First Degree Burn

Overview

A first-degree burn is the mildest kind of burn. It harms only the top layer of your skin. The skin turns red, feels sore, and may be a little swollen. It does not cause blisters. A mild sunburn is a good example of a first-degree burn. These burns usually heal on their own in about three to six days, and the top layer of skin may peel as it heals.

Yes. First-degree burns are very common. Sunburn, splashes of hot water, and touching a hot pan are everyday causes. Most people treat them at home without needing to see a doctor.

Anyone can get a first-degree burn. Babies, young children and older adults are more at risk because their skin is thinner and burns more easily. People whose skin is very fair, people who take medicines that make skin more sensitive to sunlight, and people who work with heat, steam or hot oil are also more likely to be burned.

Symptoms

Common symptoms

• Red or pink skin in the area that was burned
• Pain, soreness or a stinging feeling when touched
• Skin that feels warm to the touch
• Mild swelling
• Skin that is dry and may peel or flake after a few days
• No blisters and no open sores

Symptoms in children

• Crying, clinginess or pulling away when the sore area is touched
• Trouble saying where it hurts, especially in toddlers
• Sunburn is a common cause, often on the face, shoulders and arms
• Children's skin is thinner, so a burn can look worse and hurt more than you might expect

Symptoms in older adults

• The burn may hurt less than expected because feeling in the skin can be reduced
• Skin can look red but may also look pale or blotchy
• Healing can take a little longer
• A higher chance of infection, so keep a closer eye on the area
• Older adults may also have other health conditions that affect healing

Causes

Main causes

• Sunlight and sunlamps, which cause sunburn
• Hot liquids such as boiling water, tea, coffee or cooking oil
• Steam from kettles, pans or irons
• Touching hot objects such as an iron, a stove ring or a hot pan handle
• Friction, such as a rope burn or rug burn
• Mild chemicals, such as some cleaning products
• Electricity, though this often causes deeper burns and needs medical checks

Risk factors

• Being a baby, a young child or an older adult
• Having fair or light-coloured skin
• Working in kitchens, catering, welding, or other jobs with heat and steam
• Taking medicines that make skin more sensitive to sunlight — ask your pharmacist
• Reduced feeling in the skin, for example from diabetes or nerve damage
• Not using sun protection, or using sunbeds
• Drinking alcohol, which can make people less careful around heat and hot water

When to see a doctor

See a doctor urgently if:

• You see blisters forming or the skin looks white or charred
• The burn is on the face, hands, feet, genitals, or across a joint
• The burn is larger than the person's palm
• The burn was caused by a chemical or by electricity
• There are signs of infection such as spreading redness, swelling, warmth, pus, or a temperature
• The person is a baby, young child or older adult
• The pain is very strong or is getting worse rather than better

Book a routine appointment if:

• The burn is not healing as expected after about a week
• The skin is peeling and looks irritated
• You are unsure whether the burn is first-degree or deeper
• You have questions about keeping the area clean or covered
• You notice a change in skin colour in the healed area that bothers you

Diagnosis

A doctor or nurse can usually tell it is a first-degree burn just by looking at the skin and asking how the burn happened. They will check how much of the body is affected, whether the skin is blistered, and whether the burn is in a sensitive area. They may also ask about your general health and when you last had a tetanus vaccination.

Tests that may be done

• Usually none — the diagnosis is made by looking and asking questions
• Checking whether you are up to date with tetanus protection
• For a sunburn with feeling unwell, a check of temperature and hydration
• In rare cases, a referral to a specialist burns service for a closer look

What to expect at your appointment

The check is quick and should not be painful. The doctor or nurse will look closely at the skin, may gently touch around the edge of the burn, and will ask about pain. They will then explain how to care for it at home, what to watch for, and when to come back if it does not settle.

Treatment

First-degree burns are treated by cooling the skin, protecting it while it heals, and keeping pain under control. Most people can manage this at home. The first thing to do is to stop the burning: move away from the heat source, remove clothing and jewellery near the area unless it is stuck to the skin, and hold the burn under cool running water for about 20 minutes. Cool water, not ice — ice and very cold water can damage the skin further.

Self-care at home

• Cool the burn under cool running water for about 20 minutes, ideally within three hours of the injury
• Remove rings, watches or tight clothing near the burn before swelling starts
• Do not use ice, butter, toothpaste, oil or creams on a fresh burn
• Keep the person warm while cooling the burn — cool the burn, not the whole person
• Gently pat the area dry and cover it with a clean, non-sticky dressing or cling film laid in strips (not wrapped tightly)
• Take simple pain relief that your pharmacist recommends, following the label
• Keep the burn clean and change the dressing as advised
• Protect the healing skin from the sun with loose clothing or a high-factor sun cream once the skin has closed
• Do not pop any small blisters if they appear — see a doctor instead

Medical treatments

If you see a doctor or nurse, they may clean the burn and apply a non-stick dressing. Some burns need a prescribed cream or dressing that helps prevent infection or soothe the skin — your clinician will choose this based on how the burn looks. They may check your tetanus protection and give a booster if needed. Stronger pain relief can be provided if over-the-counter options are not enough. Burns in sensitive areas, or burns that are not healing, may be referred to a specialist burns clinic.

When is surgery considered?

Surgery is not needed for a first-degree burn. It is sometimes used for deeper burns that do not heal, but that is a different type of injury.

Living with this condition

For the first few days, keep the area clean and covered with a light, non-stick dressing. Avoid tight clothes, hot showers directly on the area, and scratching as the skin starts to peel. Gentle peeling is normal and is a sign of healing. Ease back into normal activity as the soreness settles, and protect the new pink skin from strong sun for a few weeks, as it burns more easily.

Lifestyle tips

• Keep hot drinks and pans away from the edge of surfaces, especially with children around
• Use a cool bag or cold pack wrapped in a cloth for minor spills — never place ice directly on skin
• Wear gloves and eye protection when handling hot items or chemicals
• Use sun cream and shade when outdoors, and avoid sunbeds
• Check the temperature of bath water and hot water bottles, especially for children and older adults
• Keep kettles, irons and hot pans out of reach of small children

Diet and exercise

There is no special diet for a first-degree burn. Drinking plenty of water helps, especially with sunburn, which can dry you out. Eating normally and staying active is fine. If the burn is on a foot or leg, you may want to rest it a little more until it feels comfortable, and avoid swimming in pools, lakes or the sea until the skin has fully closed.

Mental health and emotional wellbeing

Most first-degree burns are minor and pass quickly. Still, a burn can be upsetting, especially for children or if it happened during a stressful event. It is normal to feel shaken or to worry about scarring. Talking to someone you trust can help. If worry or low mood is affecting your sleep or daily life, speak to your doctor — support is available.

Prevention

Yes. Most first-degree burns are preventable. The main steps are keeping heat sources away from children, being careful with hot liquids and steam, and protecting your skin from the sun.

Screening programmes

There is no screening test for burns. Checking your home for hot water temperature and safe kitchen habits is a practical way to lower the risk for everyone in the household.

Complications

If left untreated

• Infection, if the skin becomes broken or dirty — this shows as spreading redness, swelling, warmth, pus or a temperature
• Darker or lighter patches of skin where the burn healed, which usually fade over time
• Mild scarring is unusual with a true first-degree burn, but can happen if it becomes infected
• Dehydration and feeling unwell after a widespread sunburn
• Discomfort or sensitivity in the area for a short while after healing

Long-term outlook

The outlook is very good. A first-degree burn usually heals within about a week with simple care at home, and most people have no lasting mark. If the burn happened to be deeper than it first looked, or if it becomes infected, getting medical help early makes a real difference. Most people recover fully and can get back to normal life quickly.

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