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Healthy Outlook

Blisters are Nature's Band-Aid for Burns

By Dr. Brenda Reilly

Wednesday, January 23, 2013

As an emergency room physician, I get asked about all sorts of home remedies for burns. Should I smear butter over the wound? Dress it with tobacco? Douse it with egg whites? While I can't recommend any of these solutions, I can recommend something that will help heal those burns.

Don't open those blisters.

Though they might be unsightly and bothersome, blisters provide a natural barrier to infection. They are your body's very own sterile bandages. The tissue under a blister is sensitive and, like most open wounds, is vulnerable to bacteria and viruses. If you open or drain a burn blister, you could slow the healing process, cause harmful scarring or invite infection.

Besides not popping blisters, there's more you can do to help recovery and prevent infection. First, it's important to understand the three types of burns: mild (first-degree burn), moderate (second-degree) and severe (third-degree).

Mild burns are painful and there might be some swelling and redness, but they don't usually cause blisters and they don't create an open wound. These are commonly caused by briefly touching hot items like pan handles and curling irons.

Moderate burns are excruciatingly painful, turn a deep red and often will blister. They burn the outer layer of your skin called the epidermis and can burn some of the underlying layer, called the dermis. These can be a result of fire, hot water or hot surfaces.

Severe burns are typically white, brown or black and called full thickness burns because they destroy the epidermis and the dermis, and sometimes bones, muscles or tendons. Due to the deep tissue and nerve damage, these burns are painless.

Moderate and severe burns can cause lasting damage, especially if they are to the face, feet, hands or groin, so don't hesitate in getting to the nearest emergency room.

Milder burns can be treated at home, but consider seeing a doctor if the burn is greater than four inches or if it's on the face, feet, hands or groin. Burns to these areas should be monitored to ensure they heal correctly and don't cause a loss of normal function like bending. When in doubt about a burn, contact your health care provider.

Begin treating a milder burn by running it under cool water or applying a bag of crushed ice or frozen veggies for 10 to 15 minutes at a time. Do not put ice directly on the wound. Meanwhile, start taking an anti-inflammatory like Motrin or Tylenol. You know you have something that's going to hurt, so take the pain reliever on schedule for at least 24 hours—even if pain lessens.

When the pain is manageable—usually from one to eight hours after the burn—use an ointment (Vaseline is fine) and cover the area with gauze. The ointment helps bandage from sticking. Antibiotic ointments can be used, but avoid water-based creams, which can be absorbed by the bandage.

Managing mild and moderate burns comes down to three things: pain relief, cleanliness and time. Draining or removing blisters without the advice of a doctor will lengthen the healing time and put the area at risk of infection. Remember, these small pockets of fluid are nature's Band-Aids, which keep the burned area sterile and safe.

Healthy Outlook is written by the professional staff of Contra Costa Health Services, the county health department. Send questions to series coordinator Dr. David Pepper at theairdoctor@gmail.com. For more health information, go to www.cchealth.org.
About the Author

Dr. Reilly is the Medical Director of the Emergency Department at Contra Costa Regional Medical Center.