Really burns my ass to ask...

October 28, 2011 4:18 PM

Because of a practical joke gone wrong (don't ask) I have wound up with second degree burns on my ass, including between the cheeks. I have dressed it with Neosporin and am changing the gauze regularly, but what do I do to minimize discomfort and promote healing as well as to avoid any localized infection in this notoriously unclean region?

Financial details prevent me from heading for a doctor's office right now, btw.

posted by anonymous to Health & Fitness (29 answers total)

1% silver sulfadiazine cream is a fantastic burn ointment but I think it's prescription only
posted by any major dude at 4:29 PM on October 28, 2011

Go to the baby aisle at the store and get the baby wipes meant for sensitive skin. Use those when you poop. Don't touch your butt with toilet paper. Baby wipes, air-drying, and powder (UN-medicated, unless you feel like crying) to prevent chafing. And when you poop, lean forward so that your buttcheeks are naturally more spread apart to avoid poo-burn contact. You can also try the water bidet method mentioned by rope-rider, but if you're unpracticed, now might not be the best time to experiment.

When you're not pooping, treat your cheeks with an OTC burn cream. Ask the pharmacist for advice. (Explain to the doctor that you spilled hot coffee in your lap or something. Sensitive area, prone to crotch funk, but not as embarrassing as butt burns.)

Was a bottle rocket involved in this? Or fart lighting? Because, dude.
posted by phunniemee at 4:31 PM on October 28, 2011 [7 favorites]

It is suggested to use baby wipes instead of toilet paper for hemorrhoids, because baby wipes are gentler. Perhaps baby wipes would help minimize discomfort when wiping?
posted by insectosaurus at 4:32 PM on October 28, 2011

Too bad this is anonymous, because I would want to hang out with anyone whose idea of a practical joke resulted in burns to their ass. In the words of Bill Murray in Stripes, "Oh boy, I want to party with you!"

Seconding baby wipes. wipe away in direction from burns. Be careful about trying to flush too many baby wipes.
posted by JohnnyGunn at 4:33 PM on October 28, 2011 [2 favorites]

Seconding the Dermoplast. You can also buy aloe spray with lidocaine, the aloe moisturizes and the lidocaine numbs the area. It's amazing stuff. We get ours near the first aid section or sometimes near the sunscreen.
posted by TooFewShoes at 4:38 PM on October 28, 2011

Oops, I meant explain to the pharmacist that you spilled hot coffee. If/when you see a doctor about this, you should absolutely tell the truth about your burn location.
posted by phunniemee at 4:54 PM on October 28, 2011

This article says that burns of the buttocks should be treated by a doctor even if it's only a first degree burn. Is there a free clinic anywhere in your area?

(Also, best use of an anonymous AskMe in recent history. this one needs to go in the AskMe Hall of Fame.)
posted by MexicanYenta at 5:00 PM on October 28, 2011 [15 favorites]

Oh--additionally in addition to/instead of wiping, you can put a squeezable water bottle in your bathroom and fill it with water and rinse the entire area.

This, as well as the Dermoplast, is very good advice! I speak also from post-childbirth experience. Why get involved with even baby wipes?
posted by redfoxtail at 5:10 PM on October 28, 2011

Ask Metafilter's ass is showing. The answers you have received so far are dangerously ignorant even for this site.

Depending on how far into the cheeks the burn goes infection may be inevitable and cause irreversible and lasting damage. YOU NEED TO BE SEEN A PHYSICIAN, preferably before you poop next. Is there a free clinic or cheap urgent care facility near you? Home remedies are not appropriate to your situation, if you have a wound that will be anywhere near to interacting with poop you need serious medical big guns protecting your ass.

Wounds like this can very easily turn into the kinds of infections that never heal no matter what interventions are used. You don't want an abscess in your ass that will keep you from sitting down for the rest of your life. DON'T FUCK WITH THIS.

Congratulations on the awesome practical joke, sounds like a hilarious time
posted by Blasdelb at 5:13 PM on October 28, 2011 [76 favorites]

If you are as broke as you say, you may be able to get ER care as a charity case. My friend did this when she had an ingrown toenail get infected and cause her leg to start going numb. She had to fill out forms to apply as a charity case, but owed nothing. Second degree burns are nothing to mess around with, regardless of location.
posted by DoubleLune at 5:17 PM on October 28, 2011 [1 favorite]

I was thinking diaper rash ointment (Desitin) since it's meant for that area and zinc helps would healing so I did a search on google to check for burn safety and came across this question that had to do with burns.

http://en.allexperts.com/q/Burns-1441/2nd-degree-burn-17.htm

Question
I went on motorcycle ride as a passenger for the 1st time and when I got off I hit the very hot pipes with my leg and have a large burn on my leg. This happened 2 days ago it has blistered already & has more pain today. My pharmacists told me to use zinc oxide ointment, I wanted to know if this is good to use? I don't see on the box it is used for burns, or is Bacitracin better to use?
Thank you

Answer
Hi Diane,

Call your doctor and describe this burn as a second degree injury to him/her. Ask for a prescription for Silvadene cream. If he wants to see the burn that is even better, but you really want that Silvadene! OK, Current tetanus shot? If not the doctor Does need to be seen! Clean Clean, Clean!
Wash these burns at least twice a day. If the blisters are still whole, just cover with Neosporin and gauze. When the blisters break, Remove the dead covering blister skin (just pull it off carefully) WASH with soap and water. Cover the raw area now exposed with a thin coat of silvadene. Next a layer of petroleum gauze to keep things from sticking, a layer of sterile gauze pads and a rolled gauze bandage to hold things together. Initially do this at least twice a day. Expect a lot of fluid loss from the burns at first. This will decline over the first few days. After 4 to 6 days the burns will begin to stay drier and stop oozing so much. As this happens you can cut the dressing changes to once a day. From this point on, look at the burn once a day. Use the silvadene only where the skin is open, raw or wet looking. Where the new skin is starting to cover the burn use bacitracin or neosporin, but NOT the silvadene. A typical second degree burn will superficially heal in about 10 days to 2 weeks. Until the burns have actually healed about 17 to 20 days keep them covered with a dressing 24-7! There is NO None- ZIP- NIL, NO benefit at all except for the local bacteria.

Silvadene is a sulfa drug that prevents infection. If you have raw flesh, it's probably time to bite the bullet and get a script for this stuff from a doc. If the skin is still intact (no broken blisters), I'd be tempted to keep using the neosporin with some Desitin on top (test on small area to check for sensitivity, you have enough to deal with already without an allergic rash).
posted by stray thoughts at 5:25 PM on October 28, 2011

Also, IAMAMicrobiologist IAMNYMicrobiologist, but if you memail me an email address I will send you all the pictures of necrotic para-anal infections you could ever possibly want. Your skin is your only real defense against so much of what is out there, as well as in you, and right now your skin is not only broken but leaking rich media that is actively selecting for the microbes that eat you most efficiently. When you get poop on that you an imagine of really really bad things will happen. YOUR WOUND NEEDS TO BE UNDER THE SUPERVISION OF A MEDICAL PROFESSIONAL. There are hardcore antimicrobials that can help you keep the area sanitized.
posted by Blasdelb at 5:28 PM on October 28, 2011 [29 favorites]

Depending on the exact situation, this sounds like a really nasty infection waiting to happen even with basic cleanliness efforts on your own. You shouldn't just be worried about localized infection; severe systemic infection and sepsis aren't exactly inconceivable if we're talking about fecal matter and a serious wound. Beyond that, some quick googling ("perianal burn") reveals cases where scar contracture as the burn healed between the cheeks caused intestinal blockages. Don't screw around with this; see a doctor please.
posted by zachlipton at 5:53 PM on October 28, 2011 [3 favorites]

While I appreciate the alarms that Blasdelb is setting off, don't babies get blistery oozy diaper rashes on their butts all the time? Why don't doctors freak out about that? I've definitely cleaned rashy baby butts that had broken skin on them and those babies lived to tell the tale. Is their poop less germy?
posted by otherwordlyglow at 6:56 PM on October 28, 2011 [1 favorite]

otherworldlyglow, burns are more prone to superinfection than diaper rashes.
posted by treehorn+bunny at 7:11 PM on October 28, 2011 [2 favorites]

"I've definitely cleaned rashy baby butts that had broken skin on them and those babies lived to tell the tale. Is their poop less germy?"

Infant microbiota is in fact very differently germy than adult microbiota (there is actually a major sequencing project going on right now that is investigating what is going on there). Infants also have really weird immune systems, its pretty disorienting to learn about, that are much more effective in a lot of ways. Additionally, bad diaper rashes are generally a very mild ammonia burn (enzymes in poop breaking down urea in pee into ammonia), which is differently damaging than a second degree heat burn.

Whatever amazing funny stupid thing anonymous did that anonymous is not sharing with us is in fact of greater concern than a diaper rash would be, given the information available to us. Anonymous really does need to see a physician so that someone with knowledge and access to the wound itself can make more appropriate determinations and proscribe logical interventions.
posted by Blasdelb at 7:25 PM on October 28, 2011 [6 favorites]

Or prescribe logical interventions, and proscribe further practical jokery..... :-)
posted by treehorn+bunny at 7:30 PM on October 28, 2011 [4 favorites]

Thanks for all the clarification. Anonymous: Go see a doctor!!!!
posted by otherwordlyglow at 8:05 PM on October 28, 2011

In light of what Blasdelb wrote and his/her expertise in the field, I suggest you see a doctor before you just use one of our homemade remedies, mine included.

I do not withdraw the part of my comment about wanting to party with someone whose idea of a practical joke results in a burned ass.
posted by JohnnyGunn at 9:50 PM on October 28, 2011 [3 favorites]

I studied wound healing for a while at one point (as a postgrad research student). Second degree burns are a real problem. Deep enough to break through your skin's defences, not really deep enough to bring in the kinds of internal defences you get in a cut or other wound (white blood cells etc). Add in the restricted blood flow due to the type of tissue damage done by the actual burn, the higher bacterial burden in such a sweaty, faeces adjacent area, and the yummy lymph everywhere that bacteria love, and you're in trouble. I've seen some of those pictures Blasdelb is talking about, including wounds that have been present for literally years with no hope of ever healing, and believe us, it's not something you want to risk.

Please don't rub random creams or chemical laden wipes anywhere near the area. Using anything on a serious burn without medical supervision is such a bad idea, who knows what crap you're adding in there or how much worse you can make it. Don't let faeces get anywhere near it either, that's just increasing your already reasonable chance of infection. Leave it alone until you can see a doctor.

Basically the only thing you should do in this situation is stop asking for advice on the internet and figure out how to go and see a doctor as soon as possible, like today, and get this sorted out properly.
posted by shelleycat at 2:51 AM on October 29, 2011

Listen to the people who are telling you to go to the ER: wounds on your rear end are something to take seriously. A very sweet patient of mine died earlier this year from an infection to a wound in that area, partially due to delaying treatment. It's important that you get it looked at by an MD.
posted by jennyjenny at 5:53 AM on October 29, 2011 [2 favorites]

This doesn't have anything to do with this, does it? Echoing. Please see a doctor.
posted by Lieber Frau at 6:30 AM on October 29, 2011

Nthing "see a doctor." I'm a certified first aider, and during my training we were told that anyone with ANY burns in, erm, that region should be taken to hospital immediately.
posted by Perodicticus potto at 6:39 AM on October 29, 2011

Sweet jeebus, doctor! Memail me if you are in the Twin Cities area and I will drive you. Heck, put the bat alert out and some mefite will drive you, wherever you are. I will not ask about the ass. This is my not so secret quansor. This counts as a mitzvah for people. Go to the doctor.
posted by jadepearl at 8:11 AM on October 29, 2011 [1 favorite]

In addition to getting to the ER immediately, I would think that eating as little as possible would be prudent.
posted by fingersandtoes at 8:39 AM on October 29, 2011

To the ER, definitely. In addition to all the gruesomeness above, a tetanus shot is probably in order.
posted by ricochet biscuit at 8:51 AM on October 29, 2011

Go to the ER. Send the bill to whomever played this "practical joke" on you.
posted by autoclavicle at 7:29 PM on October 29, 2011 [2 favorites]

Just a note that even if it isn't on your butt, it's strongly recommended to seek professional help for large second degree burns:

If the second-degree burn is no larger than 3 inches (7.6 centimeters) in diameter, treat it as a minor burn. If the burned area is larger or if the burn is on the hands, feet, face, groin or buttocks, or over a major joint, treat it as a major burn and get medical help immediately.

For items like this the ER really is your friend. They won't turn you away if you can't pay (long term care, etc. is a different story but they'll definitely treat you for trauma). They will come up with payment plans. And some hospitals have money set aside specifically to cover healthcare costs for those who can never pay them back.

It occurs to me that the "financial reasons" might be that you're paid by the hour and can't miss work or afford to get to the doctor's. I would suggest that if you can get time off without actually losing your job, any missed hours will be more than offset by potential savings in recovery times, as I'm fairly sure that you'll heal better/faster after receiving the attentions of a healthcare professional. A lot of hourly work is either physical (ouch!), involves a lot of sitting (ouch!) or requires smiling at (or, over the phone, sounding very cheerful towards) many people in a row. All of which might be hard with a burnt-up butt.
posted by Deathalicious at 9:48 PM on October 29, 2011

If transportation is a problem, send an email to the mods with your location, and possibly a Mefite in your area can give you a ride.
posted by MexicanYenta at 10:27 AM on October 30, 2011