1) Cool the wound.
Cooling is the first step. Ideally, you should find a sterile gauze and soak it in a cool saline solution before placing it on your wound. However, running cool or room temperature water over your burn works as well. This is your starting point. A common mistake people make is putting ice on the burn—do NOT do this.
2) Gently cleanse.
Then, gently cleanse the burn wound with mild soap and water. You could also use a sterile saline wound wash here if you have it handy.
3) Get your first aid kit.
Here are the first aid items we’ll be talking about in the following steps:
- Over-the-counter antibiotic (e.g., Polysporin, Neosporin)
- Prescription antibiotic (e.g., silver sulfadiazine, Bactroban)
- Xeroform petroleum-based gauze
- Non-stick gauze (e.g., Adaptic or Telfa pads)
- Fluffy, dry gauze pads
- Elastic gauze roll (e.g., Kerlix)
4) Assess the situation.
Next step: Do I need a topical antibiotic or not? You don’t always need to put Neosporin or Polysporin on your burn. Using a topical antibiotic is recommended, but not for minor burns (like most sunburns) and superficial burns (where the skin stays intact). These do not require a topical antimicrobial. For minor and superficial burns, instead, you will want to cover them with Xeroform, a petroleum-based gauze impregnated with bismuth, which you can buy over the counter. If this is you, skip to step 5.
5) Apply an antibiotic like Silvadene or Neosporin if you need it.
If you do need a topical antibiotic, silver sulfadiazine (Silvadene) is great but requires a prescription. It is cheap and comes in a jar, so keep this handy in your medicine chest. A good over-the-counter option for an uncomplicated burn is to use Polysporin or Neosporin ointment, which you can then cover with a non-stick dressing like Telfa pads.
6) What about deeper burns?
For deeper wounds in which the development of antibiotic-resistant bacteria like MRSA (methicillin-resistant Staph aureus) is of greater concern, think about using Bactroban (mupirocin) ointment—which is also a prescription medication.
7) Apply a dressing if you need one.
What sort of bandages and dressings should I buy? Superficial burns don’t require any fancy dressing. A basic gauze will work. But again, a bismuth-impregnated, petroleum-based gauze (Xeroform) by itself is comparable to topical antibiotics for preventing or controlling a burn wound infection. Xeroform is applied as a single layer over the burn and then covered with a bulky dressing.
How do you do a basic dressing for burns? A basic gauze dressing provides good burn coverage. It is placed after your topical antibiotic and consists of a first layer of non-stick gauze like Adaptic or Telfa laid directly over the burn. Then, you’ll want a second layer of fluffed dry gauze and an outer layer of an elastic gauze roll (like Kerlix). (Note: This dressing procedure applies to cuts, too.)
8) Treat the pain.
Lastly, you may not need it, but you can use acetaminophen (Tylenol) or an NSAID, like ibuprofen (Motrin, Advil) or naproxen (Aleve), if the pain from your burn bothers you too much.
Stay safe.
Dr O.
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