Chemical burns result when your skin, eyes or internal organs come into contact with an acid or base. Minor chemical burns tend to heal quickly with treatment. More severe burns might require specialized treatment, such as that provided at the such as that provided at the UCHealth Burn and Frostbite Center in metro Denver.
Who is most at risk of chemical burns?
Although anyone can be exposed to chemicals that cause burns, some people are at higher risk, including young children, older adults, people with disabilities who might not understand how to handle chemicals, people with mobility issues and those who work in occupations that require the use of chemicals.
Causes and types of chemical burns
You can sustain a chemical burn by accidentally misusing common products, inhaling a chemical (such as ammonia) in a gaseous state or from an assault.
Burn damage: acids v. bases
Chemical burns occur from the actions of a strong acid (e.g., battery acid) or base (e.g., bleach).
Acids damage or kill cells, while bases liquefy them. This makes burns from bases typically much worse than those from acids.
Many household products contain chemicals that can cause burns, including:
- Ammonia (found in cleaning solutions, pesticides, dyes and fertilizers).
- Battery acid (found in household and car batteries).
- Bleach (found in laundry products and tooth-whiteners).
- Carbolic acid.
- Dry lime.
- Hydrochloric acid (found in tile cleaner, toilet bowl cleaners and pool chemicals).
- Hydrofluoric acid (found in rust remover and heavy-duty cleaners).
- Muriatic acid (used to clean brick and metal and maintain swimming pools).
- Sulfuric acid (found in drain cleaners, toilet bowl cleaners and some powdered laundry detergents).
- Sodium hydroxide (found in drain cleaners and oven cleaners).
- Sodium hypochlorite (found in bleach and swimming pool chlorinating solutions).
Diagnosing chemical burns
A health care provider will diagnose the burn based on several factors:
- The amount of damage to the skin and the depth of the burn.
- How much pain the victim is experiencing.
- Signs of infection.
- The amount of swelling in the area.
Chemical burns use the same “degree scale” as regular burns:
- A first-degree burn is superficial and impacts the first layer of skin (epidermis).
- A second-degree burn impacts both the epidermis and the second layer of skin (dermis).
- A third-degree burn impacts the epidermis, the dermis and the third layer (subcutaneous).
- A fourth-degree burn can potentially go as deep as muscle and bone.
When to seek medical attention
- If the chemical burn is larger than 3 inches or is second degree or higher, seek medical care immediately by visiting an emergency room or calling 911.
Chemical burns that look mild may cause severe deep-tissue injury. Always have the affected area examined by a health care provider as soon as possible, no matter how mild the injury seems.
You should also go to the hospital if:
- The burn is on your hands, feet, face or buttocks.
- The burn covers a major joint.
- Over-the-counter pain medications don’t control the pain.
- You have the signs and symptoms of shock (shallow breathing, dizziness, low blood pressure).
Symptoms of chemical burns
Chemical burns can happen on the outside of the body (e.g., on the skin or eyes) or internally if inhaled or swallowed. Because each type of chemical burn impacts different parts of the body or organs, symptoms will vary.
Symptoms of chemical burns on the skin/eyes:
- Blisters or dead blackened skin.
- Pain or numbness.
- Redness, irritation or burning.
- Vision changes (if in contact with the eye).
Symptoms of internal chemical burns (when chemicals are inhaled or swallowed):
- Cough or shortness of breath.
- Irregular heartbeat or cardiac arrest.
- Low blood pressure.
- Muscle twitches.
Treatment and management of chemical burns
If you get a chemical burn, perform first aid immediately.
Take these steps first
- Tissue damage will continue as long as the chemical is in touch with the skin, so remove any clothing that could contain the chemical and/or might impact the affected area. Rinse the burn under water for 20 minutes.
- Don’t use water if the chemical is dry or powdered. Water can react with the chemical to create dangerous byproducts. Instead, gently wipe the powder from the skin and consult the chemical’s packaging for emergency advice.
- Be sure to immediately rinse the eyes with water for at least 20 minutes if they’ve come into contact with the chemical.
- Cover the area loosely with a clean, dry cloth.
At-home treatment for mild chemical burns
If the burn is mild enough, you might be able to treat it at home (but consult with a physician first!).
Some home remedies include:
- Cool (not cold) compresses applied in 5- to 15-minute intervals to reduce swelling.
- Antibiotic ointments to help prevent infection.
- Pure aloe vera gel to help reduce inflammation, promote circulation and kill bacteria.
- Using gel direct from an aloe vera leaf is ideal. If you buy aloe vera in a store, be sure it contains a high percentage of pure aloe vera and has no additives.
- Over-the-counter pain reliever such as ibuprofen or naproxen.
Depending on the severity of your burn, the doctor might employ a variety of treatments, including:
- Pain control if your pain is severe.
- Decontamination (usually with water irrigation).
- Itch control.
- If the chemical is a poison, you might receive an antidote to counteract it.
- If you have problems breathing, the doctor might add a breathing tube.
- Skin grafting might be an option if your burn is severe. With skin grafting, the doctor will remove healthy tissue from somewhere else to replace the damaged skin.
- Cosmetic or reconstructive surgery as needed.
- Physical therapy to reduce range-of-motion issues that might be caused by scarring.
- Counseling support for emotional issues that might be caused by trauma.
Management and follow-up
Within 24 hours of leaving the emergency room, be sure to contact your doctor for follow-up care. If new issues appear, call sooner.
Preventing chemical burns
Take these safety precautions
By taking some precautions and following safety procedures at your home or workplace, you can prevent chemical burns.
- Kids are curious by nature. Keep chemicals out of the reach of children.
- Properly store chemicals after use.
- Work with chemicals in a well-ventilated area.
- Store chemicals in their original containers with the safety labels legible.
- Refrain from mixing chemicals together.
- Keep chemicals separate from consumables.
- Wear appropriate protective gear and clothing.
National Library of Medicine. Chemical Burns (https://www.ncbi.nlm.nih.gov/books/NBK499888/)
MedlinePlus: National Library of Medicine. Chemical burn or reaction (https://medlineplus.gov/ency/article/000059.htm)