Burns and scalds are among the most common serious injuries in young children, and almost everything that matters for the long-term outcome happens in the first few minutes — at home, before any professional is involved. Done correctly, those minutes substantially limit the depth of the burn by stopping the heat that is still cooking the tissue. Done badly, with butter or ice or a tea-towel pressed on too soon, they make things worse.
The single most important thing you need to remember is this: cool running water, on the burn, for 20 minutes. Start as quickly as you can. Then assess whether the child needs hospital care. The list of things that don't help — and that actively harm — is shorter and equally important: ice, butter, oil, toothpaste, cream, aloe, and any covering that goes on before the cooling is finished.
Healthbooq (healthbooq.com) covers child safety and first aid.
Types of Burns in Children
Scalds — burns from hot liquids — are the most common burn in children under 5. A cup of tea or coffee can still cause a serious scald 15 minutes after it was poured. Bath water at 60°C causes a full-thickness burn in 5 seconds; at 50°C in around 2 minutes. A young child cannot reliably escape a hot liquid once it's in contact with their skin, which is why prevention (handles turned away, drinks set well back, water temperature checked) matters as much as first aid.
Flame burns happen when clothing or other materials catch fire. Contact burns come from touching hot objects — oven doors, irons, hair straighteners, barbecue grills, the side of a wood burner. Chemical burns from household products (bleach, drain cleaner, oven cleaner) are less common but particularly dangerous because the chemical keeps damaging tissue until it is fully removed. Electrical burns can have a deceptively small skin wound with extensive deeper tissue damage along the path the current took through the body.
Correct First Aid
Cool the burn immediately with cool — not cold, not iced — running water. The water should feel comfortable on healthy skin, not painful. Run it continuously over the affected area for 20 minutes. This is the single most effective first-aid measure and its effect on reducing burn depth is well established (Cuttle et al., 2009, Burns; Bartlett et al., 2008 systematic review).
Twenty minutes is specific. The cooling needs to be continuous: stopping and restarting does not produce the same effect. Set a timer.
Start within 3 hours. After that window, cooling is no longer effective.
While you cool, ring 999 or get the child to A&E if the burn is serious. Remove any clothing or jewellery near the burn — unless it is stuck; never pull stuck material off, you will take skin with it. Do not apply anything else to the burn — no butter, toothpaste, oil, aloe gel, ointment, ice.
After cooling, cover loosely with cling film or a clean non-fluffy material. Cling film is ideal: transparent (so the burn can be reviewed without removing it), non-adherent, and it traps moisture in the way the wound needs. Avoid cotton wool or fluffy fabrics that will stick.
Chemical burn: remove contaminated clothing carefully, then flush with large volumes of cool running water for 20 minutes. Call 999 for any significant chemical exposure.
When to Seek Emergency Care
All burns in children except the smallest, superficial ones should be looked at by a healthcare professional the same day.
Call 999 or go to A&E immediately for:
- Burns covering more than 1% of body surface area (roughly the size of the child's palm) in a child under 2, or more than 2% in older children
- Burns to the hands, feet, face, genitals, perineum, or any major joint (elbows, knees, hips) — these areas have high functional and cosmetic significance and need specialist care
- Burns that look white, brown, waxy, or black, or that are painless (full-thickness damage to nerve endings)
- Circumferential burns — going all the way around a limb or the trunk
- Any burn from chemicals, electricity, or flame
- Any burn in a baby under 5 months
- Any concern about how the burn happened (possible non-accidental injury)
Burn Depth
Superficial (epidermal): red, painful, no blistering — like sunburn. Heals in 7–10 days without scarring. Cool water and analgesia; no specialist referral needed.
Superficial partial thickness: blistering, very painful, moist appearance. Heals in 7–21 days, usually without significant scarring. Needs medical assessment.
Deep partial thickness: drier, mottled, less painful (because nerve endings have been damaged). Takes more than 21 days to heal and usually scars. Specialist care required, sometimes including skin grafting.
Full thickness: white, brown, or black; painless; dry; leathery. Does not heal without surgical skin grafting.
Prevention
- Hot water heater: turn the household setting down to a maximum of 49°C.
- Bath: use a thermometer; aim for 37–38°C. Always run the cold tap last.
- Hot drinks: never put a tea or coffee within reach of a young child. A toddler tipping a hot mug on themselves causes preventable scalds every week in UK A&Es.
- Cooking: use the back rings; turn pan handles toward the back of the hob; ideally keep young children out of the kitchen while cooking.
- Smoke alarms: one on every floor, tested monthly.
Key Takeaways
Scalds from hot liquids are the most common cause of serious burns in children under 5, with most occurring in the kitchen or bath. The correct first aid for a burn or scald is to cool the affected area with cool running water for a minimum of 20 minutes, starting within 3 hours of the injury. Do not use ice, butter, toothpaste, or other home remedies. Remove clothing and jewellery from the affected area but not if it is stuck to the skin. All burns in children other than very minor superficial burns should be assessed by a healthcare professional, and specific features – burns to hands, feet, face, genitals, or joints; large burns; circumferential burns; chemical burns; and burns in children under 5 months – require emergency assessment.
