You could also use saline wound wash if you have it.
  3. Next step: do I need a topical antibiotic or not? You don’t always need to put Neosporin or Polysporin on your burn. Using a topical antibiotic is recommended, but not for minor burns (e.g. sunburns) and superficial burns with the skin intact. Those do not require a topical antimicrobial agent. For these burns, instead, you will want to cover them with bismuth-impregnated petroleum based gauze (Xeroform) which you can buy over the counter.
  4. If you do need a topical antibiotic (if it’s more than just a sunburn or a superficial burn with the skin intact) silver sulfadiazine (Silvadene) is great, but requires a prescription. It is cheap and comes in a jar so keep this in your medicine chest for later. A good over the counter option for an uncomplicated burn is to use Polysporin ointment, then cover with a nonadherent (non-stick) dressing like Telfa pads.
  5. What about deeper burns? For deeper wounds or settings in which MRSA (methicillin-resistant Staph aureus) is of greater concern, think about using Bactroban (mupirocin) ointment—which is also a prescription med.
  6. What sort of bandages and dressings should I buy? Superficial burns don’t require any fancy dressing. A basic gauze will work. But again, a bismuth-impregnated petroleum based gauze (Xeroform) is comparable to the topical antibiotics for preventing or controlling burn wound infection. Xeroform is applied as a single layer over the burn and then covered with a bulky dressing.
  7. How to do a basic dressing for burns (this goes for cuts too): A basic gauze dressing provides good burn coverage. It is placed after your topical antibiotic and consists of the first layer of nonadherent (non-stick) gauze like Adaptic or Telfa placed over the burn. Then you’ll want a second layer of fluffed dry gauze, and an outer layer of an elastic gauze roll (e.g. Kerlix).
  8. Use Tylenol or an NSAID (ibuprofen, Motrin, Aleve) for the pain.

Your shopping list to be ready for burns or cuts:

Stay safe.

Dr O.

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