Author: Dr. Evelyn Chau Yi Wen. Lecturer and emergency physician. Department of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM); Committee of Malaysian Sepsis Alliance (MySepsis)
Co-authors: Dr Khaizurin Tajul Arifin, Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia; Committee of Malaysian Sepsis Alliance (MySepsis); Professor Dr. Tan Toh Leong, Consultant Emergency Physician, Department of Emergency Medicine, Faculty of Medicine, UKM; Founder and President, Malaysian Sepsis Alliance (MySepsis)
While it might be the first thing you reach for in a moment of panic, it is actually one of the most common and problematic household remedies we see in the Emergency Department (ED). Patients with painful burns often arrive after applying toothpaste, turmeric or other household remedies in an attempt to relieve the pain.
To understand the scale of this issue, we first have to look at how frequently these injuries occur. Burn injuries remain a significant global health problem. According to the World Health Organization (WHO), burn injuries account for an estimated 180,000 deaths annually, with the vast majority occurring in low- and middle-income countries (Burns).
Most burn injuries are thermal burns (86%), which occur when the skin is exposed to heat. Of these, 43% are caused by flames, 34% by scalds from hot liquids, and 9% by contact with hot objects. The remainder includes electrical burns at 4%, chemical burns at 3%, and other types 7% (Thermal Burns).
In the ED, one of the most common cases we encounter is scald burns from hot oil during cooking. But what is most surprising is not how these burns happen. it's what people put on them before coming to the hospital. When someone is in pain and panic, it is only natural to reach for whatever remedy first comes to mind. Unfortunately, these well-meaning home remedies often do more harm than good.
Applying food, condiments, or household pastes to a burn creates an immediate nightmare for your skin and for your attending physician. Here are a few reasons why:
- It traps heat: Oil-based products like cream or ointments can trap heat within the skin instead of allowing it to dissipate. This can cause the thermal energy to penetrate deeper into the tissues.
- It masks the wound: Dark liquids like soy sauce or turmeric discolour the skin, making it more difficult for the treating doctor to accurately assess the actual depth and severity of the burn.
- It increases the risk of infection: Our skin is the body’s primary protective barrier. Once it is damaged by a burn, applying non-sterile substances like toothpaste or food products can introduce germs and lead to secondary infections.
- It causes unnecessary pain: Removing dried toothpaste or greasy substances from an already inflamed and sensitive wound requires additional cleaning, which can be extremely painful for the patient.
Some people attempt to relieve the pain by soaking the wound in ice water. While it makes complete logical sense: fire is hot, ice is cold, so ice should be the perfect cure, right? It actually does the opposite. The extreme cold damages the already injured tissue by restricting blood flow, potentially causing frostnip, and making the burn much worse.
So, what should you actually do if you sustain a burn injury? (First Aid)
- Move away from the burn source to prevent further injury.
- Cool it down: Run the burn wound under tap water for at least 20 minutes. This helps to dissipate heat from the skin and reduce burn depth.
- Take off any jewellery and clothing: Remove any rings, bracelets or watches near the injured area. Burn injury may swell up later, and these items can act like a tourniquet, restricting blood circulation. Similarly, remove burnt, wet, or contaminated clothing around the wound. However, do not attempt to remove clothing or jewellery that is stuck to the burnt skin, as this may cause further injury.
- Cover the wound: Gently cover the wound with a clean and non-stick dressing to protect the area.
- Leave the blisters alone: Do not pop the blisters, or peel off the skin covering them. The skin served as a natural protective layer against external abrasion or infection.
- Prevent hypothermia: Keep warm, cover unburnt areas as needed.
When should you seek medical help?
Clinically speaking, a minor burn is defined as a predominantly superficial injury involving less than 15% of the total body surface area (TBSA) in adults and less than 10% in children (Thermal Burns). The good news is that the vast majority of burns fall into this category, meaning you can safely manage them at home using over-the-counter painkillers and soothing topical aloe vera gel. However, certain burns require prompt medical attention. You should seek immediate medical care if (Burns Malaysia CPG):
- The burn occurs in children under 5 years old or adults over 60 years old
- The burns involves large area of the body
- The burn involves the face, hands, genital area, nipples, feet, neck or armpit region
- There is a circumferential burn (a burn that goes all the way around the body part, like a ring around the arm, leg, finger, or chest)
- The injury involves smoke inhalation, radiation, lightning, or electrical burns
- The wound shows signs of infection, such as increasing redness, swelling, pus or fever
- There is a suspicion that the injury may not be accidental
Final Thoughts
Burn injuries are painful and often frightening, especially when they happen suddenly in everyday situations like cooking. In those moments of panic, it is easy to reach for familiar household remedies. However, the best first aid for burns is often the simplest: cool the burn with running water, protect the wound, and seek proper medical care when needed. A few simple steps, done correctly, can make a significant difference in your recovery.
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