How to Treat a Hand Burn

Assessing the Situation

Secure your environment. As soon as a burn occurs, stop what you are doing. Make the scene safe by shutting off any open flame or burner so no one else gets hurt. If there is a fire that is out of control, get out of the area as soon as possible and call emergency services. If it is a chemical burn, stop and clear the area for safety. Remove the chemical from your skin if possible. Use a dry brush for dry chemicals, or rinse the burn under cool water. If it is an electrical burn, turn off the source of the electricity if possible. If you can’t turn it off, use a dry, nonconducting object made of cardboard, wood, or plastic to move the source away.

Call for help. If the fire is out of control in your home, call 911 to get the fire department to your area. Call poison control if you are unsure whether the chemical could cause other side effects. For an electrical burn, call 911 if the wire is still live, or if the burn was caused by a high-voltage wire or a lightning strike. If you are unsure if the wire is still live, do not touch it directly. Touch it with a dry, nonconducting source like a dry piece of wood or plastic.

Assess the hand burn. Look at the burned area of the hand to assess the damage. Note the placement of the burn on the hand. Look at the appearance of the burn and note specific characteristics. This will help you decide which type of burn you have. Burns are classified as first-, second-, or third-degree, depending on how deeply they have burned the skin. First-degree burns are the mildest type, while third-degree burns are the worst. Different methods are used to treat burns depending on their degree. If you have circumferential burns on your fingers (meaning the burns wrap around any or several fingers), seek prompt medical attention. This type of burn can restrict blood flow and in severe cases could require amputation of the finger if left untreated.

Caring for a First-Degree Burn

Recognize a first-degree burn. First-degree burns only affect the top layer of skin, the epidermis. First-degree burns are a little bit swollen and red. They also are painful. When you press on the skin, they might turn white for a few moments after you release the pressure. If the burn has not blistered or opened but has just reddened the skin, you have a first-degree burn. If a mild burn covers the hand as well as the face or airway, most of the hands, feet, groin, buttocks, or over major joints, a trip to the doctor is recommended. Sunburns are common first-degree burns, unless there is blistering involved.

Treat first-degree burns. If you determine that the burn is first-degree based on the way it looks and feels, quickly but calmly get to a sink. Put your hand or arm under the faucet and run cool water over it for about 10 minutes. This will help pull heat away from the skin, which will help reduce inflammation. You can also take a bowl of cool water and place the affected area in it for a few minutes. This will also help pull heat away from the skin, reduce inflammation, and prevent as much scarring. Do not use ice or very cold water because it can cause frostbite, as well as decrease blood flow to the burned area, preventing it from healing. You should also not apply butter or blow air on the burn. This will not help and can increase your likelihood of infection.

Remove jewelry. Burns can cause swelling, which could cause jewelry on the burned hand to become uncomfortably tight, cut off proper circulation, or dig into the skin. Remove any jewelry on the burned hand, such as rings or bracelets.

Apply aloe or burn ointment. Some studies have shown aloe vera to be potentially effective for treating first-degree burns. If you have an aloe vera plant, break off one of the lower leaves near the center of the stalk. Slice off the spines, split the leaf lengthwise, and apply the gel directly to the burn. It will immediately provide a cooling relief. If you don't have an aloe vera plant, you can use store bought 100% aloe vera gel. Do not apply aloe to an open wound.

Take pain medication if needed. Over-the-counter pain relievers such as acetaminophen (Tylenol), naproxen (Aleve), or ibuprofen (Advil, Motrin) are all considered safe for short-term use.

Monitor the burn. Burns can become worse over the course of a few hours. After rinsing and treating your burn, monitor your burn to make sure that it does not become infected. If it does, consider seeking medical treatment. Signs of infection include pus or discharge, swelling, purple skin, or fever.

Treating a Second-Degree Burn

Recognize second-degree burns. Second-degree burns are more severe than first-degree burns because they extend past the epidermis and into the lower layer of skin (the dermis). This doesn't necessarily mean they need medical care. The burns will be a dark red and will produce blisters on the skin. They are more swollen and splotchy than first-degree, with more reddened skin, which may look wet or shiny. The burned area itself may look white or discolored. If the burn is larger than 3 inches (7.6 cm), treat as third-degree and seek medical attention immediately. Common causes of second-degree burns including scalding, flame, contact with a very hot object, bad sunburn, chemical burns, and electrical burns.

Remove jewelry. Burns can cause swelling, which could cause jewelry on the burned hand to become uncomfortably tight, cut off proper circulation, or dig into the skin. Remove any jewelry on the burned hand, such as rings or bracelets.

Rinse the burn. Treatment for second-degree burns is almost the same as for first-degree burns. When the burn occurs, quickly but calmly get to a sink and put your hand or arm under the cold water for 15-30 minutes. This will help pull heat away from the skin and reduce inflammation. If blisters are present, do not pop them. They help the skin heal. Popping them can introduce infection and delay healing time. Don't apply butter or ice to the burn. Also, do not blow on the burn because it can increase your likelihood of infection.

Apply an antibiotic cream. Because second-degree burns extend further into the skin, the potential for infection is greater. Apply an antibiotic cream to the burned area before bandaging it. Silver sulfadiazine (Silvadene) is a popular antibiotic ointment for burns. It is often available over-the-counter without a prescription. Use a lot of the cream so that it will soak into the skin for a long time.

Clean a popped blister. If a blister does pop on its own or by accident, do not panic. Clean it with a mild soap and clean water. Apply an antibiotic ointment and cover the burn with a new bandage.

Apply a new bandage daily. Burn dressings should be changed daily to help prevent infection. Remove the old bandage and throw it away. Rinse the burn in cool water, avoiding soap. Do not scrub the skin. Let the water run on it for a few minutes. Pat dry with a clean towel. Apply burn cream, antibiotic ointment, or aloe vera to the burn to help it heal. Cover with a new sterile bandage. When the wound is gone or mostly gone you won't need the bandage anymore.

Make a homemade honey ointment. The use of honey to treat burns is supported by several studies, although doctors consider it an alternative treatment. Take a teaspoon of honey to cover the burn. Dab it on your wound. Honey is naturally antiseptic and keeps bacteria out of the wound, but causes no damage to the outside healthy skin. The honey's low PH and high osmolarity helps the healing. Medicinal honey is recommended instead of the kind you bake with. Studies have suggested that honey may be a better alternative than regular silver sulfadiazine prescription ointment. Dressing changes should happen daily. If the wound drains more often, change the dressing more often.

Monitor the burn. Burns can become worse over the course of a few hours. After rinsing and treating your burn, monitor your burn to make sure that it does not become infected. If it does, seek medical treatment immediately. While healing, look for signs and symptoms of infection, such as pus-like oozing from the burn, fevers, swelling, or increased redness on the skin. If these signs occur, seek medical treatment.

Dealing with Third-Degree and Major Burns

Recognize major burns. Any burn can be a major burn if it is over the joints or covering the majority of the body. It is also major if the burned person is having complications with vital signs or difficulty with normal activities because of the burn. These should be treated the same as third-degree burns, with immediate medical attention. Also seek medical treatment for any burn—no matter how severe—on the hands, feet, face, groin, or buttocks.

Recognize third-degree burns. If your burn is bleeding or looks a little bit black, you may have a third-degree burn. Third-degree burns burn through all layers of skin: the epidermis, dermis, and the underlying fat. These burns may appear white, brown, yellow, or blackened. The skin may look dry or leathery. They are not as painful as first or second because the nerves have been either damaged or destroyed. These burns require immediate medical attention. Call for emergency services or get to an emergency room. These burns can become infected and your skin may not grow back correctly. If your clothes are sticking to this burn, do not pull the clothes away. Get help right away.

Respond to the situation. If you or someone near you gets a third degree burn, call 911 immediately. While waiting for EMS to arrive, check to see if the person is responsive. Responsiveness is established by gently shaking the victim. If there is no response, look for signs of movement or breathing. If they are not breathing, start CPR if you have been trained to do so. If you do not know how to perform CPR, you can ask the emergency dispatcher to talk you through it. Do not attempt to clear the airway or breathe for the other person if you do not know CPR. Instead, focus only on chest compressions. Lie the person on their back. Kneel next to their shoulders. Place your hands over the center of their chest, and move your shoulders so that they are right above your hands with your arms and elbows straight. Push straight down on their chest for about 100 compressions per minute.

Take care of the burn victim. While you are waiting on emergency personnel to arrive, remove any constrictive clothing and jewelry. Do not do this if the clothing or jewelry is stuck in the burn. If this happens, leave it as is and wait for help to arrive. Removing it will pull off skin and cause further injury. You should also keep yourself (or the patient) warm, as these severe burns can cause you to go into shock. Do not soak the burn in water, as you would with minor burns. This can lead to hypothermia. If possible, elevate the burn above heart level to help reduce swelling. Do not give any pain medication. You do not want to give anything that could interfere with the emergency medical treatment. Do not pop blisters, scrape dead skin, or apply aloe or salve.

Cover the burn. If it is possible, you should try to cover the burn so it does not become infected. You need to use something that will not stick to it, such as lightweight gauze or a moistened bandage. If the bandage will stick due to the severity of the burn, wait for EMS. You might be able to use plastic wrap. If used for a very temporary amount of time, plastic wrap has been shown to be effective as a dressing. It protects while maintaining a low level of transmission of outside organisms to the burn.

Get treatment at the hospital. When you arrive at the hospital, the staff will move quickly to be sure to treat the burn effectively. They may start an IV to replace any lost electrolytes from your body. They will also clean the burn, which can be very painful. They may give you pain medication. They will apply ointments or creams to the burn, and cover it with a sterile dressing. If needed, they might create a warm, humid environment to help the burn heal. They might have a nutritionist suggest a high protein diet to aid with healing. If necessary, the physician may talk to you about follow-up skin grafting. Skin grafting is when you take a piece of skin from another part of the body to cover the burnt area. Expect the hospital staff to teach you how to do dressing changes at home. After discharge, dressings will need to be changed. Follow-up will continue with the physician to assure adequate healing.