Introduction

A burn injury is when there is damage to the skin caused by:

  • heat
  • radiation
  • electricity
  • friction
  • chemicals.

Burns can range from mild, like a friction burn from sliding on a carpet, to severe like burns from fire.

Children are at higher risk of severe burn injuries because: 

  • their skin is thinner and more delicate
  • their skin burns deeper, more quickly and at a lower temperature than adults
  • they are more likely to explore their environment
  • they may not understand how to stay safe from different types of burns.

Common causes of burn injuries in children include: 

  • spilling hot food and drinks
  • touching cooking appliances like stoves and barbecues
  • touching other household appliances like heaters or irons 
  • touching or falling on moving treadmills
  • spilling chemicals on the skin
  • using bath, shower or tap water that is too hot.

Burn injuries are extremely painful and can cause:

  • long-lasting damage to skin, muscles, and bones
  • scarring
  • physical disability
  • ongoing infections
  • trauma and mental health issues
  • organ failure
  • death.

Signs and symptoms

Generally, there are three levels of burns.

  1. Superficial burns damage the top layer of the skin. 
    These burns cause redness and pain.
     
  2. Partial thickness burns cause damage to the first and second layers of the skin. 
    These burns can cause: 
  • pain
  • redness
  • swelling
  • peeling skin
  • blisters filled with fluid.
     
  1. Full-thickness burns damage the two top layers of skin, and the tissue underneath. 
    These burns are extremely serious and painful, and can cause long-lasting damage to: 
    • muscles
    • bones
    • nerve endings.

It can be very difficult to tell how serious a burn is just by looking at it. This is why having any burns checked and treated by a doctor is important.

Treatment

Start first-aid treatment as soon as you see a burn injury happen. 

Treatment will depend on how severe the burn injury is and what part of the body it is on.

First-aid

Start first-aid treatment as soon as you see a burn injury happen, or as soon as you notice signs of a burn injury on your child.

  1. remove the source of the burn
    • turn off electricity 
    • get your child to stop, drop and roll
    • cover your child with a fire blanket if one is available. 
       
  2. use cool running water on the burn for 20 minutes to cool the skin and stop the burn from continuing. If you don’t have access to a tap, you can use water from a:
    • lake
    • river
    • water tank
    • water bottle.
       
  3. remove any clothing and jewellery that is not attached to the skin. 

Do not:

  • pull or try to remove clothing or jewellery that is stuck to the skin
  • use ice, cream, butter or toothpaste on a burn as this can make it worse.

Go to your nearest emergency department, or call Triple Zero (000) for an ambulance if the burn is:

  • larger than a 20c coin
  • blistering
  • on your child’s face, hands, feet, groin, or bottom
  • deep and your child does not feel any pain
  • caused by chemicals or electricity
  • showing patches of brown, black and white.

Treatment at home

If your child’s burn injury is superficial or not severe, your child’s doctor may give you instructions for managing it at home.

This will usually involve:

  • keeping the burn injury covered and dry
  • giving over-the-counter pain relief as directed
  • comforting your child and managing stress and anxiety around the accident that caused the burn.

If your child’s burn injury gets worse, or their pain cannot be managed at home, see your local doctor as soon as possible.

Treatment in hospital

Severe burns are treated in the emergency department. Your child may need to be admitted to hospital for ongoing treatment that can include: 

  • pain relief
  • assessment of how deep the injury is
  • assessment of any other damage to the body
  • surgery
  • checking for signs of infection
  • wound dressing, like bandages, to protect and promote healing
  • review and redressing of wounds every 3-7 days.

Your child may be able to go home from the hospital once their burn injury is healing well without any risk of infection. 

They may need to see a specialist doctor if there is no improvement after 14 days.

Severe burns may need specialised treatment and surgery, like skin grafts or scar treatment.

Management

Skin grafts

A skin graft is a procedure that replaces damaged skin with healthy skin from another part of the body. It can be used when a burn injury: 

  • destroys a large amount of skin
  • causes scarring
  • causes slow healing. 

It can be difficult to know how deep the injury is or if scarring will happen in the first few days after a burn. 

Your child’s treatment team may need to treat the burn for 10-14 days before they can decide whether a skin graft is needed. 

Speak to your child’s treatment team If you have any questions or concerns about skin grafts.

Scar treatment

Scars can happen when a burn injury does not heal correctly. Scars are made of different tissue than skin, which means they look and feel different. Scar tissue does not have pores or sweat glands, and it cannot stretch like other skin.

Burn scars can cause:

  • redness
  • itching
  • pain
  • differences in how the skin looks. 

If they appear over a joint, they can limit movement. Scarring can be common in burn injuries that:

  • have taken longer than 2-3 weeks to heal
  • needed a skin graft procedure.

New skin and scar tissue from burn injuries need to be cared for properly.

This is to make sure that the skin has a good appearance and can move properly.

Your child’s treatment team will give you information on treating and managing scars.

Protecting healing skin

Skin that is healing after a burn injury is sensitive and needs to be protected.

You can protect your child’s newly healed skin by following any instructions given by the doctor, along with:

  • using sunscreen
  • covering the burn area with long clothing when outside
  • keeping your child out of direct sun as much as possible
  • using a moisturiser like glycerine and sorbelene cream at least twice a day.

Burns that heal quickly without any issues will usually be less sensitive 6-12 months after healing. Severe burns will need ongoing care and protection.

Getting back to everyday activities

Your child should be able to get back to their normal activities once their burn injury: 

  • has healed well
  • is not causing pain
  • is not stopping them from moving properly.

You can help your child to recover and get back to their normal activities by:

  • avoiding contact with people who are showing signs of viruses that affect the skin, including:
  • encouraging your child to take regular breaks from activities and know when pain and movement is too much
  • supporting your child emotionally by talking about or getting professional help for any lasting trauma or feelings about the burn injury and accident.

When to see your doctor

See your local doctor or go to the nearest emergency department if your child:

  • is refusing to eat or drink
  • has a high fever
  • has a bad smell coming from the burn injury
  • has redness and warmth around the burn injury
  • has an increase in fluid coming out of their burn injury
  • starts to feel more pain than usual.

Depending on the type of wound dressing your child has, you may need to see your local doctor or contact their treatment team if it becomes dirty or falls off.

Resources and more information

Disclaimer

This factsheet is provided for general information only. It does not constitute health advice and should not be used to diagnose or treat any health condition.

Please consult with your doctor or other health professional to make sure this information is right for you and/or your child.

The Sydney Children’s Hospitals Network does not accept responsibility for inaccuracies or omissions, the interpretation of the information, or for success or appropriateness of any treatment described in the factsheet.

© Sydney Children’s Hospitals Network 2024