Burns And Scalds Children

Overview

A burn is damage to the skin and the tissue underneath, caused by heat, electricity, chemicals, or radiation. A scald is a type of burn caused by hot liquids or steam. In children, scalds are the most common, often from hot drinks, bath water, or cooking.

Yes. Burns and scalds are among the most common childhood injuries, especially in children under five years old.

Children under five are most at risk, because their skin is thinner and they may not understand danger. Boys are slightly more often affected than girls, and most injuries happen in the kitchen or bathroom.

Symptoms

Common symptoms

• Red or pink skin
• Pain or tenderness
• Swelling
• Blisters — small fluid-filled bumps
• Peeling or shiny skin
• White, brown, or charred skin (in deeper burns)

Symptoms in children

• Children may scream, cry, or seem very distressed.
• They might not be able to tell you how much it hurts.
• The burn may be bigger than it first looks — get a professional to check.
• Children can become cold quickly, so keep them warm while cooling the burn.

Symptoms in older adults

• Though this article is about children, older adults also have thinner skin and slower healing, so burns in older adults should always be checked promptly.

Causes

Main causes

• Scalds from hot drinks, hot bath water, hot food, or steam
• Contact burns from hot objects like irons, hair straighteners, radiators, or ovens
• Flame burns from matches, lighters, candles, or fires
• Chemical burns from household cleaners, acids, or drain products
• Electrical burns from sockets, cables, or appliances
• Sunburn from prolonged sun exposure

Risk factors

• Being under five years old
• Inadequate supervision around hot items
• Placing hot drinks within reach (such as on low tables or at the edge of a counter)
• Using baby walkers or carrying hot food while holding a child
• Bath water that is too hot (over 50°C) or not tested before bathing
• Living in homes without smoke alarms or with poor kitchen safety

When to see a doctor

See a doctor urgently if:

• Any burn that is blistered, larger than the child's hand, or on the face, hands, feet, or genitals
• If your child is in severe pain or the pain is getting worse
• If you see signs of infection, such as increased redness, swelling, or pus
• If you are worried about the child's safety or the injury was not accidental

Book a routine appointment if:

• For a follow-up appointment to check healing
• If you have questions about dressings or scar care
• If the burn is healing but you are concerned about a change in how it looks

Diagnosis

A doctor or nurse will ask how the burn happened and examine your child's skin. They will assess the burn's size, depth, and location, and look for signs of deeper injury.

Tests that may be done

• Usually no tests are needed for minor burns.
• For larger or deeper burns, the healthcare team may check for fluid loss and organ function with blood tests.
• For electrical burns, an ECG (heart tracing) may be done.

What to expect at your appointment

The healthcare team will clean the burn, apply a dressing, and advise you on home care. They may also prescribe pain relief or a dressing to help healing. If the burn is serious, they will refer you to a specialist burn service.

Treatment

Treatment for a child's burn depends on how deep, large, and where it is. Most minor burns can be managed with good first aid and dressing care at home. More serious burns need specialist medical treatment to prevent infection and scarring.

Self-care at home

• Cool the burn with cool (not icy) running water for at least 20 minutes within the first three hours.
• Gently remove clothing and jewellery near the burn — unless they are stuck to the skin.
• Cover the burn loosely with cling film (place it over, not wrapped tight) or a clean plastic bag.
• Do not pop blisters. Let them heal naturally.
• Never apply ice, butter, creams, or ointments to a burn.
• Keep the child warm and calm while cooling the burn.
• Talk to your pharmacist about suitable pain relief for your child — always follow the label directions.

Medical treatments

A doctor may apply a special dressing to keep the burn moist and clean. Some burns need prescription creams or dressings to prevent infection. For more severe burns, treatment may include fluids given through a drip, wound cleaning under sedation or anaesthesia, and referral to a specialist burns unit.

When is surgery considered?

Deep or large burns may require surgery, especially to remove dead tissue and to place a skin graft (healthy skin from another part of the body) to help the burn heal with less scarring. This is only needed for a small number of serious burns.

Living with this condition

Caring for your child's burn at home means keeping the dressing dry and clean, watching for signs of infection, and attending follow-up appointments. Your child may need to take time off school or nursery, and you may need to help them avoid scratching or rubbing the burn.

Lifestyle tips

• Keep the burned area out of direct sunlight — use clothing or a high-SPF sunscreen once healed (ask your pharmacist or doctor for advice).
• Encourage gentle movement to prevent stiffness, but avoid rough play or sports that could hurt the area.
• Do not use tight clothing or bandages over the burn.
• After healing, moisturiser may help reduce dryness — check with your doctor which products are safe.

Diet and exercise

A healthy diet with plenty of fluids helps the body heal. Most children can return to normal activities once they feel comfortable, but avoid swimming or vigorous exercise until the burn is fully healed and your doctor says it's safe.

Mental health and emotional wellbeing

A burn can be upsetting for both the child and the family. Your child might feel scared, clingy, have trouble sleeping, or show changes in behaviour. This is normal. Offer lots of comfort, talk about what happened in a simple and calm way, and let your child know it is not their fault. If worries persist, speak to your GP or health visitor — they can point you to support.

Prevention

Yes. Most burns and scalds in children can be prevented with simple safety measures at home. These include never holding a child while holding hot drinks, testing bath water before bathing, fitting smoke alarms, and keeping matches, irons, and household chemicals out of reach.

Vaccines

There is no vaccine to prevent burns, but make sure your child's tetanus vaccination is up to date — tetanus is a serious infection that can enter through broken skin, so a booster after a burn is sometimes needed.

Screening programmes

There is no routine screening test for burns or scalds. The best approach is prevention and early first aid.

Complications

If left untreated

• Infection of the burn wound
• Scarring that can be permanent
• Contractures — tightening of skin and underlying tissues that limits movement
• In very serious burns, shock and organ failure
• Emotional distress or post-traumatic stress (PTSD) in the child or family

Long-term outlook

The outlook for children with burns and scalds is good, especially when first aid is given quickly and medical advice is followed. Most minor burns heal without long-term problems. Even deeper burns can be treated effectively, and modern dressings and specialist care can help reduce scarring. Your healthcare team is there to support you and your child through every step of recovery.

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