First Aid for Burns:

Types of Burns: First, Second, Third and Fourth Degree

The severity of a burn depends on how much of the body is affected and how deep the injury is. Large, deep burns have a high risk of serious infection that may lead to multi-organ failure.³

• Superficial burns (first-degree): Redness and pain on the outer layer of skin.³
• Partial thickness burns (second-degree): Damage to deeper skin layers with blisters, weeping fluid, redness and sharper pain.³
• Full thickness burns (third-degree): Damage to tissues below the skin. They look like black, brown or white leather and are often painless as nerves are damaged.³
• Sub-dermal (fourth-degree): Deeper tissues like tendons, muscles and bone are damaged. They look leathery and may be white, black or brown in colour.³

Common Cause of  Burns and Scalds

• Scalds from hot liquids like drinks or baths and showers that are too hot. These are usually not deep burns¹³ and mostly happen to young children or older adults.¹
• Thermal burns from hot objects like irons, ovens, and heaters cause deeper injuries.¹³
• Electrical burns may not look severe but can cause serious deep tissue damage. Electrical currents passing through the body can also affect heart rhythms and set clothing on fire. Always see a doctor.¹³
• Chemical burns tend to be deep, and damage continues until all the chemical is washed off.¹³

First Aid for Burns: Step-by-Step Guide

1. Follow the DRSABC plan¹⁰, which is an easy-to-follow first aid action plan.
2. Stop the burning.³

• If someone is on fire: STOP them moving around, DROP them to the ground and ROLL them to put out the flames.¹¹
• For electrical burns, ensure the power is turned off.³
• Remove clothing near the burn if it is not stuck to the skin.³

3. Cool the burn

• Quickly place the burn under cool running water for 20 minutes. This removes heat and stops the burn from getting worse.³
• Chemical burns need to be rinsed until the pain stops.¹³
• Never use ice, this can make the burn worse.³

4. Cover the burn

• Apply a light, non-stick dressing, which may also reduce pain.¹³
• Avoid dressings with loose fibres that may stay in the wound.¹³
• Plastic kitchen wrap can even be laid over the burn initially.¹¹

5. Manage pain

• Use simple pain relief like paracetamol or ibuprofen if needed.¹³

Many handy resources are available. Find one that works for you. Try the free first aid app from The Australian Red Cross².

Wound Care Tips to Support Burn Healing

• Wash your hands or use hand sanitiser before and after the wound care
• Perform wound care in a clean environment
• Use sterile solutions to clean the wound
• Use sterile dressing packs and supplies
• Keep the burn covered to maintain a moist healing environment and prevent infection
• Unless it is wet, dirty or loose, only change the dressing once or twice per week

When to See a Doctor for Burns

Get prompt, professional advice if:

• There is more warmth, redness, or pain around the burn³

• It has not healed in two weeks³
• You feel feverish or unwell³
• The burn has pus or a bad smell³
• You have diabetes, low immunity or circulation issues³

How to Prevent Scars After a Burn

Scars are not only ugly, but they can also be painful, itchy and lead to chronic wounds.⁴ Scarred skin is less supple and may limit physical movement. Scars occur more often in young people and darker skin tones. Raised scars might be rubbed and irritated by clothes.⁵ The longer a burn takes to heal, the more chance there is of scarring.⁹

• Good wound care is the first step in scar prevention.¹⁴ Silicone reduces pain, itching, redness and thickness of scars⁵, so protect newly formed skin with silicone based barrier wipes when dressings are changed. Traditional barrier creams can interfere with dressing absorption and moisture balance of the wound.⁸
• Apply a silicone gel or sheet once the burn is healed and completely covered by new skin. Silicone wound products are flexible, stick well to dry skin and are unlikely to cause allergic reactions.¹² They are also comfortable, easy to use⁴ and do not need to be covered by another dressing.⁶
• Use high-SPF sunscreen and cover the area with clothes or a dressing when outside. Some silicone gels and sheets provide UV protection.¹³
• Do not pick or scratch. It can cause infection and make scars worse. Try wearing a light tubular bandage or gloves and keep your nails filed short to prevent scratching.¹³
• Antihistamine medication can also help.¹³
• Massage with a pH neutral moisturiser or emollient³ to make the skin more supple. This improves appearance, pain and itchiness.¹³

References

1. Australian Institute of Health and Welfare. (15 August, 2023). Burns and scalds. https://www.aihw.gov.au/reports/injury/burns-scalds/summaryCh

2. Australian Red Cross. (2025). First Aid app. https://www.redcross.org.au/firstaid/firstaidapp/

3. Carville, K. (2023). Wound care manual (8^th). Silverchain Foundation.

4. Choi, C.et al. (2022). Management of hypertrophic scars in adults: A systematic review and meta-analysis. Australasian Journal of Dermatology, 63, 172-189.

5. Durante, C.M. & Kant, S. (2020). Silicone therapy for the treatment and prevention of problematic scars: a practical guideline. Wounds International, 11(4), 64-69.

6. Logan, I. (2016). Silicone dressings. https://dermnetnz.org/topics/silicone-dressings

7. McFee, K., Spitzer, M., & Murdoch, J. (2024). Examining the clinical outcomes of soft silicone multilayer foam dressing for exudate management in US hospitals: It is time to optimize dressing change frequency. Wounds, 36(9), 290-296.

8. Merton Borough Care Home Pharmacists. (2022). Barrier products for use in adults in primary care for the prevention of moisture associated skin damage. South West London Clinical Commissioning Group, NHS. https://swlimo.southwestlondon.icb.nhs.uk/wp-content/uploads/2022/05/SWL-Barrier-Products-Factsheet-Final-31.03.2022-2.pdf

9. Puri, V. et al. (2025). The assessment and treatment of burn wounds in the Asia-Pacific )APAC) region: consensus meeting report. Wounds International. https://woundsinternational.com/consensus-documents/the-assessment-and-treatment-ofburn-wounds-in-the-asia-pacificapac-region-consensus-meeting-report/

10. John Ambulance Australia. (2022a). First aid fact sheet DRSABCD action plan. https://stjohn.org.au/assets/uploads/fact%20sheets/english/Fact%20sheets_DRSABCD.pdf

11. John Ambulance Australia. (2022b). First aid fact sheet: Burn or scald. https://stjohn.org.au/assets/uploads/fact%20sheets/english/Fact%20sheets_burn%20or%20scald.pdf

12. Swift, T., Westgate, G., Van Onselen, J., & Lee, S. (2021). Developments in silicone technology for use in stoma care. British Journal of Nursing, 30(6), S1.

13. Wounds International. (2014). Best practice guidelines: Effective skin and wound management of non-complex burns. Wounds International. https://woundsinternational.com/wp-content/uploads/2023/02/01b2238668a7092e56899e2da730545d.pdf

14. Venkateswaran., Rao, R., Kumar, K., & Sankamithra. (2024). Evaluation of a technology lipido-colloid non-adherent dressing with silver in the management of burn patients – a case series from India. Wounds International, 15(1), 42-48.