Aftercare for burns and scalds

This resource describes how to care for your child after they have had a burn and what to expect while the burn is healing.

Dressings

If your child has had a dressing applied please keep the dressing dry.

If the dressing gets wet, please return to the Emergency Department to have it changed. There are lots of layers to the dressing, so even if it feels dry on the outside the inside may be wet.

If the dressing comes off, return to the Emergency Department have a new one put on. Burns heal more quickly when they are kept moist in a dressing and there is no scab.

You may be asked to return for a dressing change 48 hours after the injury. When you come back, the burn will be assessed again to see how deep it is and how long it will likely take to heal. Subsequent dressings may be weekly.

Pain

Usually once burns are dressed, they become much less painful. You may need to give your child simple painkillers like paracetamol or ibuprofen to help relieve pain.

Itchiness

Burns can often become itchy. Try not to let your child scratch the burn as this can delay healing.

An antihistamine medicine such as chlorphenamine maleate (Piriton) may be useful and is available from pharmacies and supermarkets.

Scarring

When the burn has only affected the top few layers of the skin it will heal within 2 to 3 weeks. This often heals without a scar. The skin colour will take some time to return to normal (may be months) as new skin is much pinker. If after around 18 months, the pigment has not returned to normal, it is unlikely that it will.

Deeper burns which take longer to heal might scar. For deeper burns or burns that need specialist care to minimise scarring you may be referred to the Burns unit (see below).

Illness

There is a small association between burns and an illness called toxic shock syndrome. These signs include:

• being unwell with temperatures
• diarrhoea
• being sick
• generally seems very unwell

If your child is experiencing these symptoms, please bring them back to the Emergency Department to see a doctor.

Infection

Burns can sometimes become infected. Please be aware of the following signs of infection:

• feels more painful
• red on the surrounding skin
• starts to discharge pus or gets very smelly

This may need review at your next appointment or if getting worse and your child is unwell you may need to return to the Emergency Department.

Movement

Encourage your child to continue to move normally for them. This will prevent the burn healing in a stuck position and prevent your child from becoming stiff with limited movement.

Once dressings are removed

Your child’s burn is now healing. Dressings are usually removed once the skin is no longer broken.

Bathing

Your child can now go back to regular baths or showers as normal.

Pat the burn dry for a few days, do not rub. The skin is more fragile and friction from rubbing it dry could cause the skin to break down.

Moisturise

Now the burn has healed the skin might feel dry and can sometimes be itchy. Apply moisturiser by patting the cream onto the skin 3 times a day with a little pressure for a few weeks.

Do not allow your child to scratch as this can cause the skin to become broken again. The cream will help to limit itch and make the new skin feel soft, supple and flat. Use any gentle non-scented creams such as Diprobase, Aveeno or E45. Wash the cream off using soap and water once a day. This will prevent pores becoming clogged and stop an “acne-like” rash from forming.

Sun cream

Use factor 50 sun cream on sunny days between April and October when the burn is exposed for 2 years.

What is the Burns unit?

At Sheffield Children’s Hospital there is a specialist Burns Unit with doctors, nurses, physiotherapists, and occupational therapists.

If the burn looks deep, is large or is in a place that might need physio therapy to heal well, then a referral will be made. This is normally when the burn is over a joint, to the face or to hands or feet.

What does a referral mean?

The doctors in the Emergency Department would like your burn to be reviewed by a specialist doctor. They have sent them either a description of the burn or a picture.

Sometimes, the specialist plastics doctor will not need you and your child to attend the Burns Unit so your follow up will be in the Emergency Department. Sometimes you and your child will be asked to attend the Burns Unit to see the specialist team mentioned above.

What happens on the Burns unit?

1. Your child will be weighed.
2. The doctors and nurses will ask some questions about the burn and how it happened.
3. Your child will be given some pain relief.
4. The burn will be cleaned.
5. Therapists will come to see your child and will often give you and your child some exercises to do at home.
6. A new bandage will be applied.
7. A follow up appointment will be made.

Where is it?

Sheffield Children’s Hospital, Main Entrance, Clarkson Street, up to B floor in the yellow lifts. Ward 2 and Burns.

When is our appointment?

You will get a phone call telling you when your appointment is. The first appointment on the Burns Unit will take around 2 hours but all appointments after that will be shorter.