Why should you immediately rinse a burn with cold water in the early stages?

Getting splattered with hot oil in the kitchen, slipping on a bowl while carrying hot soup, or knocking over a kettle—these are accidents most people will experience a few times in their lives. In the minutes following a burn, most people panic. Some apply soy sauce, some toothpaste, and some simply cover it with gauze and leave it alone. These actions are all incorrect. The most effective, simplest, and cheapest early treatment for burns is to rinse with cool water. Moreover, this action has a window of opportunity; the earlier the better, as the effect diminishes significantly later. The essence of a burn is damage to skin tissue caused by heat. When a heat source comes into contact with the skin, the heat doesn't remain on the surface but continues to be conducted deeper, leading to more protein denaturation and cell necrosis. The purpose of rinsing with cool water is to remove residual heat, lower the skin temperature, and prevent the damage from spreading deeper and to the surrounding areas. This principle is called heat clearance. Research data shows that rinsing with cool water within 30 seconds of a burn can significantly reduce the depth of the injury. The later the rinsing, the less effective it is; rinsing after 30 minutes is largely useless.

Is it better to apply a cold compress or rinse with water?

Many people have heard that cold compresses are effective for burns, but it's important to clarify whether rinsing or applying running cool water is better. Rinsing with cool running water is superior to cold compresses. This is because running water continuously removes heat, while a cold towel applied to the wound quickly heats up under the skin, reaching a temperature similar to the wound itself, and then loses its cooling effect. If you want to use cold compresses, you need to change the towel every one or two minutes or re-soak it in cool water, which is much more troublesome than rinsing directly. Rinsing also has another benefit: the flowing water washes away dust, oil, and loose skin debris from the wound, reducing the chance of subsequent infection. Ordinary tap water, around 15 to 20 degrees Celsius, is suitable for rinsing—it should feel cool to the touch but not icy. Do not use ice water or apply ice directly to the burn wound. The temperature of ice is too low, causing severe vasoconstriction, which can worsen tissue ischemia and damage, even leading to a double injury of frostbite and burns combined. Clinically, I have seen cases where people who were burned put their hands into the snow or applied ice for a long time. As a result, the wounds not only did not improve, but turned into deep second- or even third-degree frostbite combined with burns, which are much more troublesome to treat than simple burns.

How long should you rinse a burn with cold water?

The duration of rinsing with cool water is equally important. It's generally recommended to rinse for 15 to 30 minutes, or until the pain in the wound is significantly reduced. A large part of the pain after a burn comes from the continuous stimulation of nerve endings in the skin by heat. Once the heat is removed, the excitability of these nerve endings decreases, naturally relieving the pain. Some people think that rinsing for a few minutes is enough, but this is insufficient. Deep heat takes time to dissipate completely. For example, if a cup of boiling water is poured on the back of your hand, the surface temperature may drop in seconds, but the temperature two millimeters below the skin takes much longer to return to normal. During the rinsing process, there's no need to vigorously rub the wound or break any blisters; simply let the water flow naturally over the wound. If the burn area is large, such as larger than the patient's palm, it's not recommended to rinse the entire body with cool water for an extended period, as large-area cooling can lead to hypothermia, especially in the elderly and children. In this case, cover the wound with a towel soaked in cool water, changing it every two to three minutes, and seek medical attention as soon as possible.

What should I do after taking a cold shower?

After rinsing for the required time, gently pat the skin around the wound dry with a clean, lint-free towel or gauze, being careful not to rub the wound itself. Then, gently cover the wound with sterile gauze or clean cotton cloth for protection. Do not apply anything at this time—no soy sauce, toothpaste, sesame oil, mercurochrome, or gentian violet. These substances not only have no therapeutic effect but also interfere with the doctor's assessment of the burn's depth. The doctor needs to determine whether it is a superficial or deep second-degree burn based on the wound's color, blister size, and the moisture level of the base, which directly determines whether conservative dressing changes or surgical skin grafting are necessary. Applying soy sauce or toothpaste will stain the wound, making it difficult for the doctor to see clearly, requiring them to clean it before making a judgment. This cleaning process is painful for the patient and delays the optimal treatment time.

Which burns cannot be treated by simply rinsing with cold water?

Not all burns can be treated at home. Several situations require immediate medical attention. Burns larger than the patient's palm, or even smaller burns with third-degree burns (meaning the wound is waxy white, charred yellow, or even charcoal black, and there is no pain or very dull pain), indicate that the entire skin layer, including the nerves, has died. Chemical burns, such as from splashes of strong acids or alkalis, cannot be treated simply with water. First, use a dry cloth to absorb the remaining chemicals before rinsing with water, and the rinsing time should be extended to at least 30 minutes. Electrical burns often have small entry points but severe internal damage and also require professional treatment. For facial or respiratory burns, or burns combined with fractures, head injuries, or other traumatic injuries, call emergency services immediately. Remember this simple principle: if you are unsure, go to the hospital for a doctor's assessment. Don't delay because you think it's inconvenient or a minor matter.

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Editor: kiki Jia