Burns: Treatment and Pain Management

Medically Reviewed by Jabeen Begum, MD on March 21, 2024
14 min read

Burns are a type of tissue damage. They're common. You may get one if you're exposed to too much heat or radiation (like from the sun). Strong chemicals, electricity, and friction can also cause them.

Mild burns usually heal on their own with home treatment, but major ones can cause serious harm. Some are life-threatening. Go to the hospital or call 911 if you have a deep burn or one that covers a large area of your body. You may need medical attention right away.  

There are several types of burns. The kind you have depends on how deep the burn goes under your skin and whether it damages other tissue, such as fat, muscle, or bone. 

Here's a breakdown of different types of burns. 

First-degree burn

These are known as superficial burns. They're mild compared to other burns, but they still hurt and usually make the outer layer of your skin (epidermis) red. 

Common causes of first-degree burns include: 

  • Mild sunburn
  • Hot water or other liquids
  • Touching something that's already hot, like a pot or pan 

Second-degree burn

Also called a partial thickness burn, these affect the epidermis and the lower layer of your skin (dermis). Second-degree burns cause pain, redness, swelling, and blistering. 

Common causes of second-degree burns include: 

  • Scalding water, including steam
  • A bad sunburn
  • Exposure to certain chemicals 
  • Contact with electricity, open flames, or very hot objects

Third-degree burn

You might hear your doctor call this a full thickness burn. It goes through the epidermis, dermis, and deeper layers such as fat tissue. These burns need fast medical attention and result in white or blackened, charred skin. You may lose feeling if your nerves get damaged. 

Common causes of third-degree burns include extended contact with: 

  • Fire 
  • Chemicals
  • Sunlight
  • Electricity
  • Very hot things

Fourth-degree burns

These go even deeper than third-degree burns and can affect muscle, tendons, and bone tissue. This kind of burn can damage or destroy your nerve endings, which can cause numbness in the area. 

A fourth-degree burn can be life-threatening. You'll need medical help right away. 

What you'll experience depends on the cause and type of burn you have and how serious the damage is. Some signs and symptoms of burns may show up right away or within a few hours. Others may take a day or two to develop. 

First-degree burn symptoms 

When you get a burn on the top layer of your skin, you may have: 

  • Redness without blistering
  • Dry skin that may get flaky or peel
  • Pain that lasts for about 2-3 days 

Second-degree burn symptoms 

If a burn damages the top and second layer of your skin, you may notice: 

  • Redness and blistering
  • Swelling and pain
  • Wet and shiny skin
  • Skin color changes around the burned area
  • A scar after the burn heals

Third-degree burn symptoms 

This kind of burn goes a few layers under your skin and can reach deeper areas like your fat tissue. When that happens, your skin may: 

  • Turn black, brown, or white
  • Appear leathery
  • Hurt or go numb 

Fourth-degree burn symptoms

A burn that goes through all the layers of your skin into deeper tissue can:  

  • Cause numbness in the damaged area
  • Destroy other tissue, including fat, muscle, and sometimes bones

Heat sources are the most common cause of burns. You might get a so-called thermal burn for many reasons, including if you're in a house fire, vehicle crash, kitchen accident, or have an electrical appliance that malfunctions.

Some causes of heat burns include: 

  • Fire or any open flame
  • Heated metal, glass, or other object
  • Scalding liquid or steam
  • Electricity
  • Friction (also called road rash or rug burn)

Other things that cause burns include: 

  • Radiation from x-rays
  • Ultraviolet (UV) rays, such as from the sun or tanning beds
  • Strong chemicals like paint thinner, gasoline, or strong acids 

Some burns happen because of abuse. One kind is called an immersion burn. An example is when someone forces a child into very hot water and holds them there. This usually shows up on a child's fists, feet, butt, genitals, or anus. 

Contact your local department for children and families to report burns that might be related to child abuse. 

Call 911 if you think the burn is serious. This includes burns that are deep or cause fast swelling. You should seek care right away for large burns or ones that cover your hands, feet, major joints, sensitive areas, or go all the way around an arm or leg. 

Here are some things you can do until medical help arrives: 

  • Get the person away from the cause of the burn.
  • If the cause is something electrical, turn the power off before getting near them. 
  • Check to see if the person is breathing. 
  • If they're not breathing, start rescue breathing if you're trained in mouth-to-mouth resuscitation. 
  • Remove jewelry, belts, or anything else that might keep them from moving freely.
  • Cover the burned area with a clean, cool washcloth or damp bandage.  
  • Keep the burned area raised above heart level if you can. 

You'll also want to watch for signs of shock. This may include:

  • Fainting
  • Dizziness
  • Pale or clammy skin
  • Weak pulse
  • Shallow breathing

If you notice any of the above symptoms, raise the person's feet or legs a bit but don't move them. Turn them on their side if they start to throw up. 

How to clean a burn wound

Here are some tips for how to clean a mild burn: 

  • If you have a chemical burn in your skin or eyes, rinse with tap water.
  • Remove clothing, jewelry, piercings, or any other material from the burn.
  • Use soap and water to clean the burn with a washcloth or first-aid gauze.
  • If you have it, you can use an antibacterial product made to clean wounds. 
  • Rinse the burned area with a saline solution or regular water. 
  • Put a sterile first-aid bandage or dressing on the burn. 

Ask your doctor what to do next. They might want you to use an antibiotic cream like bacitracin, but it depends on how serious the damage is. 

What not to do

There are some things you shouldn't do to care for a burn, including:  

  • Don't help the person without making sure you're safe. You'll want to turn off the power to any electrical equipment and wear gloves if there are dangerous chemicals around. If possible, put out any open fires. 
  • Don't apply nonmedical things to the burn. This includes things like paste, oil, turmeric (haldi), or raw material like cotton. 
  • Don't put ice directly on the burn. This can make the pain and damage worse and raise the odds of frostbite. 
  • Don't put a large, serious burn in water (especially icy water). This could cause a sudden drop in body temperature and lead to hypothermia.
  • Don't put non-sterile material on the wound. This can raise the risk of infection. 
  • Don't put medication on the burn. Wait for medical help, if possible. They'll know which cream or ointment is best for specific types of burns.

Treatment depends on the type of burn you have and how serious it is. The location and size of the damage also matters. Seek medical attention if you're not sure how to treat a burn or how deep the injury goes. 

Here are some things your doctor might suggest when it comes to treatment for different kinds of burns:  

First-degree burn treatment

You can treat most first-degree burns at home. They usually don't need to be covered with a bandage, but to ease pain and swelling you can: 

  • Apply a cold compress like a washcloth soaked in cool water.
  • Rub skin care products like aloe vera over the burn.
  • Use over-the-counter painkillers like acetaminophen or ibuprofen.

You may or may not want to use an antibacterial cream or ointment to lessen the chances of an infection. Ask your doctor what's right for your burn if you're unsure what to do next.

Second-degree burn treatment

Treatment depends on how serious your symptoms are. In general, you can do some of the same things you'd do for a first-degree burn. But you may need to take some extra steps to keep the area clean because second-degree burns may take 1-3 weeks to heal.

Treatment for second-degree burns may include: 

  • Apply a cold compress to lessen pain. 
  • Use antibacterial ointment to prevent an infection.
  • Change your bandage or gauze every day. 
  • Take painkillers like acetaminophen or ibuprofen. 
  • Keep the affected area raised to decrease pain and swelling. 
  • If there's a blister, take care not to burst it. 

Check in with your doctor about other steps you can take to protect your skin and feel better. They may prescribe certain creams, ointments, or medication to prevent an infection or ease pain. You (or your child) may need a tetanus shot if you're not up-to-date with your vaccine. 

Third-degree burn treatment

Go to the hospital or an urgent care clinic. These burns are serious, and you'll need medical care right away that you can't get at home. 

Treatment for a third-degree burn may include the following from a health professional: 

  • Removal of dead skin and damaged tissue
  • Antibiotic ointment and a protective bandage
  • Antibiotics you take by mouth or get through a vein in your arm
  • Fluids you get through a vein in your arm
  • Over-the-counter or prescription painkillers 

If you have third-degree burns over a big part of your body, your doctor may replace burned skin with healthy tissue or man-made skin. This is a type of reconstructive surgery called skin grafting. You may need other types of surgery to repair serious damage.  

Fourth-degree burn treatment 

These are the most serious kinds of burns and they can be life-threatening. So, like third-degree burns, you'll need to get medical treatment from a health professional. 

Treatment for fourth-degree burns may include: 

  • Wound cleaning and removal of dead skin and damaged tissue
  • Skin grafts 
  • Antibiotics you take by mouth or get through a vein in your arm
  • Fluids you get through a vein in your arm
  • Over-the-counter or prescription painkillers
  • Follow-up care with physical therapy and rehab

How to treat a burn from boiling water

Hold the burn under cool (not icy) running water for 10 to 15 minutes, or until it stops hurting. Take off anything that's tight around the burn, such as rings or clothes. Place a damp cloth over the area. This will continue to cool the skin and may help ease pain and swelling. 

Follow first-aid tips for how to treat a minor burn. Get medical help if you have a major burn from boiling water.  

How to treat a friction burn

Clean the area with mild soap and water to clear away any dirt or germs. Cover your damaged skin with a bandage or loose gauze since you'll have both a burn and a scrape. Get medical help if you have a major friction burn. This may happen if you're in a vehicle crash or other serious accident. 

Electrical burn treatment  

Your treatment depends on how much electricity got into your body and how long the contact lasted. Cool the area right away and then seek medical help. You may have more serious damage inside your body even if you see only a mild skin burn.  

Here's a list of some commonly used home remedies for burns and whether they're safe to use: 

Petroleum for burns

You can apply a thin layer of fragrance-free petroleum jelly (Vaseline) on a minor burn 2-3 times a day. This can seal in moisture to protect your skin and help it heal. 

Honey for burns

Honey has antibacterial, antioxidant, and anti-inflammatory effects. And it's generally considered safe to use medical-grade honey on a minor burn. Use with caution if you're allergic to pollen. Honey is not a good way to treat serious burns. 

Mustard on a burn

You might've heard that mustard can help heal a burn, but there's no scientific proof that this is the case. In fact, putting mustard on a burn may make your symptoms worse and damage your skin even further.

Chemicals in mustard liquid or powder may irritate your skin and eyes. If you put regular mustard products on your skin, you may feel some warmth because of how it affects your blood vessels. But that process can block the blood flow needed to heal your burn.

Toothpaste on a burn

People commonly use this household product to treat minor burns, but that's not a good idea. Toothpaste on a burn can raise your odds of infection and trap heat. 

Ice on burns

Don't put ice directly on a burn. This can damage your tissue even more. If you plunge a large, serious burn into icy water, you can cause a sudden drop in body temperature and boost your chances of hypothermia.

Butter on a burn

There's no scientific evidence that butter can promote wound healing or reduce pain. In fact, greasy stuff like butter will only seal in the heat, which is the opposite of what you want to do when you have a burn and can make things worse. Like toothpaste, butter on a burn can also increase your risk of infection. 

You may not get a blister if you only have a minor burn. But there are some steps you can take to care for a blister once it forms. 

How to treat a burn blister

Blisters protect your skin, and you shouldn't try to break one open on purpose. They'll drain on their own. 

If the blister does burst on its own, clean it with mild soap and cool or lukewarm water. You can use an antibiotic ointment to prevent infection. Cover the wound with a bandage or gauze until it heals. 

If you develop a big blister, see your doctor. They may want to remove it and give you a special kind of medical dressing to cover the burn.  

How long do burn blisters last?

Your recovery time depends on how serious and deep your burn is. Blisters don't usually form with first-degree burns. But you may have a blister for 1-3 weeks if you have a second-degree burn. You may need surgery with a skin graft to heal a blister that forms with a serious burn. 

You may have mild or serious pain until your burn heals. But there are steps you can take to control your discomfort. Seek medical help if you're not sure what's best for your symptoms and type of burn. 

Here are some things your doctor might suggest to manage burn pain: 

  • Apply a cool compress. 
  • Take over-the-counter painkillers such as acetaminophen or ibuprofen.
  • Keep the burned area (like your arm or foot) above your heart to keep down swelling.
  • Use moisturizing lotion to ease dryness and stop yourself from scratching.
  • Take antihistamines if your healing skin itches a lot.

Ask your doctor what else you can do if OTC drugs and home remedies don't help enough. You may need a more aggressive pain management plan if you have a serious burn.

Pain management for burns might include:

  • Stronger painkillers
  • IV numbing agents like lidocaine
  • Local anesthesia
  • Cognitive-behavioral therapy
  • Hypnosis
  • Virtual reality

Your doctor may suggest you try physical and occupational therapy if you have a large burn across certain joints. This is a type of treatment that can help you stretch your skin so you can move easier as you heal. 

It's important to get treatment for major burns right away because they can lead to serious health issues, including:  

  • Sepsis (a kind of infection that happens when bacteria get into your bloodstream) 
  • Tetanus (a disease caused by a certain type of bacteria that get into your body through an open wound) 
  • Hypovolemia (a dangerous loss of body fluids, like blood) 
  • Hypothermia (a severe drop in body temperature) 
  • Breathing issues from smoke or hot air 
  • Bone and joint problems caused by scar tissue's effects on skin, muscles, or tendons 
  • Disfigurement or scars
  • Trouble fighting infections because of damage to skin

Burns can also affect your mental health. You may have depression, nightmares, or recurrent thoughts about the event that hurt you. Tell your doctor if you have trouble managing your emotions. They can refer you to a therapist to talk about your feelings. 

You can take some simple steps to prevent burns at home, especially in the kitchen: 

  • Always pay close attention to anything on the stove, and turn pot and pan handles toward the back so you don't accidentally hit them. 
  • Wear oven mitts.
  • Don't hold your baby or young child while you're cooking. 
  • Keep kids away from any appliance that can get hot. 
  • Cover electrical outlets with caps.
  • Keep a working fire extinguisher on every floor of your house. 
  • Check and make sure there are working batteries in your smoke and carbon monoxide detectors to make sure they're working.
  • Don't smoke in bed.
  • Set the maximum temperature of the hot water in your house to less than 120 degrees, and always check the temperature of the water before putting your child in the bathtub.
  • Check the temperature of any buckles or straps before putting your child in the car, especially if the car has been parked in the sun.
  • Be careful with chemicals, and wear protective goggles when you use them. When you're not using them, keep them away from kids and out of the house, ideally locked in a secure, childproof place.
  • Don't put electrical appliances anywhere near water, unplug them when they're not in use, and put them in a safe place away from kids.

To prevent friction burns, you can: 

  • Wear protective gear (helmet, shoes, clothes) riding a bike or motorcycle.
  • Put on knee and elbow pads if you're playing sports.
  • Drive the speed limit and follow road safety rules when driving.

Always wear sunblock or protect yourself from the UV rays to lessen the chances of a mild or serious sunburn. 

Mild burns usually heal within a couple of weeks with home treatment. But you may need medical care for more serious burns. This might include prescription medication, special wound care, or surgery. When in doubt, call your doctor to find out how to manage your burn. 

Should you cover a burn or let it breathe?

You typically don't need to cover a minor burn. But you might want to wear a bandage or loose gauze if you have a more serious burn, especially if you develop a blister and it bursts. Covering an open wound until your skin heals can lessen the chances you'll get an infection. 

What is the first aid for burns?

It depends on the type of burn you have and how serious the damage is. For minor burns, you'll want to cool the area right away and clean it with mild soap and water. You'll need medical attention for serious burns. This may include medication, wound care to remove dead skin and prevent infection, or surgery.

What are first-, second-, and third-degree burns?

These terms describe how deep a burn goes. A first-degree burn affects the top layer of skin (epidermis). A second-degree burn affects the epidermis and the layer of skin below that (dermis). A third-degree burn goes through your epidermis, dermis, and into your fat tissue. 

How long will a burn hurt? 

If you have a minor burn, you may start to feel better in a few days. A second-degree burn may hurt for 1-3 weeks. If you have a serious burn that damages your nerves, you may not have any pain.