cooling the burn

Last reviewed 10/2022

Cooling an area of the skin that has been burnt is important because it:

• reduces direct thermal damage
• stabilizes mast cells to limit the production of inflammatory mediators e.g. histamine
• reduces the progression of a burn in the 'zone of stasis'
• frequently provides analgesia

Cooling should be undertaken with flowing water:

• temperature:
• 15 degrees centigrade optimal
• below 7 degrees centigrade, vasospasm is likely which will actually promote the ischaemic progression of the burn
• in young children with a relatively large surface area to volume ratio, the skin away from the burn should be kept warm to reduce the tendency to hypothermia
• duration:
• for flowing water, ideally at least 20 minutes
• for alkaline burns, longer periods should be considered as there is a tendency for liquefaction and greater penetration of the agent
• means of application of water:
• ideally flowing
• wet towels suboptimal as they quickly heat up; if used, they should be replaced regularly