Hot! Hot Hot!

Scalded my hand on some hot water two days ago -- wasn't so bad, and I attempted some home treatment with help from online info and several friends who happened to notice. Quite surprising that there is actually no consensus in the medical articles about what the proper treatment should be; and also that most of us (including me) are rather ignorant about it.

In short, I finally stopped by the campus health center this morning, just to find out for sure from a doctor =D and so I thought I'd share. I should first emphasize that I have no qualification to give medical advice here; please use your own discretion if you decide to believe me. ^^

Types

The type of burn I get is a second-degree burn -- the type that blisters, with clear fluid inside (or oozing, depends whether the skin is punctured). First-degree burns are the dry ones, the most popular being sunburn. Interestingly, third-degree burns (the worst type) are actually not painful, though it's nothing to be happy about because it stems from the fact that the nerves are damaged. Third-degree burns are usually surrounded by the exquisitely painful second-degree burns, anyway.

First Aid

All articles agree that the first thing to do for any kind of burn is to stop the burning (think "drop and roll" in fire accidents). In my case I ran tap water on it. In contrast, ice shouldn't be applied directly, because the extreme cold might shock the wounded area and damage the cells further.

Treatment

Common sense, wounded area should always be kept clean to avoid infection. (No such risk if the skin is intact.) But from here is where opinions differ: should we drain the fluid or leave it to dry by itself? remove the blister skin so it dries faster, or leave it as a protection layer?

I was confused by the contrasting suggestions until an article clarifies that there are indeed three schools of thought regarding this, and I quote:

"[1] One group contends that the blister should be left intact, as the top layer of the blister acts as a barrier to infection.

[2] Another group adopts the "middle-of-the-road" approach of aspirating blister fluid with a syringe (the fluid is thought to impair white blood cell activity), but leaving the blister covering intact.

[3] The third school of thought advocates complete removal of all blister fluid and the outer blister covering, due to concerns about impaired wound healing."

[3] is obviously painful as it exposes the nerve ends, but I've always thought it was necessary to allow the applied medicine to reach the relevant parts (the outer skin is mere dead cells by then). However I suppose this alternative requires proper dressing or some other means of avoiding infection -- something to note for people who, like me, are less meticulous about wound-caring.

Doctor Says

This person related that his doctor went for [3], so I initially thought that the professional care would be [3].

Differently, though, my doctor advised [1] for the protection reason. He said the blister would dry by itself in time (about a week), and I could leave the fluid (that was the plasma, he said) to ooze out naturally. In my case the blister skin is still intact (I've "put back" the peeled part) so there is no need to cover it, either.

He asked if I wanted pain-killer (not necessary) and if I wanted anti-tetanus injection (also very little necessity in the case of hot water scalding, which is unlikely to be non-steril). He then gave me some cream ("Bactroban ointment") to apply on it. Unless there are signs of infection (swelling redness) he told me not to worry.

Home Treatment

I asked the doctor if I should prevent contact with water, and he said there is no need, though I should dry it up as soon as possible. From experience, I think the concerns about getting the wound wet are basically these:

(1) In the early stage, the open wound will throb when water gets on it. But for me, I am more tolerable for this short-term pain than for the inconvenience of not using the wounded hand. =P

(2) In the healing stage, the forming scab/crust gets tender when it is wet for an extended period. Need to take care that it doesn't peel off, which will revert the process and prolong the healing.

My trip to the doctor is quite "dry" after all =D and indeed burns below the third degree should be able to be treated at home. General-purpose antiseptic like Betadine lists burns as one of the wound types it is applicable to, so I suppose it should suffice to help the wound dry out. I went for the "yellow medication liquid" (Hemisulphate lotion) which served the same purpose. This one leaves stains, not permanent on the skin, but not sure if on clothing.

Ah well. I hope the above is useful as some tips. Do apply with reasonable judgement. =)