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A chemical burn occurs when your skin or eyes come into contact with an irritant, such as an acid or a base. These are different from thermal burns, which are caused by fire, steam, hot objects, or the sun. Chemical burns can be painful and may cause significant injury, and their severity depends on multiple factors including the type of chemical, the duration of exposure, and how the chemical was contacted.

Types of Chemicals That Can Cause Burns

Chemical burns are caused by a wide variety of substances. These generally include:

Acids: Substances like battery acid, bleach, and some types of cleaners.
Bases: Also known as alkalis, these include substances like ammonia, drain cleaners, and wet cement.
Oxidizers: Chemicals like chlorine and peroxides.
Solvents: Substances that dissolve other materials. They are found in paint thinners and nail polish removers, among others.
Desiccants: These are substances that absorb water, such as silica gel.

Generally, we categorize chemical burns into three types based on severity: first-degree, second-degree, and third-degree burns.

First-Degree Burns are the mildest form, only affecting the outer layer of skin, also known as the epidermis. These burns often appear red and might cause mild pain or discomfort. You can treat most first-degree burns at home with over-the-counter creams and ointments.
Second-Degree Burns are more serious. They reach deeper layers of the skin, the dermis, and may cause blisters. These burns usually cause severe pain, swelling, and red, white, or splotchy skin. Professional medical care is often necessary for these burns.
Third-Degree Burns are the most severe type, extending through every layer of skin. They may cause damage to underlying tissues, like nerves, muscles, and even bones. These burns can be painless, as nerve endings are often destroyed. Skin may look white, charred, or leathery. Immediate medical attention is critical for these burns.

It’s important to know the signs of a chemical burn. Common symptoms may include:

A burning or painful sensation on the skin.
Dead or blackened skin.
Irritation, redness, or burning in the eye if it has come into contact with the chemical.
Shortness of breath or cough if the chemical was inhaled.
Vomiting if the chemical was ingested.

Causes

Most common causes of chemical burns, providing a straightforward and uncomplicated description of each one to ensure understanding for everyone. We will also make sure to present this information in a way that’s both digestible and easily searchable.

Acids: These include sulfuric acid, hydrochloric acid, nitric acid, or acetic acid. Found in everyday household products like vinegar, toilet cleaners, or car batteries, they can cause severe burns upon contact with the skin.
Alkalis: Substances like lye, ammonia, and bleach are alkalis. These can be in household cleaners, dishwashing detergents, and drain openers. Alkalis tend to cause more severe burns than acids as they penetrate deeper into the skin.
Oxidizing agents: These include substances like hydrogen peroxide and bleach. Often used for cleaning or disinfecting, these chemicals can burn the skin on contact.
Solvents: Found in products like paint thinners and nail polish removers, solvents can cause chemical burns, especially if left on the skin for extended periods.
Detergents: Highly concentrated laundry and dishwashing detergents can cause chemical burns, especially in young children who may accidentally ingest them.
Petroleum products: Gasoline, kerosene, and similar products can cause chemical burns. This typically happens during accidents when these substances come into contact with the skin.
Hair dye: Some people can have severe reactions to the chemicals in hair dye, leading to burns on the scalp, face, or neck.
Pesticides: Pesticides, particularly in their most concentrated form, can cause chemical burns if they come into contact with the skin or are accidentally ingested.
Cement: Wet cement can cause alkaline burns if it comes into contact with the skin and isn’t washed off promptly.
Pool chlorination products: Accidental contact or improper handling can cause chemical burns due to the strong oxidizing nature of these products.
Plaster: Fresh plaster can cause chemical burns if it comes into contact with the skin and isn’t immediately washed off.
Fertilizers: Certain types of fertilizers, particularly in concentrated forms, can cause chemical burns.
Pepper spray: The capsaicin in pepper spray can cause a burning sensation or even actual chemical burns on the skin or in the eyes.
Mercury: Mercury and its compounds can cause burns, especially in their liquid form or as vapor.
Arsenic: Arsenic is highly toxic and can cause burns if it comes into direct contact with the skin.
Fireworks: The chemicals in fireworks can cause burns if they explode near or come into contact with the skin.
Lime: Lime is a strong alkali that can cause burns if it comes into contact with the skin.
Desiccants: Substances like silica gel that absorb moisture can cause burns if they come into prolonged contact with the skin.
Battery fluid: The sulfuric acid in battery fluid can cause chemical burns if it leaks and comes into contact with the skin.
Chemical peels: These skin treatments can cause burns if they’re too strong, left on for too long, or used improperly.
Photographic developers: These chemicals can cause burns if they come into contact with the skin or eyes.
Industrial cleaners: Many industrial cleaning products contain strong acids, alkalis, or other chemicals that can cause burns.
Airbag propellants: The chemicals used to inflate airbags can cause burns if they’re accidentally discharged outside of a crash scenario.
Chemotherapy drugs: Some chemotherapy drugs can cause chemical burns if they leak out of veins during administration.
Mustard gas: This warfare agent can cause severe, painful burns upon contact.
Phenols: Used in many industries and laboratories, phenols can cause burns if they come into contact with the skin.
Rubber accelerators: These chemicals used in the production of rubber can cause chemical burns.
Mace: Similar to pepper spray, mace can cause burns or severe skin irritation upon contact.
Warfarin: If this anticoagulant comes into contact with the skin in large amounts, it can cause chemical burns.
Chemical waste: Improperly discarded chemical waste can contain a variety of substances that could cause burns upon contact.

Symptoms

Redness: One of the first signs of a chemical burn is redness on the skin. The area touched by the chemical may look redder than the surrounding skin.
Pain: It’s common to feel pain in the affected area, though some severe burns might damage nerves, leading to no pain.
Swelling: A chemical burn can cause your skin to swell up. This is your body’s response to injury.
Blisters: These are small, fluid-filled pockets that develop on the skin surface following a burn.
Burning Sensation: You might feel a burning or stinging sensation on your skin.
Blackened or Dead Skin: Severe chemical burns can cause skin to turn black or die. This happens when the chemical destroys skin cells.
Numbness: If a chemical burn is deep, it might damage nerve endings and cause numbness.
Coughing or Choking: If the chemical was inhaled, it could lead to coughing or choking.
Changes in Vision: If the chemical came in contact with the eyes, vision might become blurry, or there may be partial or complete vision loss.
Shortness of Breath: Inhalation of toxic fumes can cause difficulty breathing.
Vomiting: Some chemicals, when ingested, can cause nausea and vomiting.
Headache: Exposure to harmful chemicals can often lead to headaches.
Dizziness: You may feel light-headed or dizzy due to a lack of oxygen or toxic exposure.
Low Blood Pressure: Severe burns can lead to shock, a condition characterized by low blood pressure.
Fainting: If the chemical is extremely toxic or if the body goes into shock, fainting may occur.
Blue Color of Lips or Fingernails: This indicates that the body isn’t getting enough oxygen, a sign of potential respiratory distress.
Cardiac Arrest: In extreme cases, the body’s response to a severe burn may include a heart attack or cardiac arrest.
Muscle Weakness: Some chemicals can cause muscle weakness or paralysis, particularly if they affect the nervous system.
Seizures: In rare cases, exposure to certain toxic chemicals may cause seizures.
Irregular Heartbeat: Exposure to some chemicals can cause disturbances in the heart’s rhythm, leading to an irregular heartbeat.

Diagnosis

Diagnoses and Tests

When dealing with chemical burns, healthcare professionals can use various methods to diagnose the severity and extent of the burn. Here are common diagnoses and tests:

Visual Examination: The most basic assessment tool. By looking at the affected area, doctors can estimate the severity and depth of the burn.
Medical History: It is crucial to understand the cause of the burn. A detailed patient history can help determine which chemical caused the burn and guide treatment.
Physical Examination: A physical check can provide information about the patient’s overall health status and reveal any other injuries.
Pain Assessment: Pain levels can sometimes indicate the severity of a burn. Typically, more severe burns may cause more pain.
Burn Severity Classification: Burns are classified as first (superficial), second (partial-thickness), and third (full-thickness) degree, based on their depth. This classification aids in determining the best course of treatment.
Blood Tests: These tests help measure the patient’s overall health and can indicate any infections or imbalances caused by the burn.
Urine Tests: Sometimes, chemicals can enter the bloodstream and damage internal organs. A urine test can detect these problems.
Imaging Tests: X-rays, CT scans, or MRI scans might be required if the burn has penetrated deeply, affecting muscles, bones, or other tissues.
Wound Culture: A small sample from the wound can be tested in a lab to check for infections.
Tetanus Immunization: Tetanus can be a concern with burns, so doctors may check your immunization status.
Pulse Oximetry: This measures how much oxygen is in your blood, an important factor for healing.
EKG/ECG (Electrocardiogram): If the burn is extensive, an EKG can check for heart damage or stress.
pH Test: If the chemical is still present on the skin, a pH test can identify its acidity or alkalinity.
Ophthalmological Exam: Chemicals that reach the eyes can cause serious damage. An ophthalmological exam is crucial if there’s any chance of eye exposure.
Bronchoscopy: In case of inhalation of chemical fumes, a bronchoscopy might be done to inspect the airways and lungs.
Skin Biopsy: Rarely, a small sample of skin might be taken to examine the extent of skin cell damage.
Psychological Assessment: Serious burns can be traumatic. A psychological evaluation can help identify any need for emotional support or therapy.
Lung Function Tests: Inhalation injuries may require these tests to assess the damage to the lungs.
Lactic Acid Test: A high lactic acid level can indicate that the tissues aren’t getting enough oxygen.
Cardiac Enzyme Test: Severe burns can put a lot of stress on the heart. This test can indicate if any heart damage has occurred.

Remember, not all tests are necessary for every patient. Which ones are required depends on the specific situation, the type and severity of the burn, and the patient’s overall health.

Treatment

A chemical burn isn’t something to be taken lightly; prompt and effective response can significantly impact the outcome. Here’s a 20-point first aid guide in simple English.

1. Ensure Your Safety

The primary rule of any first aid is to ensure your safety before helping others. If the situation is unsafe, call for professional help. Avoid direct contact with the chemical causing the burn.

2. Identify the Chemical

Try to determine the chemical that caused the burn. This will help in providing the right treatment and relaying vital information to medical professionals.

3. Call Emergency Services

Dial your local emergency number immediately. While waiting for help to arrive, begin administering first aid if it’s safe.

4. Remove the Victim from Exposure

If it’s safe, remove the victim from the exposure area to prevent further harm. If the chemical is a gas, move the person to a well-ventilated area.

5. Remove Contaminated Clothing

Carefully remove clothing or jewelry contaminated by the chemical. But do not pull clothing over the head if the chemical has burned the face or neck.

6. Rinse with Water

Rinse the burn area with cool running water for at least 20 minutes. If the chemical is a powder-like substance, brush it off the skin before rinsing.

7. Do Not Use Ointments or Creams

Do not apply any ointment, cream, or oil to the burn as it can lead to a chemical reaction or trap the chemical on the skin.

8. Cover the Burn

Cover the burn with a sterile nonstick dressing or clean cloth. This helps protect the burn from further damage and infection.

9. Monitor Vital Signs

Keep track of the person’s vital signs, like breathing and consciousness level, while waiting for help. If the person becomes unconscious, perform CPR.

10. Do Not Neutralize

Do not try to neutralize the burn with other chemicals or substances. It could lead to a harmful reaction.

11. Do Not Break Blisters

If blisters form, do not break them. Broken blisters are more vulnerable to infection.

12. Elevate the Burn

If possible, elevate the burned area above the level of the heart to reduce swelling.

13. Do Not Remove Adhered Chemicals

If the chemical has adhered to the skin and hardened, do not attempt to remove it. This may cause more injury.

14. Check for Signs of Shock

Keep an eye out for signs of shock, like pale and cold skin, rapid heartbeat, or fainting. If you notice these signs, lay the person flat, raise their feet about a foot, and cover them with a blanket.

15. Eye Exposure

If the chemical has gotten into the eyes, rinse with cool water for 15-20 minutes, encouraging blinking. Do not force the eye open.

16. Ingestion

If the chemical has been swallowed, do not induce vomiting. Rinse the mouth with water and have the person drink large amounts of water or milk if advised by poison control or a healthcare provider.

17. Provide Reassurance

Keep the person calm. Anxiety can heighten the pain and discomfort, and slow recovery.

18. Retain Chemical Container

Keep the container or a sample of the chemical, if safe. This will be helpful for medical professionals in identifying the chemical.

19. Follow Medical Instructions

Once medical professionals arrive, follow their instructions closely. Provide them with as much information about the situation as possible.

20. Seek Mental Health Support

After a traumatic event like a chemical burn, consider seeking mental health support. This can help cope with any lingering fear, anxiety, or stress.

Treatment In Hospital

treatments for chemical burns, explained simply to facilitate understanding and provide valuable insights.

Immediate Rinse: The first line of action for any chemical burn is to rinse the affected area with a copious amount of running water. This helps dilute and wash away the harmful chemical and reduces its damaging impact.
Removal of Contaminated Clothing: Discard any clothing, jewelry, or other items that have come into contact with the chemical. This step prevents further exposure and spread of the harmful substance.
Mild Soap Wash: After rinsing, gently wash the area with mild soap and water to ensure all remnants of the chemical are removed.
Over-the-counter (OTC) Pain Relievers: Drugs like Ibuprofen or Acetaminophen can help manage the pain associated with chemical burns.
Cold Compress: Applying a cold compress to the area can help reduce swelling and alleviate pain. Never apply ice directly to the skin, as it can cause more damage.
Topical Antibiotic Ointments: Apply a thin layer of a topical antibiotic like Neosporin to prevent infection and promote healing.
Use of Hydrogel: Hydrogel dressings help keep the wound moist, promoting healing and reducing pain.
OTC Burn Creams: Over-the-counter burn creams like Silver Sulfadiazine can help with pain management and infection prevention.
Tetanus Shot: If you have a serious burn and it’s been more than five years since your last tetanus shot, your doctor may recommend a booster.
Prescription Pain Medication: For more severe burns, doctors may prescribe stronger pain medications.
Oral Antibiotics: If there’s a risk of infection spreading in your body, oral antibiotics may be necessary.
Wound Dressings: Regularly changing wound dressings helps keep the wound clean and promotes healing.
IV Fluids: For severe burns, intravenous fluids may be administered to prevent dehydration.
Skin Grafting: This surgical procedure involves transplanting healthy skin from another part of the body to the burned area.
Physical Therapy: For large or deep burns, physical therapy may be needed after healing to restore range of motion and prevent scar tissue formation.
Pressure Garments: Wearing pressure garments can help reduce scarring after a severe burn.
Silicone Sheets: These can be applied to healed burns to improve the appearance of scars.
Plastic Surgery: In severe cases, plastic surgery might be necessary to improve function or appearance of the burn area.
Steroid Injections: These are sometimes used to reduce keloid or hypertrophic scars that can form after a burn.
Laser Therapy: Laser treatments can be used to reduce scarring and discoloration from burns.
Breathing Support: In cases where chemical inhalation has occurred, oxygen or other breathing support may be necessary.
Nutritional Support: Severe burns may require nutritional support through a balanced diet or supplements to facilitate healing.
Antidepressants and Anti-anxiety Medication: These may be prescribed to help patients cope with the emotional trauma associated with serious burns.
Wound Debridement: This is the medical removal of dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue.
Protective Bandages and Wraps: These keep the wound clean and help prevent infection.
Hydrotherapy: This therapeutic whole body treatment aids in healing and helps remove dead tissue from the burn.
Pain Management Counseling: This can be helpful for individuals suffering from chronic pain as a result of their burns.
Tissue Expansion: This procedure allows the body to “grow” extra skin to use for skin grafting.
Artificial Skin: In some cases, doctors may use artificial skin as a temporary cover or permanent replacement for damaged skin.
Psychological Counseling: Counseling can help patients cope with the psychological impact of their injuries, such as body image issues and PTSD.

It’s crucial to remember that the severity and type of chemical burn determine the most appropriate course of treatment. Always seek professional medical advice immediately after a burn injury.

Medications

Luckily, various drugs and treatment options are available to manage chemical burns effectively. Here, we’ll delve into 15 different drug treatments that are commonly employed.

1. Debridement Agents: Debridement agents like Santyl (Collagenase) are used to clean wounds and promote healing by removing dead skin and tissues. It’s applied as an ointment and aids in creating a clean environment for healing.

2. Analgesics: Pain management is crucial in chemical burn treatments. Over-the-counter pain relievers like Ibuprofen or Tylenol (Acetaminophen) are often used. However, in severe cases, stronger prescription painkillers might be required.

3. Antibiotics: Topical antibiotics such as Mupirocin or Silver Sulfadiazine cream are often applied to prevent or treat infections in the burn area. In severe burns, oral or intravenous antibiotics may be needed.

4. Tetanus Prophylaxis: Chemical burns can potentially lead to Tetanus, a severe bacterial disease. Drugs like Tdap (Tetanus, Diphtheria, and Pertussis) or Td (Tetanus and Diphtheria) are used for prevention.

5. Antihistamines: Antihistamines like Benadryl (Diphenhydramine) can be used to reduce itching, which often occurs during the healing process.

6. Corticosteroids: Corticosteroids such as Prednisone can be used to reduce inflammation. They are typically used in moderate to severe burns to control the inflammatory response.

7. Proton Pump Inhibitors: In patients with oral or throat burns, Proton Pump Inhibitors (PPIs) like Omeprazole can be used to reduce acid production in the stomach, minimizing further damage.

8. Moisturizers: Emollients or moisturizers like Aquaphor or Cetaphil are often applied to keep the burn area moist and facilitate healing.

9. Topical Anesthetics: Topical anesthetics like Lidocaine can be used to numb the burn area, providing immediate, although temporary, relief from pain.

10. Colloidal Dressings: Silver-based colloidal dressings like Acticoat or Silvercel are used to cover the burn wound, promoting a moist environment for healing and offering antibacterial protection.

11. Antidepressants: In some cases, especially for extensive burns, the psychological impact can be significant. Antidepressants like Prozac (Fluoxetine) or Zoloft (Sertraline) can be prescribed.

12. Antipsychotics: Drugs like Seroquel (Quetiapine) can be given to help manage sleep issues and anxiety often associated with severe burns.

13. H2 Blockers: H2 Blockers like Ranitidine can also be used to reduce stomach acid in patients with oral or throat burns, similar to PPIs.

14. Anticoagulants: In some cases, blood clots can form in the healing burn areas. Anticoagulants like Warfarin are used to prevent clotting.

15. NSAIDs: Non-steroidal anti-inflammatory drugs (NSAIDs) like Aspirin or Naproxen are used to manage pain and inflammation.

References