Burns and Scalds
The twenty-minute rule for cooling a burn, what not to put on it, and which burns need hospital.
Last revised
Cooling a burn properly in the first minutes limits how deep the injury becomes. The single most useful intervention is cool running water for twenty minutes, and it is frequently cut short.
Cool it for twenty minutes
Remove the source of heat and any clothing or jewellery near the burn, unless it is stuck to the skin. Hold the burn under cool or lukewarm running water for a full twenty minutes. Not ice, not iced water, not butter, not toothpaste, not any of the household remedies. Twenty minutes is longer than people expect and the benefit continues for up to three hours after the injury, so it is still worth doing late.
Keep them warm while you cool the burn
Cooling a large burn can cause hypothermia, particularly in children and older adults. Cool the burn itself while keeping the rest of the person warm with a blanket or coat. This matters more the larger the burn.
Covering it
After cooling, cover loosely with cling film laid over the burn rather than wrapped around it, since tissue swells. A clean plastic bag works for a hand or foot. Do not burst blisters. Paracetamol or ibuprofen can be taken for pain if appropriate.
Which burns need hospital
All chemical and electrical burns. Burns to the face, hands, feet, genitals or across a joint. Burns larger than the person's hand. Any burn that looks white, brown or charred, or that is painless, which suggests it is deep. All burns in babies and young children. Anyone who may have inhaled smoke or hot gases.
At a glance
| Term | Detail |
|---|---|
| Cooling time | 20 minutes under cool or lukewarm running water |
| Still beneficial | up to about 3 hours after the injury |
| Never use | ice, iced water, butter, creams or toothpaste |
| Covering | cling film laid on loosely, not wrapped |
| Blisters | do not burst them |
| Always hospital | chemical, electrical, and burns to face, hands, feet, genitals or joints |
| Size threshold | larger than the affected person's hand |
| Sign of a deep burn | white, brown or charred skin, or a painless burn |
When to get help
Call 999 for large or deep burns, any burn to the airway, suspected smoke inhalation, electrical burns, or if the person is having difficulty breathing. Go to A&E for chemical burns, burns to the face, hands, feet, genitals or joints, burns larger than the hand, any burn in a baby or young child, or a burn that looks white, brown or charred. Seek advice for signs of infection: increasing pain, swelling, pus or fever.
Where to go next
Where this comes from
- NHS - Burns and scalds
- British Burn Association - first aid guidance
- St John Ambulance - burns advice
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.