Burns and Scalds: Cool Water First, Folk Remedies Never

For a heat burn, once the source of heat is gone, hold the burn under cool running water for 20 minutes — any cooling is better than none — then cover it loosely with cling film or a clean non-stick dressing. Butter, oil, ice and toothpaste do not help and can make things worse. Chemical and electrical burns follow different rules, set out below.

When to see a doctor

Now — emergency (999 in the UK, 911 in the US, 112 in the EU): a large burn (US, MedlinePlus: palm-sized or bigger calls for 911); a deep burn — white, brown or charred skin, or skin that does not hurt; burns to the face, hands, feet, large joints, genitals or buttocks; a burn that goes all the way round an arm or leg; any chemical or electrical burn; soot around the mouth or nose, a hoarse voice, coughing or trouble breathing after a fire indoors; any burn in a baby. UK specialist services ask for all burns of the hands, feet, face and genitals to be discussed with them (British Burn Association).

Today: any burn in a child, an older person or someone with diabetes, even a small one (British Red Cross; IFRC); in the UK, for a child under 5 you can call 111 (NHS). Signs of infection — fever, pain that grows instead of easing, pus, redness spreading around the burn — mean contacting a doctor the same day.

Routine: a burn that has not healed in 2 weeks (British Burn Association).

What is happening

Heat keeps working after contact ends. Skin stays hot and tissue damage continues; cooling limits it and eases pain. The International Liaison Committee on Resuscitation (ILCOR) makes a strong recommendation to cool with running water immediately — while rating the evidence as very low certainty, and it sets no exact duration because studies of different durations found no clear difference in outcomes.

Where 20 minutes comes from. The NHS, St John Ambulance, the European Resuscitation Council (ERC 2021, which replaced its earlier 10 minutes) and Australian guidelines say 20 minutes. US and IFRC guidance: at least 10, ideally 20. The ERC "urges any cooling as opposed to no cooling". Cooling still helps if started up to 3 hours after the burn (NHS; ANZCOR).

Superficial or deep. A superficial burn is red, swollen, often with clear blisters, and very painful. A deep burn may have blood-filled blisters or white, brown or charred skin that feels little pain — a numb burn is not a mild one. For size, the person's own palm with fingers together is roughly 1% of their body surface.

Why folk remedies fail. Butter and oil hold heat in; toothpaste feels cool because of menthol but treats nothing; and whatever is put on the burn has to be cleaned off in hospital, which adds pain and damage (British Red Cross). Ice deepens the injury by narrowing blood vessels and can chill the person (St John Ambulance; ANZCOR; WHO). These remedies are common: in one survey about 70% of respondents had used honey on a burn and more than half toothpaste — which shows how widespread they are, not that they work.

What to do

For a heat burn or scald:

Stop the burning and move away from the source.
Cool running water, cool but not icy, for 20 minutes. No tap nearby: cool bottled water, a wet towel or cold milk and drinks (NHS; British Red Cross).
Take off rings, watches and clothing near the burn before it swells. Leave anything stuck to the skin (NHS).
Cool the burn, not the person. Keep the rest of the body warm; do not put a small child under a cold shower all over. In ILCOR's data, 5 of 117 children under 4 became too cold, 4 of them after a whole-body shower.
Cover it loosely. UK, European and Australian guidance suggests cling film laid over the burn, not wrapped round it, or a clean plastic bag for a hand; not on the face. US guidance: a dry sterile dressing (MedlinePlus). No adhesive plasters.
Do not burst blisters — that invites infection (NHS; IFRC).
Pain relief as on the leaflet: paracetamol or ibuprofen; for children, see doses by weight. No aspirin for under-19s (MedlinePlus, US).

Chemical burn. Wear gloves, brush off any dry chemical first, take off contaminated clothing, then rinse with running water for at least 20 minutes and keep going while help comes (NHS; ANZCOR). Do not try to neutralise acid with alkali or the other way round — the reaction releases more heat. Do not cover with cling film. Call an ambulance or poison control (US: 1-800-222-1222). For the eye: chemical in the eye; to avoid making fumes at home: never mix bleach with ammonia or vinegar.

Electrical burn. Do not touch the person while they are still in contact with the current: switch it off at the switch or fuse box first (St John Ambulance). Near high voltage, stay at least 10 metres away and wait for emergency services — wood can conduct high voltage (ANZCOR); see downed power lines. Always call an ambulance, even for a small mark: current can affect the heart, up to cardiac arrest. If the person is unresponsive and not breathing normally (occasional gasps are not normal breathing), call an ambulance and start CPR. Cool the burn itself like a heat burn.

When this is not the case

Babies, small children, older people, large burns: the highest risk of getting too cold — cool only the burn and cover the rest.
Sunburn: see sunscreen and when sunburn needs a doctor.
Kitchen fires: when a pan catches fire. Keep dressings and cling film in the home first aid kit.

Sources

Checked: 27 September 2026