One rule before everything else

If you take a single thing from this page, make it this: hold the burn under cool running water for a full 20 minutes. Not a quick splash. Not a dab with a wet cloth. Twenty timed minutes under the tap.

It sounds almost too simple, but this one step pulls heat out of the tissue, limits how deep the damage goes, eases pain, and measurably reduces scarring and the chance of needing a skin graft. Research from burns units consistently shows that people who cool properly do better — and remarkably, cooling still helps if you start up to three hours after the injury. So even if the kettle went over half an hour ago, get to a tap now, then read on.

Doing the 20 minutes properly

  • Use water that feels cool but comfortable — around the temperature of a cold tap in spring. Icy water does harm, not good.
  • Set a timer. Twenty minutes feels endless with a crying child; without a timer almost everyone stops early.
  • While the water runs, slide off rings, watches and loose clothing near the burn before swelling makes that impossible. Leave anything that is stuck to the skin exactly where it is.
  • Keep the rest of the person warm, especially small children and older people — you are cooling one patch of skin, not the whole body.

Once cooling is done, lay cling film loosely over the burn (along it, not wound round a limb like a bandage). Straight off the roll it is effectively sterile, it will not stick to raw skin, and staff can inspect the burn through it. No cling film? A clean plastic bag or a smooth, non-fluffy cloth will do. Then give paracetamol or ibuprofen, because burns hurt a great deal.

The kitchen-cupboard myths

Generations of well-meant advice have made burns worse. To be clear:

  • No butter, oil, egg white or toothpaste. They seal heat in and feed infection.
  • No ice or freezer packs on the skin. Extreme cold constricts the blood supply and can deepen the burn.
  • Do not burst blisters. The blister roof is a natural sterile dressing; opening it at home invites infection.
  • No sticky plasters directly on burned skin, and no cotton wool — the fibres embed in the wound.

How bad is it? Two questions

How deep does it go?

  • A burn that is red, sore and dry — classic sunburn territory — involves only the surface layer and usually heals within a week.
  • Blistering, weeping, intensely painful skin means the burn has gone into the deeper layer. These take weeks to heal and can scar.
  • Skin that looks waxy white, brown or charred, or feels leathery — particularly if it is strangely painless because the nerves are gone — is a deep burn that will always need specialist care.

How big is it?

A handy yardstick: the injured person's own palm and fingers cover roughly one per cent of their body surface. Anything bigger than their palm deserves professional assessment; in a young child, anything approaching palm-size does.

When to dial 999

Some burns are ambulance jobs from the start:

  • Anyone caught in a house fire or exposed to thick smoke — a hoarse voice, coughing, soot around the mouth or singed eyebrows suggest the airway itself may be burned, which can close up fast
  • Burns from electricity — the surface mark can be tiny while the damage inside is severe
  • Chemical splashes to the eye (rinse continuously while help is on the way)
  • Extensive burns, deep burns of any size, or a person who is becoming pale, drowsy or confused
  • Burns alongside other serious injuries, such as after an explosion or crash

If you are unsure whether it is a 999 situation, our guide to calling 999 can help you decide quickly.

When A&E is the right place — under your own steam

Make your way to an emergency department for:

  • Any burn on the face, hands, feet, genitals or across a joint — these areas scar and stiffen in ways that affect function, so specialists want to see them regardless of size
  • Blistered burns larger than the person's palm
  • A burn that wraps all the way around a finger, arm or leg — swelling inside a complete ring of burned skin can cut off circulation
  • Any burn in a child under five or an adult over sixty — and in a baby under one, treat every burn as needing professional assessment without exception
  • Chemical burns, once you have irrigated thoroughly
  • Anything you honestly cannot judge — clinicians would far rather reassure you than see a neglected burn a week later

Have a look at live A&E waits nearby before choosing a department if more than one is reachable.

Smaller burns: urgent treatment centre or home

An urgent treatment centre can clean and dress modest burns and scalds — a splash from a pan, a grab of a hair straightener — provided they are smaller than a palm and not on the sensitive areas listed above. Truly minor burns (smaller than a postage stamp, surface-level, not on the face or hands) can be managed at home: keep them clean, cover with a non-stick dressing, and watch for spreading redness, increasing pain, oozing or fever over the following days, any of which means infection and a same-day appointment. NHS 111 is the right call when you are hovering between options.

Why children are different

A toddler's skin is dramatically thinner than an adult's, so the same cup of tea burns deeper — and a mug of tea can still scald a small child a quarter of an hour after it was made. Hot-drink scalds are the single most common serious burn in under-fives, usually from a mug pulled off a table edge. Do the same 20-minute cooling (a shower head or gently poured jugs of cool water work if the child will not tolerate the tap), keep them warm and cuddled, and set your threshold for professional assessment much lower than you would for yourself. Our guide to bringing a child to A&E covers what the visit itself will involve.

What happens at hospital, and afterwards

Expect the team to assess the depth and area of the burn, clean it properly with good pain relief, decide what to do with blisters (practice varies — leave that call to them), apply a specialist dressing, and check your tetanus status. Deeper or awkwardly placed burns get referred on to a regional burns service, and the deepest may eventually need grafting. Afterwards there is often a rhythm of dressing changes at your GP surgery or a clinic, then months of scar care: moisturise, keep healed skin out of the sun or under high-factor sunscreen, and do any stretching exercises you are given so skin over joints stays supple. Our after your visit guide explains discharge paperwork and follow-up generally.

The short version

  • Cool running water for a timed 20 minutes — the most valuable thing anyone can do, effective up to three hours after the burn
  • Cling film on loosely, painkillers in, jewellery off early
  • Never ice, butter, creams or burst blisters
  • Face, hands, feet, genitals, joints, ring-shaped burns, deep burns, palm-sized-or-bigger blistering, and every burn in a baby → hospital
  • Smoke inhalation, electrical and large burns → 999
  • Unsure? 111 for advice, or find your nearest department