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Cool at once for 10 to 20 minutes under lukewarm water, never ice — and be suspicious when a burn does not hurt at all.
Also known as: burn · scald · burn wound · chemical burn · electrical burn · sunburn
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
With a burn, the first minute counts. First remove the heat source and take off hot or soaked clothing, rings and watches while you still can — fabric burnt onto the skin stays put. Then cool immediately for 10 to 20 minutes under lukewarm running water, not with ice and not with a cool pack, because cold damages the tissue further. With large burns and in children the other rule applies at the same time: do not let the body chill — cool only the burnt area and cover the rest warmly. Nothing goes on the wound: no oil, no flour, no butter, no toothpaste. Depth is described in degrees. First degree is red, dry and painful, like sunburn. Second degree blisters, weeps, is red and very painful. Third degree looks white, leathery or charred — and often does not hurt at all, because the nerve endings have been destroyed with it. That painlessness is the most dangerous misunderstanding of all: here, no pain does not mean harmless, it means deep. For extent, use the palm rule: the person’s own palm including fingers is about one per cent of their body surface. Blisters are not opened. Always have looked at: burns to face, hands, feet, genitals and over joints, burns running right around an arm or leg, any larger area, burns in children, and electrical and chemical burns; scalds in small children should be assessed as a matter of principle. For extensive, deep or electrical burns: call 144. Above ten per cent of burned body surface in adults and fifteen per cent in children, cooling stops and warmth is kept instead; in children the cooling time does not exceed ten minutes in any case. Regardless of the area, burns in children under eight and in people over sixty are assessed by a doctor.
Heat source away, remove hot or wet clothing plus rings and watches, leave anything stuck, then cool.
Lukewarm tap water, no ice, no cool packs, no ointments. Cold further damages already injured tissue.
Cool only the burnt area, cover the rest warmly. Small children chill very fast — that is the bigger danger.
No oil, no flour, no butter, no toothpaste. Do not open blisters, cover loosely and sterilely, nothing sticky.
Face, hands, feet, genitals, joints, circumferential or larger burns, children, electricity, chemicals, scalds in toddlers.
Rinse chemicals for a long time. After an electric shock go to hospital even with a tiny wound — the damage is inside.
Burns hurt badly; adequate pain relief is part of care from the start and is not a side issue.
Shield and care for fresh scars from sun for a year. Pan handles turned in, kettle cords short, water heater temperature capped.
Hold at once under lukewarm running water for 10 to 20 minutes, then cover loosely and cleanly.
Cooling works only in the first twenty minutes and only with hand-warm to cool water around twenty degrees — ice damages the tissue further and can chill the body over larger areas. Ointments and home remedies such as butter or flour do not belong on a fresh burn; they hold the heat in the tissue. A blister stays closed as long as possible. From about the size of a palm, on the face, hands, feet or genitals, it is assessed medically.
A first-degree burn affects only the outer skin and heals in three to six days without a scar. Superficial second degree with blisters heals in one to two weeks, deep second degree in three to four and with a scar. Third degree does not heal by itself. The area is estimated with the person’s own palm: it equals about one per cent. From about ten per cent in adults and five in children it becomes a circulatory matter and not only a skin one.
Like sunburn, no blisters. Heals within days without scarring and is not counted in the burnt area.
The commonest picture after a scald. The deeper it goes, the paler the base and the more likely specialist care is needed.
The nerve endings are destroyed too. A burn that does not hurt is not harmless but deep — always to hospital.
The person’s own palm with fingers is about one per cent of body surface — a simple estimate without arithmetic.
Face, hands, feet, genitals, joints and circumferential burns are a case for the doctor regardless of size.
Increasing pain, spreading redness, bad smell, pus or fever after a few days need prompt review.
With larger burns fluid seeps into the tissue; the blood thickens. This value shows how much fluid is missing.
Sodium and potassium shift considerably in the first days. They help steer the fluid given.
The kidneys suffer first when too little fluid arrives. A rise is an early warning sign.
Falls, because protein is lost through the injured skin. That explains swelling and an increased need for food.
Skin and lining renew themselves quickly and need zinc for it. With places that heal badly, cracked corners of the mouth and frequent skin infections a lack is a serious possibility.
Without vitamin C no stable collagen forms — the wound closes but holds less well. With a very one-sided diet, smoking and alcohol the intake is often tighter than assumed.
Steers the horn-forming of the skin. Too little makes it rough and dry, too much over longer periods harms liver and bone — and in pregnancy a strict upper limit applies.
Every healing needs building material. Anyone eating little during an illness loses exactly that — a sufficient amount spread across the day belongs to the treatment.
With large-area burns high-dose intravenous vitamin C is studied in hospitals — that is intensive care, not a capsule. For everyday use 100–200 mg a day covers the raised need of healing.
Zinc is lost through an open wound surface. With extensive burns it is part of the hospital’s replacement plan; with a blister on a finger it is not.
A large-area burn puts the body into a state of raised turnover that lasts weeks — the energy need rises by up to half. That is why nutrition here is part of the treatment.
Through the open surface fluid evaporates without a brake. With extensive burns the fluid replacement in the first 24 hours is the measure that decides the course.
With extensive burns needs can rise by 50–100 % and stay raised for weeks. 1.5–2 g protein per kg a day is the usual range; with small burns nothing changes.
Medical honey is used in wound care; kitchen honey does not belong on open wounds.
Red oil is traditionally applied to light burns — only after cooling, never on open wounds.
AWMF 044-001 · S2k · 2025-11 — in force
Behandlung thermischer Verletzungen bei Erwachsenen
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checked 2026-09