Hot Water Burn: First Aid, Treatment, Healing Time, Causes, Symptoms, Classification, Prevention

People suffer from all types of accidents, which leave behind wounds and scars. Some of the common skin injuries include hot water burns. A hot water burn, as the name itself suggests, is scalding or burn on the skin from boiling or hot water. A person can suffer from hot water burns from simple accidents, such as dropping a kettle full of boiled water or a glass during pouring water or being involved in a hot tap water accident. Hot water burn or scalding can occur anywhere on the body including the hands and legs. Hot water burns most commonly occur during showers or baths. Children more commonly tend to suffer from scald burns or hot water burns due to their curious nature and decreased awareness of the harm. The severity of the pain and hot water burn depends on the layer of the skin hurt.

Burn is the commonest of skin injuries suffered by a person. There are different causes of burns and anyone can be a victim of a burn. If the burn is mild or if it is a low-degree burn, then it can be treated easily at home or can heal without any treatment. If the burn is severe in nature, then medical attention is needed as it can be very painful and become life threatening if not treated immediately. The severity of a hot water burn depends on the temperature of the water, length of exposure to the hot water, size of the affected area and patient’s age. Depending of the severity of the burnt skin, burns are categorized into first, second and third-degree burns. Children are more susceptible to burns, as they are curious by nature and this makes some of the common household things harmful. So, it is important to know the potential causes of burns so one can take precautions for them.

• Failure to check the temperatures of the water at home before taking a bath or shower.
• Hot water tanks which do not have thermostatic mixing valves or tempering valves can cause hot water burns.
• Leaving children or elderly individuals unattended in shower or bathtub can also cause hot water burns.
• Children also are at higher risk for suffering from any type of burn as their skin is thinner than adults.
• Elderly individuals are also at an increased risk for burns as they have decreased sensitivity to extreme temperatures which delays their withdrawal reflex.

Our skin covers our entire body and protects our cells and organs from outer environment. Any injury to the skin including hot water burn causes wounds and scars. The pain and severity of the injury depends on the layers of skin affected, which include:

• Epidermis: This is the external part of the skin, through which the dead cells of skin are shed.
• Dermis: This is the underlying layer made of fibrous tissues, which contains sweat glands, hair follicles, blood vessels and nerves.
• Subcutaneous Tissue: This is the lowermost and final layer of the fat and tissues and contains larger blood vessels.

Scalds or scalding is a burn which causes damage to the skin and flesh from wet sources, such as steam or boiling water. Scalds cause deeper wounds than other burns and have increased risk for scars. A hot water burn can cause splits and blisters in the skin layers. A hot water burn can be either mild or severe. However, the pain experienced does not depend on the size of the hot water burn and depends on the depth of the skin damage. Suffering from a hot water burn in a specific area can be more painful than a major hot water burn. Given below are some characteristics of a hot water burn:

• The skin turns red or blackish in color.
• There is peeling of the skin layer (epidermis or dermis).
• There is appearance of blisters on the affected area. The blisters can be small or big in size.
• There is swelling around the area of the hot water burn.

• If the burn/wound becomes smelly or painful.
• If the patient with hot water burn develops fever.
• If there is any fluid leaking from the hot water burn wound and the dressing becomes soaked with this fluid.
• If there is no healing of the wound even after two weeks.

In case of hot water burns, it is important to get immediate treatment, as the heat from severe hot water burns can spread to a large area under the skin and cause tissue damage. Immediate action also gives soothing sensation, albeit temporary from the hot water.

• First Aid for Hot Water Burn- Step 1:- It is important to cool and calm the skin by keeping the affected region under tap water for 10 minutes or as long as it takes to alleviate some of the pain. This is the most important first aid for hot water burn.
• Step 2:- After cooling of the skin has been achieved, patient should try to keep warm. A blanket can also be used for this purpose.
• Step 3:- Any type of jewelry or clothes present near the affected region should be removed to prevent bacterial contamination, which can cause infection.
• Step 4:- It is important to keep the patient calm by making the patient sit or lie down.
• Step 5:- As a part of first aid for hot water burn, the extent of the affected area of hot water burn should be determined because if the hot water burn is large with severe blistered and peeled skin, then immediate medical assistance should be sought.
• Step 6:- Do not put anything on an open hot water burn, such as lotion, aloe vera gel, honey, egg white, butter or any other ointment as it can cause infection.
• Step 7:- First aid for hot water burn also includes covering the affected area with a sterile cloth or gauze while waiting for medical assistance.
• Step 8:- The wound dressing should be changed regularly and patient should take necessary medications prescribed by the doctor.

• First Degree Burn: There is redness and swelling in the outermost layers of the skin.
• Second Degree Burn: There is blistering along with redness and swelling, which can extend to deeper layers of skin.
• Third Degree Burn: There is damage and destruction to the entire depth of the skin.

A burn which occurs as a result of hot water or boiling water can look mild and harmless. However, it has the potential to cause extreme pain accompanied by damaged skin and blisters. Treatment of a hot water burn should be done as soon as possible, as immediate treatment helps in reducing the temperature, which has damaged the skin, which in turn decreases the chances of further skin damage. The degree of the heat of the water determines the severity of a hot water burn. Some hot water burns may be mild and some can be serious and painful. Given below are methods to treat a hot water burn:

Reducing the Temperature: This is the initial step in treating a hot water burn, i.e. to cool or bring down the temperature in the area of the hot water burn. This is achieved by placing the affected region under running water. It is important to continue doing this until there is decrease in the severity of the pain caused due to hot water burn.

Drying the Hot Water Burn: This can be achieved by gently patting the wound dry by using clean tissues or towels. Never rub a burn, whether it is a hot water burn or any other type of burn, as rubbing the wound causes further damage to the skin tissues.

Keeping the Hot Water Burn Clean: After patting the wound dry, the wound or the burn should be loosely covered with a gauze. This helps in preventing further damage. If there is pain , then application of cold compresses helps in reducing the pain associated with hot water burn. It is also beneficial to keep the affected region above the level of the heart. This helps in relieving pain, as an elevated position decreases the pressure on the affected region.

Application of Medicine: There are different ointments for treating burns available today. They can be used for small burns; however, they should be used with caution for severe hot water burns, as some of the ointments can cause temperature inside the burn wound to increase causing more pain.

Keeping the Burns Moist and Regular Changing of the Gauze: It is important to keep the wound moist and changing the gauze regularly, as this will boost the healing process along with avoiding any bacterial infection. If there is a major hot water burn, then medical help may be needed for changing the dressing to avoid any tearing or harm to the healing skin.

Avoiding Irritants & Bursting of Blisters: Avoid bursting any blisters, as it can lead to infection. If you have burned the inside of the mouth from drinking something hot, then it is important to avoid things which cause further aggravation or irritation to the area, such as hot and spicy food, smoking and alcohol till the burn heals.

The healing time for a hot water burn depends on the severity of the burn and the treatment which is given. If there is infection of the burn wound, then the healing time is delayed and medical attention should be sought immediately. Mild hot water burns affecting only the superficial epidermal, i.e. the uppermost layer of the skin heal about in one week and often without any scarring.

• Appropriate supervision is needed for preventing hot water burns for children during bath times. It is important to keep all the supplies needed for a shower/ bath handy before entering the bathroom, so the individuals can be supervised appropriately.
• The hot water heater thermostat should be tuned to 120 degrees Fahrenheit or less.
• Scald resistant faucets, thermostatic mixing valve or a tempering valve should be installed. This is very helpful in preventing hot water burns.
• Always test the temperature of the water in your tub with your wrist first before entering the tub. It is advisable to wait till the tub water is at the desired level which you want.

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