What is the first thing to do for a burn?

Stop the burning: move away from the heat source, put out any flames, and remove clothing and jewellery near the burn unless it is stuck to the skin. Then cool the burn under cool or lukewarm running tap water for 20 minutes. Keep the person warm, and cover the burn loosely with cling film or a clean plastic bag.

Should I put ice, toothpaste or butter on a burn?

No. Ice and iced water can damage the skin further, and toothpaste, butter, oil, yoghurt, egg, flour or coffee grounds trap heat, raise the risk of infection, and have to be scrubbed off by a doctor later. Cool running water for 20 minutes is the only first aid that helps. After cooling, cover the burn loosely with cling film.

When should I go to the ER for a burn?

Go to the ER for burns larger than the injured person's palm, deep burns that look white, leathery or charred (even if painless), blistering burns on the face, hands, feet, genitals or over a joint, all chemical and electrical burns, burns in babies and young children that blister, and any burn with smoke inhalation, coughing or a hoarse voice. Call 911 for large burns, breathing trouble or someone who is drowsy or confused.

Should I pop a burn blister?

No. A blister is a natural sterile dressing that protects the healing skin underneath. Leave it intact and cover it loosely. If it bursts on its own, keep the area clean and covered. A burn that blisters on a child, or on the face, hands, feet, genitals or a joint, should be seen by a doctor.

How do you know how bad a burn is?

Look at depth and size. Superficial burns are red and painful without blisters, like sunburn. Partial-thickness burns blister and are very painful. Full-thickness burns look white, brown, leathery or charred and may not hurt because nerves are damaged — these are the most serious. For size, the person's palm including fingers is about 1% of their body surface.

How long should you run a burn under water?

20 minutes of cool or lukewarm running water, ideally started as soon as possible after the burn. Cooling still helps if started up to three hours after the injury. Use a timer, because 20 minutes feels much longer than people expect. In babies and small children, cool only the burned area and keep the rest of the child warm.

Burns: First Aid and When to Go to the ER

A pot of tea on the table, a child reaching for something, and then a scream. Or a quick brush against the hot surface of a heater on a winter night. In that moment most of us do what we saw our parents do: ice, toothpaste, yoghurt, or a handful of coffee grounds. The intention is good, but these remedies can make a burn deeper and more likely to get infected. The good news is that correct first aid is very simple, and the first 20 minutes are what changes the outcome most.

The burns we see most at home

Scalds from hot liquids: tea, coffee, kettle water and soup. These are among the most common burns in young children, because a single cup of tea is enough to scald a large area of a child's thin skin.
Contact burns: the surface or guard of a heater, the oven, an iron, a cooking pot.
Hot water bottles: common in winter, and they can burn when they leak or burst, or cause slow burns when pressed against skin for a long time.
Flame burns: a flare-up from a gas heater, or loose clothing that gets too close to a flame.
Chemical and electrical burns: strong cleaning products, and exposed wires and sockets.

Burns first aid, step by step

Stop the burning. Move the person away from the heat source. If clothing catches fire: stop, drop and roll, or smother the flames with a heavy blanket.
Cool the burn for 20 minutes under cool or lukewarm running tap water. Not iced water. Use a timer. Cooling still helps if you start it up to three hours after the burn.
Remove rings, watches, bracelets and clothing near the burn quickly, before swelling starts. But don't pull off anything stuck to the skin.
Keep the person warm. Cool the burn, not the whole person — cover the rest of the body with a blanket, especially children, who get cold quickly.
Cover with cling film, laid over the burn in a layer rather than wrapped tightly round a limb, or put a burned hand in a clean plastic bag. Don't use cotton wool or fluffy dressings that stick.
Treat the pain with paracetamol or ibuprofen at the right dose for age, unless there's a reason you can't take them.
Decide: home, urgent care or the ER? (See the sections below.)

What never to put on a burn

These remedies are common in homes across the region, and every one of them does more harm than good:

Ice or iced water: narrows blood vessels and cuts blood flow to the injured skin, which can deepen the burn, and can make children dangerously cold.
Toothpaste: feels cooling but traps heat, contains ingredients that can irritate the skin, and makes it harder for a doctor to see the burn.
Butter, oil or ghee: fats hold heat in the skin and raise the risk of infection.
Yoghurt, labneh, egg or honey: not sterile, and can carry germs into broken skin.
Coffee grounds, flour, salt or tomato paste: they stick to the burn and have to be scrubbed off by the doctor, which is painful and delays treatment.
Popping blisters or peeling skin: a blister is a natural sterile cover, and opening it exposes the wound to infection.

How bad is the burn? Depth and size

How serious a burn is depends on two things: how deep it is and how big it is. Its appearance can change over the first day or two, so a burn that looked superficial may turn out to be deeper.

Depth	What it looks like	What to do
Superficial (first-degree)	Red, dry, painful, no blisters; blanches when pressed	Usually home care after cooling, unless large or in a baby
Partial-thickness (second-degree)	Blisters, red and moist or blotchy skin, very painful	See a doctor if larger than a coin, or on face, hands, feet, genitals, joints, or in a child; ER if larger than the palm
Full-thickness (third-degree)	White, brown, waxy, leathery or charred; may be painless	Emergency department, whatever the size; call 911 if large

The palm rule for size

The injured person's own palm, including the fingers, is roughly 1% of their body surface area. Use their hand, not yours — a child's palm is smaller than an adult's, and so is their body. Any blistered or deeper burn larger than the injured person's palm needs the ER. In children especially, burns covering around 10% of the body or more (around 15% or more in adults) can cause serious fluid loss and shock, and are a reason to call 911.

When does a burn need the ER?

Call 911

Large burns, or burns that go all the way round an arm, leg or the chest.
Smoke inhalation, or a burn to the face with coughing, a hoarse voice, difficulty breathing, singed nasal hair or soot around the mouth and nose.
A high-voltage electrical injury, or loss of consciousness after an electric shock.
Drowsiness or confusion, or cold, pale skin with a fast pulse (signs of shock).

Go to the emergency department

Any blistered or deeper burn larger than the injured person's palm.
A white, brown, waxy, leathery or charred burn, however small, even if it doesn't hurt.
A blistering burn on the face, hands, feet, genitals, or over a joint such as the knee or elbow.
All chemical burns: rinse with plenty of running water and remove contaminated clothing while protecting your own hands, then go.
All electrical burns, even if the skin looks almost normal, because damage can be internal and can affect heart rhythm. Switch off the power before touching the person.
A blistering burn on a baby or young child, or any burn whose story doesn't match how it looks.

Urgent care or a doctor

A small blistered burn (smaller than the palm) somewhere that isn't a sensitive area.
A burn in someone over 60, pregnant, diabetic, or with weakened immunity or heart, lung or liver disease — even a small one.
Signs of infection over the following days: spreading redness, increasing swelling or pain, pus, a bad smell, or a fever.
A burn that isn't healing within about two weeks.

Urgent care sees walk-ins around the clock to assess, clean and dress a burn. Large or deep burns, and burns to sensitive areas, belong in the emergency department. If you're not sure which to choose, see our guide to ER vs urgent care.

Burns in children: why they are different

A child's skin is thinner than an adult's, so it burns deeper and faster at the same temperature. Their body is small, so one cup of tea can burn a large share of it, and they lose fluid and heat faster. That's why the threshold is lower for children: any blistering burn on a baby or young child deserves to be seen by a doctor the same day, and burns larger than their palm go to the ER. When cooling, cool only the burn and keep the child wrapped and warm.

Prevention in the kitchen and around the heater

Keep teapots, coffee pots and hot cups away from the table edge, and avoid hanging tablecloths a child can pull.
Don't hold a child while holding a hot drink.
Turn pan handles inwards, and use the back burners.
Keep the electric kettle's cord out of children's reach.
Put a guard around the heater, and keep clothes, blankets and curtains away from it.
Test bath water before putting a child in, and run the cold water first.

In winter a heater is a double hazard: burns, and carbon monoxide if it runs on gas or kerosene in a closed room. Read our guide to carbon monoxide poisoning symptoms from heaters. And if the injury is a deep or open cut rather than a burn, our guide on whether a cut needs stitches covers that.

Caring for a minor burn at home

After cooling, keep the burn clean and covered with a non-stick dressing.
Leave blisters intact.
A plain, fragrance-free moisturiser can go on a superficial burn once it has fully cooled, to ease dryness and itching.
Protect healed skin from the sun for several months, because it burns and discolours easily.
Watch for signs of infection, and see a doctor if they appear.

Worried about a burn right now?

Start cooling the burn under running water for 20 minutes, and call 911 for large burns or breathing difficulty. Emergency Plus in Dabouq, Amman is open 24/7: an emergency department with board-certified emergency physicians in the building around the clock, walk-in urgent care with no appointment, and an Arabic- and English-speaking team.

Call us 24/7: +962 79 247 1313

Sources

Medical disclaimer: This article is for general information only and is not a substitute for professional medical advice, diagnosis, or treatment. If you think you are experiencing a medical emergency, call 911 or go to the nearest emergency department immediately. Emergency Plus in Dabouq, Amman is open 24/7 — +962 79 247 1313.