Best Treatments for Hand Burns

Pain from a burn can last anywhere from minutes to months, depending on the cause of the burn, how deep the burn is, and how it is treated.

A minor burn may cause only fleeting burn pain that goes away within an hour. Most burn pain should dissipate within days to weeks. 

With more severe burns, the burn pain can be extensive and take months to heal.

The first thing to do is:

  1. Cool Burn. Hold burned skin under cool (not cold) running water or immerse in cool water until pain subsides. Avoid direct ice as it can constrict needed blood vessels if too cold. Keep in cool water for minutes to hours as needed.
  2. Protect Burn. Apply an antibiotic and Cover with sterile, non-adhesive bandage or clean cloth. 
  3. Treat Pain with ibuprofen or acetominophen. 
  4. See an MD if below
  5. Follow Up.

CALL 911 IF:
  • The burn penetrates all layers of the skin, skin is black, there is no pain and skin is clearly burned.
  • The skin is leathery or charred looking, with white, brown, or black patches.
  • The burn blister is larger than two inches or oozes.
  • The hands, feet, face, or genitals are burned.
  • The person is an infant or a senior.

For First-Degree Burns (Affecting Top Layer of Skin)

1. Cool Burn
  • Hold burned skin under cool (not cold) running water or immerse in cool water until pain subsides.
  • Use compresses if running water isn’t available.
2. Protect Burn
  • Cover with sterile, non-adhesive bandage or clean cloth.
  • Do not apply butter or ointments, which can cause infection, especially if skin is broken.
3. Treat Pain
  • Give over-the-counter pain reliever such as ibuprofen (Advil, Motrin), acetaminophen (Tylenol), or naproxen (Aleve).
How Does an MD treat a burn:
1. It depends on where the burn is and how extensive it is.
2. When my son had a burn I did the following:  all the above except I put Lidocaine 1% gel on skin after cooing the burn in running cool water or a cold bath for 10-50min depending on how severe the burn is.  I put his hand in cold water for about 30 min before applying the Lidocaine 1% -2% gel.

3. We kept the burn clean and in a water bath for 3 hrs.
4. I gave him ibuprofen.
5. I put Vit E sterile liquid on the burn and then Erythromycin ointment on top and covered with a very large band aid to go to mass.
6. I put Silver sulfadiazine 1% to wound. This was an Rx. 
7. Polyhexanide/betaine gel Prontosan Wound Irrigation Solution and Wound Gel may be better but many insurances do not cover it.  Polyhexanide/betaine gel Prontosan Wound Irrigation Solution and Wound Gel

When you go to the ER, this is what they will do if it is a bad burn.

1. Give you strong pain meds even oral anesthesia
2. Debride the burn: take out all necrotic tissue and dead skin.
3. Apply the below

The treatments MD’s will recommend are:
1. Silver sulfadiazine or
2. Polyhexanide/betaine gel Prontosan Wound Irrigation Solution and Wound Gel 

4. Some centers are now using sterile Tilapia skin as artificial skin. 

The Key Concerns:
1. Risk of infection
2. Risk of contracture (scar tissue) if skin is burned badly. 

Int J Low Extrem Wounds. 2017 Mar;16(1):45-50. doi: 10.1177/1534734617690949. Epub 2017 Feb 1.

Randomized Controlled Trial of Polyhexanide/Betaine Gel Versus Silver Sulfadiazine for Partial-Thickness Burn Treatment.


Silver sulfadiazine is commonly used in the treatment of partial-thickness burns, but it sometimes forms pseudo-eschar and delays wound healing. Polyhexanide/betaine gel, a new wound cleansing and moisturizing product, has some advantages in removing biofilm and promotes wound healing. This study was designed to compare clinical efficacy of polyhexanide/betaine gel with silver sulfadiazine in partial-thickness burn treatment. From September 2013 to May 2015, 46 adult patients with partial-thickness burn ≥10% total body surface area that were admitted to the Burn Unit of Siriraj Hospital within 48 hours after injury were randomly allocated into 2 groups. One group was treated with polyhexanide/betaine gel, and the other group was treated with silver sulfadiazine. Both groups received daily dressing changes and the same standard care given to patients with burns in this center. Healing times in the polyhexanide/betaine gel group and silver sulfadiazine group were 17.8 ± 2.2 days and 18.8 ± 2.1 days, respectively ( P value .13). There were no significant differences in healing times, infection rates, bacterial colonization rates, and treatment cost in both groups. The pain score of the polyhexanide/betaine gel group was significantly less than the silver sulfadiazine group at 4 to 9 days after treatment ( P < .001). The satisfactory assessment result of the polyhexanide/betaine gel group was better than that in the silver sulfadiazine group. These data indicate the need for adequately designed studies to elicit the full potential of polyhexanide gel as a wound dressing for partial-thickness burn wounds.
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