What is the best burn cream for different stages?

First and Second degree burn
Medically reviewed by Dr. Mavra Farrukh

Overview

Burns are among the most common household injuries, ranging from minor mishaps in the kitchen to more severe accidents. Proper treatment is crucial to alleviate pain, prevent infection, and ensure the best healing outcome. Burn creams are an integral part of this treatment process, but with a plethora of options available, choosing the right one for each stage of healing can be overwhelming. In this blog, we will explore the most effective burn creams for various stages and degrees of burn, providing you with a comprehensive guide to managing and treating burns effectively. Whether dealing with a minor first-degree burn or a more serious second or third-degree burn, knowing which creams to use and when can make a significant difference in recovery.

Should You Get Medical Attention for the Burn?

Determining whether a burn requires medical attention is crucial for effective treatment and recovery. While minor burns can often be managed at home, more severe burns necessitate professional medical care. Here are guidelines to help decide when to seek medical attention for a burn:

Major Burns

Major burns include third and fourth-degree burns, which penetrate deeper layers of skin and tissues. These burns require emergency medical treatment and should never be treated solely with over-the-counter remedies.

Minor Burns

Minor burns include first and second-degree burns, which affect the outer and sometimes deeper layers of skin but do not cause severe tissue damage. Proper burn creams and first aid techniques can often treat these at home.

Burn DegreeCharacteristics of different degrees of burnsWhen to Seek Medical Attention with respect to the degree of burn
First-Degree Burn1st degree burn affects only the outer layer of the skin (epidermis). Symptoms of 1st-degree burn: redness, minor swelling, and pain. Typically heals within a week without scarring.If the burn covers a large area (more than three inches in diameter). If the burn is on the face, hands, feet, groin, buttocks, or over a major joint. If pain exists or there are signs of infection (increased redness, swelling, or pus).
Second-Degree Burn2nd degree burn affects both the outer layer (epidermis) and the skin’s underlying layer (dermis). Symptoms of 2nd-degree burn: severe pain, redness, blistering and swelling  It can take weeks to heal and may result in scarring.If the burn covers a large area (more than three inches in diameter).  If the burn is on sensitive areas like the face, hands, feet, groin, buttocks, or over a major joint. If there are multiple second-degree burns.  – If blisters are large or widespread.  If pain is severe and unmanageable at home. If there are symptoms of infection (increased redness, swelling, pus, fever).
Third-Degree Burn3rd degree burn affects all layers of the skin and may penetrate deeper tissues.  Symptoms of 3rd-degree burn: white or charred appearance, lack of pain in the burn area due to nerve damage, and dry, leathery skin. It requires extensive healing time and often results in significant scarring.Always seek immediate medical attention for third-degree burns. These burns can be life-threatening and require specialized treatment.  Contact emergency or go to the nearest emergency room immediately.
Fourth-Degree Burn4th-degree burns extend through all layers of the skin and into underlying fat, muscle, and bone. Symptoms of 4th-degree burn: charred skin with possible exposure of bone and muscle, no sensation in the area due to nerve destruction. Extensive medical treatment is required, often including surgery and rehabilitation.Always seek immediate medical attention for fourth-degree burns. Because of the potential for death, these burns need to be treated immediately.Make an emergency call or head straight to the nearest emergency center.

General Guidelines for Seeking Medical Attention

  • Chemical Burns: These require immediate attention from healthcare professionals.
  • Electrical Burns: Burns caused by electrical sources can cause internal damage. Obtain medical assistance right away, even if the burn seems small.
  • Inhalation Injuries: Burns sustained during a fire or from breathing in smoke or fumes must be treated as urgent medical situations.
  • Children and the Elderly: Because of their thinner skin and slower rates of healing, burns to children or the elderly are more dangerous. In these age groups, get medical attention for any serious burns.
  • Immunocompromised People: Those with compromised immune systems should consult a doctor if they have burns because they are more prone to infections.

What are common causes of Burns?

Burns can be brought on by several things, including heat, chemicals, and electrical risks. The following are some typical burn causes:

  • Thermal Burns: Heat sources, including flames, hot liquids (scalds), steam, or contact with hot items like stoves, irons, or cooking utensils, cause these burns.
  • Chemical Burns: Strong acids, alkalis, solvents, and other caustic materials can cause chemical burns. These burns can result from the consumption of chemical fumes, inhalation, or direct skin contact.
  • Electrical Burns: Electrical burns happen when the body comes into contact with an electrical current. Power lines, electrical appliances, malfunctioning wiring, and lightning strikes can all cause this.
  • Radiation Burns: Prolonged exposure to ultraviolet radiation from artificial sources like tanning beds or the sun causes sunburn or more serious damage like radiation dermatitis.
  • Friction Burns: When skin brushes against an uneven surface, friction burns, commonly referred to as abrasions or “road rash,” happen. These burns frequently occur in incidents involving falls or motorbikes.
  • Cold Burns: Also known as frostbite, cold burns occur when skin and underlying tissues freeze due to exposure to extreme cold temperatures. Frostbite commonly affects the fingers, toes, nose, and ears.
  • Radiant Heat Burns: Exposure to intense heat sources like fireballs, explosions, or hot gases can cause radiant heat burns. These burns may occur in industrial settings, during fires, or near explosive devices.
  • Scalds: Scald burns result from contact with hot liquids or steam and are common in kitchen accidents involving boiling water, hot beverages, or cooking oils.

Understanding the various causes of burns is essential for prevention strategies and appropriate management to minimize the risk of injury and promote safety in different environments.
“The right burn cream can excessively impact healing and comfort after a burn injury.”Dr. Richard Honekar

Have you experienced a recent burn? Consult now to prevent scarring and complications.

Which Topical Ointments or Creams are Best to Put on a Burn?

Treating burns with the appropriate topical ointments or creams is crucial for alleviating pain, preventing infection, and promoting healing. The choice of ointment or cream depends on the burn’s severity and stage. Here’s a detailed look at the best options for various types of burns:

First-Degree Burns

First-degree burns affect only the outer layer of the skin and are characterized by redness, minor swelling, and pain. They typically heal within a week without scarring.

Over the Counter (OTC) Ointment/Cream 1st degree burns

For mild first-degree burns, over-the-counter ointments or creams containing ingredients such as aloe vera, lidocaine, or hydrocortisone can help soothe the skin, reduce inflammation, and alleviate pain. These products are readily available at pharmacies and can provide relief from symptoms.

  • Aloe Vera Gel

Aloe vera gel is renowned for its natural anti-inflammatory, soothing, and moisturizing properties, making it an excellent choice for treating minor burns. When applied, it forms a thin layer over the burn, cooling and hydrating the skin and effectively reducing redness and pain. For optimal results, it is best to use pure aloe vera gel without any additives, ensuring that the skin receives the full benefit of this natural remedy.

  • Hydrocortisone Cream

Hydrocortisone cream is effective due to its anti-inflammatory properties, which help to reduce swelling and itching associated with burns. It should be applied sparingly to the affected area, making it particularly useful during the healing process to manage discomfort. However, it is important to note that hydrocortisone cream is not recommended for open wounds; it is ideally used once the skin begins to heal and itching becomes a concern.

Prescription Ointment/Cream for first-degree burns

In most cases, prescription ointments are not necessary for first-degree burns, as they primarily affect the outer layer of the skin (epidermis). However, a healthcare provider may prescribe topical treatments containing ingredients like silver sulfadiazine, neomycin or mafenide acetate if there are complications or underlying conditions.

  • Antibiotic Ointments (e.g., Neosporin)

Antibiotic ointments such as Neosporin prevent bacterial infections in burn wounds. These ointments form a protective barrier over the burn, reducing the risk of infection. A thin layer should be applied to the burn, especially if there is a heightened risk of infection. Additionally, these ointments are suitable for treating minor cuts and abrasions, making them a versatile option for basic first aid.

Second-Degree Burns

Second-degree burns affect the skin’s outer layer (epidermis) and the underlying layer (dermis), causing severe pain, redness, swelling, and blistering. These burns take longer to heal and may result in scarring.

Over the Counter (OTC) Ointment/Cream for 2nd-degree burns

Over-the-counter ointments or creams with ingredients like aloe vera, hydrocortisone, or antibiotic ointments (e.g., Bacitracin) can help soothe the skin, reduce pain, and prevent infection in mild to moderate second-degree burns.

  • Antibiotic Ointments (e.g., Bacitracin)

Antibiotic ointments like Bacitracin prevent infection in minor to moderate burns. When applied as a thin layer to the burn, these ointments create a protective barrier that inhibits bacterial growth and supports healing. However, it is important to consult a healthcare provider for extensive burns for proper evaluation and treatment. Bacitracin and similar antibiotic ointments are valuable tools in burn care, but medical advice should guide their use to ensure optimal outcomes.

Prescription Ointment/Cream for 2nd degree burns

Prescription ointments may be recommended for second-degree burns, affecting both the skin’s outer layer (epidermis) and the underlying layer (dermis). These ointments often contain antimicrobial agents such as silver sulfadiazine (Silvadene) or mupirocin (Bactroban) to prevent infection and promote healing.

  • Silver Sulfadiazine (Silvadene)

Silver sulfadiazine, commonly known as Silvadene, offers broad-spectrum antibacterial action, making it an effective treatment and considered the best cream for burns. When applied as a thin layer to the burn once or twice daily, it helps prevent bacterial infections and promotes healing. However, before using Silvadene, it is crucial to check for sulfa allergies, as some individuals may experience adverse reactions. Silvadene is often prescribed for moderate burns because it effectively manages wound infections and supports healing.

  • Mupirocin ointment/cream 2%

Mupirocin ointment/cream, 2%, is effective for small to medium surface area burns, including the face, ears, nose, and perineum. It provides gram-positive coverage, including methicillin-resistant Staphylococcus aureus (MRSA). Mupirocin offers ease of application and removal but may lead to bacterial resistance, allergic reactions, and signs of re-epithelialization. Adverse effects may include yeast colonization and skin hypersensitivity.

  • Hydrocolloid Dressings (e.g., DuoDERM)

Hydrocolloid dressings, such as DuoDERM, provide an optimal environment for healing burns by maintaining moisture, reducing pain, and protecting the wound from external contaminants. These dressings should be applied directly to the burn and changed every few days or as needed, depending on the extent of the injury. Hydrocolloid dressings are particularly effective in managing burn blisters and are crucial in minimizing the risk of infection and scarring.

Third-Degree Burns

Third-degree burns penetrate all layers of the skin and affect deeper tissues. They require extensive medical treatment and often result in significant scarring. OTC treatment and home remedies are not recommended for third-degree burns.

Prescription Ointment/Cream for 3rd degree burns

Third-degree burns, which affect all layers of the skin and may penetrate deeper tissues, typically require specialized medical care. Under medical supervision, prescription ointments containing antimicrobial agents, growth factors, or advanced wound dressings may be used to promote healing and prevent complications.

  • Silver Sulfadiazine (Silvadene)

A study demonstrates silver sulfadiazine, known as Silvadene, remains effective due to its potent antibacterial properties, making it a critical component in treating severe burns. Silvadene should be applied according to their instructions when prescribed by a healthcare provider. Its primary role is to prevent infection in severe burns, where the risk of bacterial invasion is high. Silvadene acts as a protective barrier, reducing the likelihood of complications and supporting the healing process.

  • Mupirocin (Bactroban)

Mupirocin, commonly marketed as Bactroban, is a potent antibiotic designed to treat secondary infections in burn wounds. When applied as prescribed, usually three times a day, it effectively targets and eliminates bacteria responsible for infection. Mupirocin is crucial in managing infected burn wounds, helping alleviate symptoms and promote healing. Medical advice should guide its use to ensure appropriate treatment and optimal outcomes.

  • Silicone Gel Sheets (e.g., Mepiform, ScarAway)

Silicone gel sheets, such as Mepiform and ScarAway, offer a non-invasive solution for reducing scar formation and improving the appearance of scars from healed burns. When applied over the healed burn for several hours daily, these sheets create a favourable environment that promotes scar reduction. Consistent use over weeks to months can significantly enhance the appearance of scars, making them less noticeable. Silicone gel sheets are essential to scar management, providing patients with a non-invasive and effective option for improving skin aesthetics post-burn injury.

  • Combination antibiotic ointment (eg, bacitracin, neomycin, and polymyxin B)

A combination antibiotic ointment containing bacitracin, neomycin, and polymyxin B is an alternative for individuals allergic to sulfonamides. It is used for burns in small surface areas, similar to bacitracin alone. This ointment offers ease of application and removal but may lead to bacterial resistance, allergic reactions, and signs of re-epithelialization. Neomycin-containing ointments like Neosporin carry a risk of ototoxicity and nephrotoxicity.

Fourth-Degree Burns

The fourth-degree burns penetrate all skin layers, exposing underlying bone, muscle, and fat. Due to the potential for death, these burns need to be treated medically right away.

  • Specialized Medical Care

Specialized medical care for severe burns involves a comprehensive approach that may include surgical interventions such as debridement, grafting, and possibly amputation. These procedures aim to remove damaged tissue, promote healing, and restore functionality. Managed in a hospital setting, specialized care provides patients with comprehensive treatment, including topical and systemic therapies tailored to their needs.

Follow-up care is essential for the best possible outcome following initial treatment. This frequently entails applying cutting-edge dressings to accelerate wound healing and lower the chance of infection. Additionally, physical therapy may enhance function and mobility in the afflicted areas. When significant tissue damage occurs, reconstructive surgery could be required to restore the damaged area’s appearance and functionality.

A multidisciplinary team comprising burn specialists, surgeons, nurses, physical therapists, and other medical professionals is necessary to provide specialized medical care for severe burns. Specialized care seeks to improve patient outcomes and quality of life after severe burn damage by integrating several treatment modalities and offering continuous support.

Burn DegreeOTC Medications for BurnsPrescription Medications for Burns
1st Degree BurnsAloe Vera GelSilver Sulfadiazine
Hydrocortisone CreamMafenide Acetate
Antibiotic Ointments (e.g., Neosporin)Neomycin
2nd Degree BurnsAloe Vera GelSilver Sulfadiazine
Hydrocortisone CreamMupirocin (Bactroban)
Antibiotic Ointments (e.g., Bacitracin)Mafenide Acetate
3rd Degree BurnsNot ApplicableSilver Sulfadiazine
Mupirocin (Bactroban)
Collagenase (Santyl)
4th Degree BurnsNot ApplicableSpecialized Medical Care (Hospital)

General Tips for Using Topical Ointments and Creams

  • Clean the Burn: Clean the burn with cool water and mild soap before applying any ointment or cream.
  • Apply Sparingly: Use a thin layer of ointment or cream to avoid suffocating the skin.
  • Avoid Home Remedies: Do not use butter, oils, or toothpaste on burns, as they can worsen the injury.
  • Consult a Healthcare Professional: If you have severe burns or are unsure about the appropriate treatment, always seek medical advice.
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Benefits of Using Medicated Cream and Ointment for Burns

Using medicated creams and ointments on burns offers several benefits that can significantly aid in the healing process and overall recovery:

Preventing Infection:

Medicated creams and ointments contain antimicrobial agents that help prevent bacterial growth and infection in burn wounds. These treatments lessen the chance of pathogens entering the wound by covering the damaged region in a protective layer, essential for accelerating recovery.

Reducing Pain:

Many medicated creams and ointments contain ingredients with soothing properties that help alleviate pain and discomfort associated with burns. These topical agents provide a cooling sensation and help relieve inflammation, allowing patients to experience greater comfort during the healing process.

Minimizing Scarring:

Proper wound care with medicated creams and ointments can help minimize scarring by promoting optimal healing conditions. Some products contain ingredients that support skin regeneration and reduce scar tissue formation, leading to improved cosmetic outcomes for the patient.

Promoting Healing:

Medicated creams and ointments keep the affected area moist and protected, which is conducive to wound healing. This optimal healing environment supports the body’s natural healing processes, allowing burns to heal more efficiently and effectively.

Enhancing Overall Recovery:

By addressing infection, pain, and scarring, medicated creams and ointments contribute to an overall improved recovery experience for burn patients. These products facilitate physical healing and promote psychological well-being by reducing discomfort and promoting confidence in the healing process.

Ensure the best care for your burn with a personalized treatment plan.

Burn Blister Healing Stages

The healing process of a burn wound typically progresses through three main stages: inflammation, proliferation (granulation tissue formation), and remodelling. Here’s a closer look at each stage:

 Inflammation:

Following a burn injury, the body initiates an inflammatory response to remove damaged tissue and prepare the wound for healing. During this stage:

  • Redness and warmth are caused by blood vessel dilatation, which increases blood flow to the affected area.
  • White blood cells—such as neutrophils and macrophages—migrate to the wound site to eliminate debris and infections.
  • Inflammatory cytokines and growth factors are released, triggering the next stage of healing.

Proliferation (Granulation Tissue Formation):

In the proliferation stage, the body begins to rebuild and repair the damaged tissue. Key events during this stage include:

  • Formation of granulation tissue: New blood vessels and connective tissue, known as granulation tissue, fill the wound bed.
  • Epithelialization: To create a barrier of protection, epithelial cells move from the borders of the wound and cover the wound surface.
  • Contraction: Myofibroblasts contract the wound edges, reducing its size and facilitating wound closure.

Remodeling:

During the remodelling phase, the newly formed tissue undergoes maturation and remodelling to restore strength and function. This stage involves:

  • Collagen deposition and organization: initially randomly oriented, Collagen fibres become aligned along tension lines to increase tensile strength.
  • Scar formation: Excessive collagen deposition may result in scar formation, which may appear raised, thickened, or discoloured.
  • Scar maturation: Over time, scars undergo further remodelling and maturation, becoming lighter in colour and less prominent.

While scarring is a natural part of the healing process, interventions such as scar massage, silicone gel sheets, and topical treatments can help improve the appearance of scars and promote better functional outcomes. It’s important to note that the duration and outcome of each stage may vary depending on factors such as the severity of the burn, the individual’s overall health, and the effectiveness of wound care interventions. Routine monitoring and follow-up with medical professionals are required to guarantee healing and reduce problems.

Don’t wait until it’s too late. Get a consultation and prescription medications to prevent complications of burn.

What shouldn’t you put on a Burn?

While many home remedies are commonly used for burns, it’s essential to recognize that only some are safe and effective. Here are some common myths and misconceptions about home remedies for burns, along with reasons why they should be avoided:

Butter or Oil:

Myth: Applying butter or oil to a burn can relieve pain and promote healing. 

Reality: Butter and oil can trap heat in the skin, worsening the burn and increasing the risk of infection. Additionally, these substances may contain bacteria that can further contaminate the wound.

Ice:

Myth: Placing ice directly on a burn can reduce pain and inflammation.

Reality: Ice can cause further damage to the skin by constricting blood vessels and potentially leading to frostbite. Cold water or a cool compress is a safer alternative for relieving pain and cooling the burn without causing additional harm.

Toothpaste:

Myth: Applying toothpaste to a burn can relieve pain and promote healing. 

Reality: Fluoride and menthol are two substances in toothpaste that can irritate skin and make it feel worse. It is advisable to use more suitable therapies instead of toothpaste for burns.

Egg Whites:

Myth: Applying egg whites to a burn can create a protective barrier and promote healing. Reality: Egg whites can increase the risk of bacterial contamination and infection in the burn wound. Additionally, they can be difficult to remove from the skin and may cause further irritation.

Vinegar:

Myth: Applying vinegar to a burn can help alleviate pain and prevent infection. 

Reality: Vinegar is acidic and can cause further irritation and damage to the skin. It may also delay healing and increase the risk of scarring. Clean water or a mild saline solution is safer for cleaning the burn wound.

Honey:

Myth: Applying honey to a burn can promote healing and prevent infection.

 Reality: While honey does have some antibacterial properties, it can also increase the risk of bacterial contamination and delay healing. Medical-grade honey may be used under medical supervision, but it’s not recommended for home use on burns.

When treating burns, it’s essential to stick to evidence-based methods and avoid using home remedies that can cause more harm than good. Instead, apply a sterile dressing, let the burn cool with clean water, and get medical help if needed. Promoting recovery and lowering the risk of burn-related problems require prompt medical attention and proper wound care.

Should You Pop a Burn Blister?

No. Burn blisters are a natural protective barrier over the damaged skin, helping prevent infection and promote healing. Popping a burn blister can increase the risk of infection by exposing the underlying tissue to bacteria from the environment or your hands.

Additionally, popping a burn blister can lead to further damage to the skin, including pain, inflammation, and delayed healing. The fluid inside the blister contains proteins and nutrients that aid in the healing process, and removing this fluid prematurely can impede the skin’s ability to repair itself.

If a burn blister accidentally pops on its own becomes large, painful, or interferes with movement, seeking medical attention is essential. A doctor can check the severity of the burn and provide appropriate treatment, which may include cleaning the area, applying a sterile dressing, and prescribing medications to prevent infection and manage pain.

When to Consult a Doctor?

Seeking medical attention is imperative in severe burns, burns encompassing extensive body areas, or when signs of infection manifest, such as heightened pain, redness, swelling, or pus formation. These indicators necessitate prompt consultation with a healthcare professional to ensure proper assessment and management, as burns can lead to significant complications if left untreated. Early intervention is crucial for mitigating risks, promoting effective healing, and safeguarding overall well-being.

Don’t leave your burn to heal by chance. Consult now and get a prescription to ensure proper healing.

FAQs About  Burn Cream Answered By your Doctor Online Team

Can I cover a first-degree burn?

A superficial burn can be treated at home with a clean, non-stick, and sterile bandage. If blisters occur, let them heal on their own.

Do burns need air to heal?

No burns do not need air to heal. Air can further damage the tissues as burns are considered open wounds. They heal better in a moist environment.

Can a second-degree burn be treated at home?

You can treat a second-degree burn at home. Use antibiotic ointments and special dressings to treat a second-degree burn at home.

Should you put lotion on a first-degree burn?

A soothing lotion such as aloe vera can help alleviate pain and moisturize the skin.

Should you cover a burn or let it breathe?

Covering a burn with a clean, non-stick bandage can protect it from infection and aid healing. Allowing minor burns to breathe occasionally can also be beneficial.

How to make a burn stop throbbing?

Apply an appropriate burn cream, and take over-the-counter pain relievers like ibuprofen to reduce throbbing.

Why should we not give water to a burn victim?

It’s a myth that burn victims should avoid water. Cool water can help reduce the temperature of the burn and alleviate pain. However, for severe burns, immediate medical attention is necessary.

How Long Does Sunburn Last?

Sunburns generally heal within a week but can vary depending on the severity. Proper hydration, moisturization, and avoiding further sun exposure can help speed the healing process.

Your Doctors Online uses high-quality and trustworthy sources to ensure content accuracy and reliability. We rely on peer-reviewed studies, academic research institutions and medical associations to provide up-to-date and evidence-based information to the users.

  • Todd, J. P. “Notes on the Burn Creams.” Postgraduate Medical Journal 21.234 (1945): 119.
  • Hosseinimehr, Seyed Jalal, et al. “Effect of aloe cream versus silver sulfadiazine for healing burn wounds in rats.” Acta Dermatovenerologica Croatica 18.1 (2010): 0-0.
  • Palmieri, Tina L., and David G. Greenhalgh. “Topical treatment of pediatric patients with burns: a practical guide.” American journal of clinical dermatology 3 (2002): 529-534.
  • Greenhalgh, David G. “Topical antimicrobial agents for burn wounds.” Clinics in plastic surgery 36.4 (2009): 597-606.

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