Burns and scalds are among the most common household injuries in the UK. NHS England estimates that approximately 250,000 people attend emergency departments with burn injuries each year, but many more minor burns are managed at home or with pharmacy advice. Hot drinks, cooking accidents, hair straighteners and steam are the most frequent causes — and children under five are disproportionately affected.

Community pharmacists are regularly asked for advice on burn first aid, wound dressings and pain relief. Knowing what to recommend — and when to refer — is essential.

First aid: the 20-minute rule

The single most important intervention for any thermal burn is immediate cooling with running water. This is backed by strong evidence and endorsed by the British Burns Association, NICE and the Resuscitation Council UK.

Cool the burn under cool running water for at least 20 minutes. This should begin as soon as possible after the injury. The water should be cool (approximately 15°C) — not icy cold, and never ice. The 20-minute duration is evidence-based: shorter cooling is less effective at limiting tissue damage, and ice causes vasoconstriction that can worsen the injury.

Key points for pharmacy teams to communicate:

• Remove clothing and jewellery near the burn before swelling starts (unless stuck to the skin)
• Do not apply butter, toothpaste, oil, egg white or any other home remedy — these trap heat and increase infection risk
• Do not burst blisters — intact blisters protect the underlying tissue
• After cooling, cover the burn loosely with cling film (laid over the wound, not wrapped circumferentially) or a clean, non-fluffy dressing to protect it and reduce pain from air exposure

Assessing whether a burn can be managed at the pharmacy

Pharmacists should assess burns using a simple framework:

Suitable for pharmacy management (minor burns)

• Superficial (first-degree): red, painful skin without blisters
• Less than 3cm in diameter in adults, or smaller than the patient's palm
• Not on the face, hands, feet, genitals or over a joint
• Not circumferential (encircling a limb)
• Patient is otherwise well and not in a vulnerable group

Requires GP or minor injuries unit

• Superficial partial-thickness (blistered) burns larger than 3cm
• Burns in children under 5 years (lower threshold for referral)
• Burns in patients with diabetes, immunosuppression or peripheral vascular disease
• Burns that are not healing after 2 weeks
• Any concern about non-accidental injury — safeguarding referral

Requires A&E / burns unit

• Deep partial-thickness or full-thickness burns (white, waxy or charred skin)
• Burns larger than the patient's palm
• Burns to the face, hands, feet, genitals, perineum or over major joints
• Circumferential burns
• Chemical or electrical burns
• Inhalation injury (burns in a fire, soot around nose/mouth, hoarse voice)
• Burns in infants

Pharmacy products for minor burns

Pain relief

• Paracetamol — first-line for all ages. Give appropriate dose immediately.
• Ibuprofen — useful for the inflammatory component. Can be combined with paracetamol. Avoid in children with dehydration risk.
• Topical anaesthetics — lidocaine-containing creams or sprays may provide temporary relief for superficial burns but should not be applied to broken skin or blisters.

Dressings

The primary role of a dressing is to protect the wound, reduce pain from air exposure and maintain a moist healing environment.

Key dressing advice:

• Change dressings every 1–2 days or when soiled
• Do not use adhesive dressings directly on the burn — they will stick to damaged tissue
• Non-adherent dressings (e.g. paraffin-impregnated gauze) are the standard recommendation
• Hydrogel dressings provide additional cooling and are useful as an immediate measure

Infection prevention

Minor burns are at risk of infection, particularly once blisters have broken. Pharmacists should advise:

• Keep the wound clean — gentle washing with clean water is sufficient
• Do not routinely apply antiseptic creams (e.g. Savlon, TCP) — NICE guidance does not recommend routine antiseptic use on minor burns, as it can delay healing
• Watch for signs of infection: increasing redness, swelling, warmth, pain, pus, red streaks from the wound, or fever
• If infection is suspected, refer to a GP for assessment and possible antibiotic treatment

Scar management (after healing)

Once a minor burn has healed, patients may be concerned about scarring. Pharmacy products that may help include:

• Silicone-based scar gels or sheets (e.g. Dermatix, Kelo-Cote) — the best-evidenced OTC scar treatment, recommended by dermatologists for 8–12 weeks
• SPF 50+ sunscreen on the healed area for at least 12 months — new scar tissue is highly susceptible to UV damage and permanent discolouration
• Moisturising regularly to maintain skin hydration and flexibility

Special considerations for children

Burns and scalds are the most common cause of hospital admission for injury in children under five. The most frequent scenario is a toddler pulling a hot drink from a table or worktop.

Pharmacy teams should:

• Have a lower threshold for referral in children — blistering burns in under-5s should be seen by a healthcare professional
• Be aware of safeguarding considerations — burns in unusual patterns, on unusual sites, or with inconsistent explanations should prompt a safeguarding referral
• Advise parents on prevention: keep hot drinks out of reach, turn pan handles inward, use a kettle with a short cord, test bathwater temperature

The pharmacy's role

With more than 13,000 community pharmacies across England — many open evenings and weekends — pharmacies are often the first healthcare contact for minor burn injuries. Providing correct first aid advice (cool running water for 20 minutes) and appropriate product recommendations can significantly improve outcomes and reduce unnecessary A&E attendance.

For pharmacies near you, visit PharmSee's pharmacy finder. For pharmacy professionals looking for clinical roles, explore current vacancies on PharmSee.

Sources: NICE Clinical Knowledge Summary — Burns and Scalds; British Burns Association — First Aid Position Statement; NHS England — Burns Statistics; Resuscitation Council UK; British National Formulary; PharmSee pharmacy register data (April 2026).