How to deal with blisters from burns

Burns are skin damages sustained as a result of contact with a hot surface, flame or other substance such as boiling water or excessive exposure to the sun. Burns can also be caused by exposure to high levels of electric current or by chemicals.

The term 'burn' doesn't just relate to the burning sensation that occurs with this injury, burns cause skin cells to die which leads to severe skin damage. Learn about the different degrees of burns and the best method for treating burns.

How long it takes to recover from a burn or scald depends on how serious it is and how it's treated. If the wound becomes infected, seek further medical attention.

Burns that don't need medical attention

If your burn or scald is mild and treated at home, it normally heals without the need for further treatment. Read more about first aid for burns and scalds.

While the skin heals, keep the area clean and don't apply any creams or greasy substances. Don't burst any blisters as this can lead to infection.

If you've scalded the inside of your mouth by drinking something hot, try to avoid things that can irritate the scalded area, such as hot and spicy food, alcohol and smoking, until the area heals.

Mild burns or scalds that only affect the uppermost layer of skin (superficial epidermal burns) usually heal in about a week without any scarring.

Burns that need medical attention

If you have a burn or scald that requires medical treatment, it will be assessed to determine the level of care required.

The healthcare professional treating you will:

  • assess the size and depth of the burn by examining the area
  • clean the burn, being careful not to burst any blisters
  • cover the burn with a sterile dressing – usually a pad and a gauze bandage to hold it in place
  • offer you pain relief if necessary – usually paracetamol or ibuprofen

Depending on how the burn happened, you may be advised to have an injection to prevent tetanus, a condition caused by bacteria entering a wound. For example, a tetanus injection may be recommended if there's a chance soil got into the wound.

Your dressing will be checked after 24 hours to make sure there are no signs of infection. It will be changed after 48 hours, and then every three to five days until it's completely healed.

Minor burns affecting the outer layer of skin and some of the underlying layer of tissue (superficial dermal burns) normally heal in around 14 days, leaving minimal scarring.

If the burn is severe, you may be referred to a specialist. In some cases, it may be necessary to have surgery to remove the burnt area of skin and replace it with a skin graft taken from another part of your body. 

More severe and deeper burns can take months or even years to fully heal, and usually leave some visible scarring.

Blisters

Expert opinion is divided over the management of blisters that are caused by burns. However, it's recommended that you shouldn't burst any blisters yourself.

If your burn has caused a blister, you should seek medical attention. The blister will probably remain intact, although some burns units at hospitals follow a policy of deroofing blisters. Deroofing means removing the top layer of skin from the blister.

In some cases, a needle may be used to make a small hole in the blister to drain the fluid out. This is known as aspiration and may be carried out on large blisters or blisters that are likely to burst.

Your healthcare professional will advise you about the best way to care for your blister and what type of dressing you should use.

Exposure to the sun

During the first few years after a burn, you should try to avoid exposing the damaged skin to direct sunlight as this may cause it to blister. It's especially sensitive during the first year after the injury. This also applies to a new area of skin after a skin graft.

It's important to keep the area covered with cotton clothing. If the burn or scald is on your face, wear a peaked cap or wide-brimmed hat when you're out in the sun. Total sun block – for example, one with a sun protection factor (SPF) of 50 – should be used on all affected areas.

The area can be exposed to sunshine again around three years after the injury, but it's still very important to apply a high-factor sun cream (SPF 25 or above) and stay out of the midday sun.

Thermal Burns Treatment

Written by WebMD Editorial Contributors

Medically Reviewed by Carol DerSarkissian, MD on January 16, 2022

In this Article

  • Call 911 if:
  • For All Burns
  • For First-Degree Burns (Affecting Top Layer of Skin)
  • For Second-Degree Burns (Affecting Top 2 Layers of Skin)
  • For Third-Degree Burns

Call 911 if:

  • The burn penetrates all layers of the skin.
  • The skin is leathery or charred looking, with white, brown, or black patches.
  • The person is an infant or a senior.

 

For All Burns

1. Stop Burning Immediately

  • Put out fire or stop the person's contact with hot liquid, steam, or other material.
  • Help the person "stop, drop, and roll" to smother flames.
  • Remove smoldering material from the person.
  • Remove hot or burned clothing. If clothing sticks to skin, cut or tear around it.

2. Remove Constrictive Clothing Immediately

  • Take off jewelry, belts, and tight clothing. Burns can swell quickly.

Then take the following steps:

For First-Degree Burns (Affecting Top Layer of Skin)

1. Cool Burn

  • Hold burned skin under cool (not cold) running water or immerse in cool water until the pain subsides.
  • Use compresses if running water isn't available.

2. Protect Burn

  • Cover with sterile, non-adhesive bandage or clean cloth.
  • Do not apply butter, oil, lotions, or creams (especially if they contain fragrance). Apply a petroleum-based ointment two to three times per day.

3. Treat Pain

  • Give over-the-counter pain reliever such as acetaminophen (Panadol, Tylenol), ibuprofen (Advil, Motrin, Nuprin), or naproxen (Aleve, Naprosyn).

4. When to See a Doctor

Seek medical help if:

  • You see signs of infection, like increased pain, redness, swelling, fever, or oozing.
  • The person needs tetanus or booster shot, depending on date of last injection. Tetanus booster should be given every 10 years.
  • The burn blister is larger than two inches or oozes.
  • Redness and pain last more than a few hours.
  • The pain gets worse.
  • The hands, feet, face, or genitals are burned.

5. Follow Up

  • The doctor will examine the burn and may prescribe antibiotics and pain medication.

For Second-Degree Burns (Affecting Top 2 Layers of Skin)

1. Cool Burn

  • Immerse in cool water for 10 or 15 minutes.
  • Use compresses if running water isn't available.
  • Don't apply ice. It can lower body temperature and cause further pain and damage.
  • Don't break blisters or apply butter or ointments, which can cause infection.

2. Protect Burn

  • Cover loosely with sterile, nonstick bandage and secure in place with gauze or tape.

3. Prevent Shock

Unless the person has a head, neck, or leg injury, or it would cause discomfort:

  • Lay the person flat.
  • Elevate feet about 12 inches.
  • Elevate burn area above heart level, if possible.
  • Cover the person with a coat or blanket.

4. See a Doctor

  • The doctor can test burn severity, prescribe antibiotics and pain medications, and administer a tetanus shot, if needed.

For Third-Degree Burns

1. Call 911

2. Protect Burn Area

  • Cover loosely with sterile, nonstick bandage or, for large areas, a sheet or other material that that won't leave lint in wound.
  • Separate burned toes and fingers with dry, sterile dressings.
  • Do not soak the burn in water or apply ointments or butter, which can cause infection.

3. Prevent Shock

Unless the person has a head, neck, or leg injury or it would cause discomfort:

  • Lay the person flat.
  • Elevate feet about 12 inches.
  • Elevate burn area above heart level, if possible.
  • Cover the person with a coat or blanket.
  • For an airway burn, do not place a pillow under the person's head when the person is lying down. This can close the airway.
  • Have a person with a facial burn sit up.
  • Check pulse and breathing to monitor for shock until emergency help arrives.

4. See a Doctor

  • Doctors will give oxygen and fluid, if needed, and treat the burn.

Show Sources

SOURCES:

CDC: “Mass Casualties: Burns.”

Family Doctor: “First Aid: Burns.”

Subbarao, I. AMA Handbook of First Aid and Emergency Care, Random House Reference, 2009.

University of Rochester Medical Center: “Hot Tips: First Aid for Burns.”

Merck Manual: “Burns.”

New York-Presbyterian: “Burns.”

Thermal Burns Information from eMedicineHealth

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How long do burn blisters last?

Second-degree (partial-thickness) burns — Second-degree burns (also called partial-thickness burns) involve the top two layers of skin. These burns form blisters, are very painful, may seep fluid, and blanch when pressed (picture 2). Second-degree burns typically heal within 7 to 21 days.

Should you cover a burn blister or let it breathe?

Should you cover a blister or let it breathe? It is recommended to leave the blisters intact if possible. If the blisters remain intact, you may not need to cover them. However, if the blisters are already broken or open, the blisters should be covered in a sterile bandage.