How well can I expect a burn to heal?

February 21, 2007 10:04 AM

How well will a 2nd degree burn heal? My 6 year-old daughter was burned on her forearm..

..by very hot coffee. It broke the skin, blistered pretty good and she rightfully screamed her head off. I applied a cold washcloth for about 20 minutes and then applied a non-stick burn bandage along with some Burn-Free ointment and wrapped it in gauze. Any ideas as far as how well I can expect it to heal? I'm not asking for free medical advice - I know burns can leave some pretty nasty scars. I'm just feeling like the worst father in the world right now and need to hear of any experiences with this. (She will be seeing her pediatrician within the hour).

posted by KevinSkomsvold to health & fitness (34 comments total)

It depends. I had one of these 6 weeks ago. A french press detonated and sprayed boiling water all over me. Figure a 2 inch 2nd degree burn.

I was told that it depends if the burn kills the hair follicles.

If it did, it's going to have to heal from the outside in. Apparently it grows around 1mm a day, and if it has to do that, sometimes you might need skin grafts if it's big.

If it didn't, it heals outward from the follicles, so you heal much more quickly.
posted by Lord_Pall at 10:10 AM on February 21, 2007

I've had three good second degree burns in my life. One when I was about twelve on my inner forearm from a hot piece of metal. The scar faded in a year or two and there's no trace left. The second was on my lower leg from a presumably faulty electrical blanket about five years ago. It took quite an infection before it healed. That scarred very noticably but has faded with time. It's still there as of now but the most noticable thing about it is the lack of leg hair on that spot. The third was a couple weeks ago when I let someone put a cigarette out on my upper arm. It's not quite finished healing, but it looks like the scar won't be very noticable and will fade very well. I got no medical attention for any of these - I think by most people's standards the second merited it but I just waited out the infection - so with treatment the scarring probably won't be all that bad.
posted by TheOnlyCoolTim at 10:18 AM on February 21, 2007

About three years ago I poured near-boiling oil all over the back of my hand. Needless to say it was not fun. The healing process was long and painful, but two years later you couldn't tell the difference between the skin on my hands. The only scar that remains is about the size of a nickel and is from a re-injury to the healing skin a few months after the initial burn.

I did this when I was 20, and the skin on my burned hand is maybe a shade or two lighter, but you can't tell the difference. A lot of people I've told about this in the past year or so actually have not believed me.

IANAD, but your child still has a lot of growing to do. I don't think this will be a serious issue a few years down the line as long as you take care that she does not re-injure or tear the skin while it heals.
posted by baphomet at 10:21 AM on February 21, 2007

i was burned by FRESHLY perked coffee on my right arm and chest when i was about 20 months old - 2nd and 3rd degree burms. i'm 29 now and the scar is still somewhat visible, but inconsequential. my girlfriend and i were talking about it a week or two ago and she never even notices it.

after the initial weeks of ointment and doctor visit (which i, of course, have no memory of) the only other thing we did was to make sure to have high spf sunblock on my burned arm and chest when i was younger during the summer.
posted by noloveforned at 10:23 AM on February 21, 2007

Poor little thing! Honestly, kids heal so much better than adults. You responded correctly. Just make sure you follow the doc's directions.

And don't feel too bad about it. Pretty much every parent has had some stupid accident. As long as she's always wearing a seatbelt, you kept poisonous products away from her when she was a baby, etc., you're definitely not the worst parent ever!
posted by radioamy at 10:29 AM on February 21, 2007

Burned my inner forearm badly on an oven when I was <10 years old. Healed perfectly, no trace of a scar. Also very little remnants of the sun poisoning I had right around that same time. My mother used tons of liquid vitamin E on me.
posted by atayah at 10:31 AM on February 21, 2007

I spilled boiling water all over myself two years ago and got a big second-degree burn all the way across my stomach and hip. Even though I neglected to go to the doctor for several days after I got the burn, the whole thing healed up beautifully and I don't have any scars at all.

I also stepped on a radiator when I was two and got second-degree burns on my foot, which I don't have any scars from or memory of.

Skin is an amazing thing.
posted by lemuria at 10:34 AM on February 21, 2007

When I was about nine, I was pushed into the still-hot exhaust pipe of a VW bus. I had a crescent scar on my knee for some years but it has pretty much disappeared by now.
posted by Blazecock Pileon at 10:36 AM on February 21, 2007

I recently had a smallish 2nd degree burn (grabbed a falling cast-iron skillet with a non-gloved hand) - it was probably borderline 2nd degree, although it did blister up like no burn I'd had before - and it's a few months later and you can't tell.

Younger kids heal up pretty well. The only lasting scars I have are from some jackass on the playground and that disappearing scourge, varicella.
posted by cobaltnine at 10:38 AM on February 21, 2007

Nthing everyone who says they had a similar childhood injury and now appear unscathed. Mine took a lot longer to fade than it sounds like others' did, but I don't spend much time in the sun (which definitely helps scars fade.)

You might also try Mederma... I was prescribed it for scars from a car accident (not the same thing, but it is reccommended for burns as well) and it really did quickly reduce the appearance of the scar. I'm told Vitamin E is also good for this (just buy the supplements, break them open, and apply to the skin) but I have no personal experience with that.
posted by chickletworks at 10:46 AM on February 21, 2007

Thanks everyone. I felt that her age would be helpful in the healing which is a good thing. I guess I base my own fear on the burns I got when I was 16 which required skin grafts (hers are nothing that serious). As much as AskMe isn't suppose to be therapeutic, you all have allayed my fears significantly and I appreciate that very much.
posted by KevinSkomsvold at 10:53 AM on February 21, 2007

When I was 10, I was running to get to a ride at Disneyland when I collided with a woman carrying very hot coffee. It spilled down my back. I had blisters all over my back and later the skin turned black and peeled off. It was pretty gross. However, I was fine within 2-3 weeks. It didn't scar.
posted by mingshan at 10:55 AM on February 21, 2007

boy i tell you.. i use the new bandaid blister bandaids for cuts nicks, wounds... the ones that are kind of rubbery and form a sealed cover over the wound. they are amazing - double the healing time and almost always leave fresh pink scar free skin.

Id cover her burn with a large one and watch how well they work.
posted by specialk420 at 10:56 AM on February 21, 2007

I got a second degree burn back in June '06. (Weight Watchers frozen entree + microwave + glop of "cheese" on inside of forearm = OW OW OW OW OW OW OW). It looked like this about a week or so afterwards (icky burn picture).

My doctor said not to use Neosporin (which, of course, I had been using) but rather Vitamin E. I got some JASON Natural skin cream stuff at the health food place, put it on.

Eight months later, I have a very faint pink spot on my arm, and that's it.
posted by Lucinda at 10:59 AM on February 21, 2007

When my cousin was six, she leaned up against my uncle's motorcyle's exhaust tube thingy (I guess it's muffler) after a ride. Second degree burn on the calf. Now, 20+ years later, you can hardly see a thing -- very very slight discoloration that migrated a bit north as she grew.
posted by macadamiaranch at 11:43 AM on February 21, 2007

When my sister was 4 or 5 she ran into a hot BBQ that burned her so bad the skin on her chest actually came off within minutes.

She healed pretty quickly with absolutely no scarring.
posted by sideshow at 11:56 AM on February 21, 2007

Just want to chime in with more reassuring "been there" sentiment.

You want to talk mortified? When our daughter was about five years old, my wife pulled a pot roast on a glass tray out of the oven and put it on the table. Our daughter ran right up to get a happy sniff... and ended up with a horrible, long burn right across the front of her neck from the hot glass.

I swear to god it looked like someone tried to slash her throat. We tried to avoid leaving the house for weeks! Even with the bandage, she looked like she'd walked off the set of a horror movie.

Within a couple of years, perhaps sooner, it was all healed. You couldn't find any trace of that burn even if you were looking.

I think the hair follicle thing may be the only long-term issue. You're first aid seemed appropriate and the fact that she'll get quick professional medical help is great. With the right care, I doubt there'll be much, if any, visible effects a few years from now.
posted by pzarquon at 12:02 PM on February 21, 2007

Just wanted to thank everyone for some tips/products I hope I don't ever need - What a thread, I'm going home and encasing my daughter in bubble wrap.
posted by jalexei at 12:14 PM on February 21, 2007

Chiming in with a "felt like the worst father in the world" story. I left a hot clothes iron on the floor of our den and my, then 2 or 3 year old, son grabbed it. He had a sizable 2nd degree burn on the palm of his hand. I'm not a crier but, I felt so guilty I let a few tears go then. The good news was that within a matter of weeks there was no sign of the burn.
posted by Carbolic at 12:20 PM on February 21, 2007

I got a 2nd degree burn from hot coffee on my foot when I was 15. By the time I was 16 there was just a patch of skin that was slightly darker than the surrounding tissue. You're already doing the best thing you can, which is taking her to a doctor. While it seems awful now, it won't even be a memory in a year.
posted by lekvar at 12:53 PM on February 21, 2007

Go easy on the ointment and dressing. I like Silvadine cream - applied *very lightly*. If you glom it on in a thick layer that dries out into a dessicated, foreign-body crust, it will worsen the scarring. It should be the thinnest possible layer that still covers the whole burned area.

Also, use a non-adherent dressing. Little cotton fibers from the gauze, again, are foreign bodies and will worsen the scarring.

I know I just said non-adherent, but if the burn crusts a lot or gets infected, you may wish to use a wet-to-dry dressing instead. Google away or ask your pediatrician.
posted by ikkyu2 at 1:08 PM on February 21, 2007 [1 favorite]

Looks like plenty of advice and commiseration is already present in this thread, but I will say one thing: Never ever run a burn under cold water. I know that you said you used a washcloth with cold water, but it's nearly as bad. It will make it feel better more quickly, but the rapid change in temperature will result in much worse blistering. A lukewarm washcloth would be the way to go.

Also, I had a couple layers of skin burnt off by way of melted nylon on the inside of my right elbow two years ago. (Not to mention the skin pulled off when they took off the cooled nylon, that was even worse!) It has healed so completely by now that I sometimes have trouble recalling which arm it happened to!

Skin is indeed a wondrous organ!
posted by InsanePenguin at 1:33 PM on February 21, 2007

Very sorry to hear about your trouble.

When my eldest son was about two years old he pulled a pan of boiling potatoes off the stove. The water missed his head thank God (even us atheists believe at times like these), but caught his right fore-arm. I know what you mean about feeling like the worst father in the world. I still feel guilty about it, nearly eight years later.

Anyway, for my son, initially there was an emergency dash to hospital. His skin was coming off in my hands as he struggled. My wife was driving (like Evil Knievel) because my son wouldn't let go of me. We got to hospital, he got attention straight away. They shot him up with pethidene, which was the first time that I'd ever watched somebody get stoned right in front of me.

After emergency treatment, my son was transferred to a specialist childrens' burns unit that night. His arm was coated in anti-sceptic gel and wrapped in a jiffy cloth. (I'm not sure what the USian is for jiffy cloth - basically it's one of those cloths that you buy in packs of ten and use to wipe down kitchen surfaces.) Over the jiffy cloth, and covering the hand, was a clear plastic bag. A bandage was wrapped around the arm to keep the bag in place.

My son stayed in hospital for a week. It should have been longer, but he was let out on Christmas Eve, as it was a special occasion that the nursing staff felt merited his early release.

For burns cases, after the initial trauma, the problem is with infection. That often presents itself with symptoms similar to a bad case of flu. The plastic bag, mentioned earlier, collected quite a large amount of pus from the wound.

Finally, just before release, the bandage and plastic bag were removed, and the jiffy cloth had to be cut off. And the cutting off was one of the most traumatic experiences of my life. Basically, I had to pin him down in the bath whilst one nurse hosed him down with water and another nurse cut the cloth off. My wife, after watching for about ten seconds, spent the rest of the time outside in the corridor listening to the unearthly shieaking and throwing up into a bucket.

Now, all these years later. The whole thing has passed into family lore. He's absolutely fine, and his parents are so careful about hot liquids and surfaces it's comical.

Normally, you'd never notice anything unusual about my son's arm. However, when he's been out in the sun, if you look closely, you can see the faint trace of the jiffy cloth pattern (a checkered effect).

Sorry for the rambling.

Good luck, and don't worry. Your daughter will be fine.
posted by veedubya at 1:38 PM on February 21, 2007

I should have previewed, but I couldn't disagree more with InsanePenguin's comment.

According to the doctors that treated my son, amongst which were people with many years dealing with burns injuries, the consensus was that my wife's initial action of dumping my son in the shower and dousing him with cold water, was the difference between the treatment he got and him needing surgery for skin grafts. According to every doctor and nurse we spoke to, cold water is the best initial treatment for a burn.
posted by veedubya at 1:44 PM on February 21, 2007

When I was taught first aid we were told that, when treating a wound, the most important thing you can do is cool it down. We were told this stops any 'cooking' continuing and making the wound deeper and more serious. Running under cold water was the way we were told to do this. Looks like this is pretty commonly accepted.
posted by prentiz at 2:30 PM on February 21, 2007

Given how young she is, I'd say there's a good chance that it'll heal without a scar. Keep the skin moisturized with aloe or (even better) polysporin; polysporin also prevents infection.
posted by Dasein at 3:13 PM on February 21, 2007

When I was about eight or nine, I got a second degree burn just like the one macadamiaranch describes. Hot moped exhaust makes contact with bare calf, produces crisped brown skin and screaming child. The burn was roughly the size and shape of a potato chip. It was ugly looking while it healed, lots of pus and needing to gently scrub off bits of dead tissue around the edges, but it did heal up smoothly with no changes to skin texture. There was some visible discoloration -- basically red and white mottling -- but it wasn't terribly bright, and probably was a lot more noticeable in my own mind than it actually was to anyone else. And even that skin discoloration did eventually fade almost to nothingness, although it didn't really seem vanish until my mid/late twenties. Now in my thirties, if I look very, very closely I can still find very tiny spots of very faintly uneven skin tone that are the last remnants of the scar -- but that's only because I know where and what to look for. Anyone else who wasn't deliberately looking for the tiniest imperfections would say my leg looks unscarred.
posted by Smilla's Sense of Snark at 3:40 PM on February 21, 2007

Somebody slammed a wood stove door on my leg, it was branded "Boston Stove Company" for a few years, but faded by adulthood. Back then, first aid consisted of ignoring you unless you were dripping pus, and I wasn't.
One of the kids fell into a wood campfire with both palms, they basted her with silvadene from ER for a while, and she has no scar now.
I believe the accepted first aid is to cool it as fast as you can, so cold water should be OK.
posted by unrepentanthippie at 7:34 PM on February 21, 2007

Yarrow, the herb, does absolutely amazing things for burns and healing tissue. I am not an herbalist, but you may want to contact one in your area for more information.
posted by Riverine at 9:12 PM on February 21, 2007

I got a second-degree burn from unprotected sun exposure as a teen once. It blistered and healed up, but took weeks and weeks to finally feel normal. It blistered, oozed, peeled, and I couldn't sleep or turn or carry anything on my shoulders and back for a while. didn't know it was a second degree burn at the time. Didn't get medical care since I was uninsured.

All I have left are some sunspots and a story of me being a stupid teenager.
posted by cmgonzalez at 10:55 PM on February 21, 2007

My son laid his hand flat on a hot metal fireplace insert when he was 11 months old. His whole hand blistered. He was treated at a wound clinic and the hand was gooped up really well and wrapped up every two days by the nurses there. He has full mobility in the hand (they wrapped it with a wad of bandage in his palm, sort of as if he was holding a baseball). No scars. I have to look at pictures from the time to remember which hand it happened to.

I felt like the worst mom ever, too. He got over the trauma long before I did.
posted by not that girl at 11:02 PM on February 21, 2007

Cold water is good for a burn because it stops the skin from burning. Ice is bad because it can further damage the skin.

And please try to avoid ointments until you see a doctor, and only then if the doc recommends them. Some ointments can hold in heat and worsen the burn.
posted by IndigoRain at 6:17 AM on February 22, 2007

I got second degree burns over my entire back 10 years ago. They healed completely within a few weeks, with no scarring. Ask your doctor about Silvadene Cream - that's what I was prescribed, it worked wonders.
posted by chundo at 7:26 AM on February 22, 2007

Just a comment or two, as the mom of an 11-year-old son who burned his stomach on the oven door, of all things.... He too was given silvadene, but we didn't put it on until the next day.

If it's at all possible, cold running water is your best bet, to cool the burning - I mean for maybe 20 minutes. Repeat until the person doesn't feel the heat, if you can. As others have said, no ointment for the first 24 hours, then I've had great success with Bag Balm, both for preventing scarring and infection.
posted by Lynsey at 12:12 PM on February 22, 2007