How to reduce pain after a burn

Burn pain is not something that can be easily endured. After heat damages the skin, nerve endings are exposed, inflammatory mediators are continuously released, and local swelling and blister tension all exacerbate the pain. Poor pain control can lead to reluctance to move, difficulty sleeping, and loss of appetite, hindering recovery. Reducing burn pain must begin immediately after the injury and continue throughout the entire process of rinsing, covering, applying medication, and changing dressings; it cannot be achieved solely through painkillers.

Why is rinsing with cold water the first step in relieving pain?

The sooner you rinse a burn with running cool water, the more effective the pain relief will be. Keep the water temperature between 15 and 20 degrees Celsius and rinse for 15 to 30 minutes, until the pain is significantly reduced after removing the cool water. Cool water helps remove residual heat from deeper layers of the skin, preventing further heat conduction and reducing nerve ending excitability, thus reducing swelling. Do not apply ice water or ice directly, as excessively low temperatures can cause strong vasoconstriction, worsening tissue ischemia and potentially leading to frostbite. Keep burns large areas warm and infants warm during rinsing to prevent hypothermia. If pain rebounds after rinsing, you can rinse briefly with cool water or apply a wet compress, but the best results are achieved within three hours of the burn. 

How can I treat blisters and dressings without worsening the pain? 

Do not pop blisters after a burn. An intact blister skin protects the underlying wound and reduces irritation to exposed nerve endings from air and clothing. Blisters larger than two centimeters in diameter, under high tension, or located near joints prone to friction should be drained by healthcare professionals under sterile conditions, preserving the blister skin. For dressings, silicone foam dressings, hydrocolloid dressings, or petroleum jelly gauze are preferred. These materials do not adhere to the wound and will not tear new tissue when removed. Ordinary dry gauze, once soaked with exudate, dries and scabs; tearing it off during dressing changes will cause significant pain and secondary damage. Secure dressings with hypoallergenic tape, avoiding excessive tightness. For burns on the limbs, elevate them appropriately to reduce swelling and pain.

Can painkillers be used, and how should they be used?

When burns cause significant pain, oral analgesics can be used. Acetaminophen and ibuprofen are common choices; take them according to the instructions. Do not take ibuprofen on an empty stomach. People with stomach ulcers, renal insufficiency, bleeding tendencies, or those currently using anticoagulants should consult a doctor first. Taking medication as prescribed when pain is persistent is more effective than waiting until the pain reaches its peak. Topical lidocaine gel or spray should only be used on small, intact areas of the burn. Do not use it on large, broken skin to avoid excessive absorption. Do not apply toothpaste, soy sauce, sesame oil, medicinal powder, alcohol, iodine, or hydrogen peroxide to burns. These will not relieve pain and may irritate the wound, interfere with a doctor's assessment, and increase the risk of infection.

How to reduce pain when changing dressings? 

Before changing the dressing, prepare thoroughly, and be gentle and quick. Before removing the old dressing, moisten any adhesions with saline solution. Wait for the dressing to loosen, then slowly peel it off parallel to the skin; do not tear it vertically. Clean the wound with room temperature saline solution under low pressure; do not rub back and forth with cotton balls. Choose non-adhesive dressings to reduce the frequency of changes; if there is not much exudate, it is not necessary to remove and check it every day. Take pain medication as prescribed before changing the dressing to make the procedure smoother. After changing the dressing, keep it flat and avoid wrinkles or overly tight bandaging. If the pain continues to worsen after changing the dressing, or if the redness and swelling around the wound expands, the exudate turns into pus, there is an odor, or fever, it indicates a possible infection, and you should seek medical attention as soon as possible. For large, deep burns, burns located on the face, hand joints, or genitals, or for infants and the elderly, do not attempt to treat at home; seek immediate medical evaluation at a hospital. The key to reducing burn pain is early and adequate cold therapy, wound protection, appropriate analgesia, and gentle dressing changes. Doing these things well will significantly reduce pain and promote smoother healing.

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Editor: kiki Jia