When hot soup spills onto the back of your hand, most people react in similar ways. They look for ice, try to apply an ointment, or even consider old folk remedies like toothpaste or soybean paste. However, a burn is not an injury that ends with a moment of pain. How you handle the first few minutes can significantly change the depth of the injury, the extent of scarring, and the speed of recovery.
In reality, burns can occur not only from high heat but also from electricity, chemicals, steam, and prolonged exposure to relatively low heat, such as hot packs and electric heating pads. When an injury becomes deep or extensive, it can progress beyond simple skin damage to serious systemic complications.
Kim Kyung-sik, Chairman of the Bestian Foundation, emphasizes that burns are not just a surface-level problem. Once blisters form and fluid begins to ooze, the injury may already be beyond the stage of home management. Extensive burns can lead to fluid loss, infection, and decreased kidney function. His message is simple and clear: use cool running water instead of ice, choose a hospital over folk remedies, and never dismiss even small blisters.
Many people take burns lightly when they happen at home. At what point is hospital treatment necessary?
“If blisters form, it is best to come to the hospital. Even if a blister is only the size of a fingernail, it is safer to get it evaluated rather than toughing it out at home.”
Burns are classified as first-, second-, or third-degree depending on their depth. Second-degree burns cause blisters and severe pain, significantly increasing the risk of infection and scarring. Functionally important areas—such as the face, hands, feet, and joints—require extra caution regardless of the size of the burn.
What is the very first step of first aid after a burn? Is icing the correct approach?
“Not ice. It is better to run cool—not cold—water over the area for about 10 to 15 minutes. Applying ice because it feels good can actually further damage the tissue.”
The key is to remove residual heat as quickly as possible. However, cooling the area too much for too long can worsen tissue damage. Therefore, avoid direct ice application. Folk remedies such as applying toothpaste, soybean paste, soy sauce, potatoes, or irritating antiseptics are strongly discouraged due to the high risk of secondary infection.
After cooling the burn with water, what should you watch for?
“Even if you don’t see blisters at first, they can appear over time. You should monitor the area closely for about 24 hours. If blisters form, you need to seek medical care.”
The true extent of a burn often becomes clearer several hours after the injury. What initially appears as simple redness may later develop into blisters. If pain persists or a severe burning sensation remains, it is better to seek professional help. As a rule, you should never pop blisters at home.
Experts say burns are “not an illness where you only look at the wound.” Why is that?
“When the affected area is large, fluids and electrolytes leak out. If these aren't replaced properly, the kidneys are among the first organs to run into trouble. How you manage the whole body is what matters.”
While small burns are treated locally, extensive and deep burns are a different matter. As the skin barrier breaks down, the risk of shock, low blood pressure, and decreased kidney function rises. Electrical and chemical burns, as well as inhalation injuries, can be much more severe than they appear on the surface, requiring rapid diagnosis.
What types of burn accidents do you see most often?
“We see many scalds from hot water, as well as low-temperature burns from hot packs and electric heating pads. Older adults often sustain these after lying in the same position for a long time.”
Chairman Kim compares low-temperature burns to the idea that “meat cooks even over a low flame.” If the same heat stays on one area for a long duration, the skin will eventually be damaged. Older adults and those with diabetes or reduced sensation are at higher risk because they may not notice the damage until it is advanced.
Why don't low-temperature burns feel as dangerous?
“Because the temperature isn't extremely high, people assume they are safe. However, the heat causes damage deep beneath the surface while the person is asleep or stationary. The actual depth can be much greater than it looks from the outside.”
What patients worry about most is scarring. How can scars be minimized?
“The most important factor in scar management is early wound care. If blisters and oozing are not managed properly and allowed to harden into a scab, it can interfere with skin regeneration.”
Timely, professional dressing matched to the wound depth is the first step to reducing scars. Following the initial healing, moisturizing, sun protection, and compression or laser therapies may be used to ensure the best outcome.
It is said that burns do not just injure the body, but the mind as well.
“Absolutely. For patients with severe burns, the physical pain is intense, but the emotional shock is profound. It is vital to talk with patients and approach them in a warm, familiar way.”
Emotional wounds can last as long as physical ones. Patients often struggle with changes in appearance and fear regarding their return to daily life. Chairman Kim emphasizes that communication is an essential part of the clinical treatment process.
As Chairman Kim notes, a burn is not an injury to be brushed off. Even a small-looking wound can have a long recovery if handled incorrectly. Proper early cooling and timely medical care are the most effective ways to reduce long-term aftereffects. The rules are simple: water instead of ice, medical care instead of folk remedies, and checking instead of enduring.
