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Chemical burns. The basics. First aid. Prevention


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Nov 23, 2021
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During production, there may be situations when highly active reagents get on the skin or mucous membranes. This can be extremely dangerous, so below we will try to disclose the basic safety rules for those whom it may concern.

At first. What you need to know about chemical burns
The most aggressive substances for the skin and mucous membranes are acids and alkalis. At the same time, acid burns are more favorable, since when they come into contact with the proteins of your tissues, a scab forms, preventing further penetration of the aggressive substance.

Alkalis also have a fat-dissolving effect. They create deep burns, which are considered more dangerous than burns with other substances, because at the initial stages the depth and area of the lesion seem small, but subsequently increase. The total area of the alkali burn can be determined only after 48-72 hours. Alkalis cause hydrolysis of the protein structure and cell destruction, leading to wet tissue necrosis.

In general, it`s characteristic for tissue damage to occur before complete neutralization and elimination of the substance at this stage. First aid measures will be aimed at this. But more on that later.

Symptoms and diagnosis of chemical burns
The symptoms of the burns received are related to the chemical nature, concentration, quantity, duration of the damaging effect of the substance and the place of injury. The burned person experiences intense pain in the affected area. Burns of the pharynx or esophagus are accompanied by a violation of swallowing. With severe chemical burns, common symptoms are noted (fever, impaired consciousness, etc.), burn shock may develop.

The mechanism of action of substances is related to the method of protein denaturation. Potassium permanganate, sodium hypochloride, chromic acid have a pronounced oxidizing effect, disrupt the work of enzymes and, as a result, quickly cause cell death. Such corrosive substances as sodium hydroxide, dichromates, white phosphorus, phenol instantly destroy all cellular structures.

Under the influence of oxalic, hydrochloric, sulfuric acid, massive dehydration, cell lysis occurs. Upon contact with gasoline, mustard gas, and methyl bromide, tissue stratification and the release of tissue amines are observed. Ammonia, acetic, formic, tannic, sulfuric salicylic, and some other acids bind protein or cations by forming salts.

Determining the degree of burn is of paramount importance, since some wounds will heal themselves (only local therapy is enough), and a hospital and surgery will be needed to heal others


Grade 1st burns are limited to the epidermis. They are manifested by soreness, erythema formation (redness), paleness of the skin when pressed. The protective function of the epidermis does not suffer, bubbles do not form. Such burns are eliminated independently after 3-6 days. Treatment is aimed at maintaining rest, not injuring this area of the skin, using soothing ointments and nonsteroidal anti-inflammatory drugs or acetominophen.

Burns of the 2nd degree (not penetrating the entire thickness of the skin) are divided into two types: superficial and deep. With all grade 2nd burns, the dermis is not damaged to the full depth, and the type of burn depends on the depth of its destruction.
a) Superficial burns of the 2nd degree are clinically manifested by erythema, soreness, moist surface, paleness of the skin when pressed and the formation of bubbles. Blisters may appear a few hours after the injury, so burns of the first degree the next day may be accompanied by burns of the second degree.
Such burn wounds regenerate themselves in 7-14 days. Skin discoloration can persist for a long time.

b) Deep burns of the 2nd degree with a spread to the reticular layer are not pink, but a paler or spotted color, do not turn white when pressed, may be accompanied by blunted sensitivity (less sensitive to needle irritation compared to the surrounding healthy skin). Epithelialization of such wounds will occur within 21-28 days or longer, often with the formation of hypertrophic scars.​

Burns of the 3d degree affect the entire thickness of the dermis and are characterized by the formation of a dense rigid scab, with loss of sensitivity, having a black, white or cherry-red color. Deep dermal burns and burns to the entire depth of the dermis are treated by autodermoplasty, with the aim of timely closure of wounds.

In some cases, the type of damaging agent can be determined by the smell and color of the scab
After interacting with sulfuric acid, the skin initially turns white, then turns brown or gray. The scab from such a burn will be black.

a. Destruction by nitric acid gives the skin a yellow-brown or light yellow-green color.
b. Acetic acid burns are dirty-whitish, dry, dense, clearly limited.
c. Hydrochloric acid gives yellow burns, carbolic acid – first white, then brown.
d. Under the action of concentrated hydrogen peroxide, the tissues become grayish.
e. In the case of alkali burns, the whitish scab has a soft, loose consistency and blurred borders.
f. After burning with phosphorus, a dry, glowing scab remains when darkened.

Actions and first aid
1. Remove the excess
Shake off the remnants of the substance, remove clothing, jewelry, protective equipment. Everything on which particles of the active substance could remain.

2. Rinse with water. Or saline
In most cases, the first thing to do is to rinse the affected area abundantly with medium-cold water. Abundantly and for a long time, at least 20 minutes. The later you start rinsing with water, the longer it takes to do it.

After the first washing of the wound, the burning sensation may increase - rinse the burned area again with running water for another 5-10 minutes.

NOT to wipe the reagent with napkins, tampons moistened with water - so you rub the chemical into the skin even more. Only washing!

Important! In some situations, water can do harm. For example, if there is damage from quicklime, the burned area is washed with oil, not water. Or first you need to remove all the remnants of the substance from the site of the lesion. You always need to know what you are working with.

3. Neutralize the remaining substance
No matter how well we would like to wash the affected area, some part of the reagent may remain in the depths of the tissues. It can cause complications, so it needs to be neutralized.

You should not rush headlong to carry out a neutralization reaction from a school chemistry course on yourself or someone else. The problem with this reaction is that it releases free energy in the form of heat. This means that you can add a thermal burn to a chemical burn if you don't know what you're doing.

For acid burns, lotions with 2% soda (about 1 teaspoon per glass of water), irrigation with 0.1% ammonia solution (15 drops per glass of water), 1% lime water, chalk powder or burnt magnesia are used. You can also use cold soapy water if there is nothing else.
The burn with hydrofluoric acid should be washed with running water for a particularly long time - 2-3 hours.

To neutralize alkalis, 2% solutions of hydrochloric, acetic, boric, citric acids are used (half a teaspoon of powder per glass of water) or table vinegar, half diluted with water.

In case of lime burns, a 20% sugar solution is used to neutralize.

For burns with hydrofluoric acid, a 10% solution of calcium gluconate is used. But you can not apply it too much, so as not to provoke an undesirable tissue reaction.

Treatment with ethyl alcohol or polyethylene glycol allows to increase the solubility of phenol, which is then better washed off with water.

Carbolic acid is neutralized by glycerin and lime milk.

Phosphorus is neutralized with 1-2% copper sulfate solution. Next, the burned area is closed with a sterile bandage with panthenol. Important! Do not lubricate the phosphorus burn with lipid products - fat, oil or ointments - this can stimulate the absorption of fofsor into the skin.

4. In any case, you need to apply a free bandage made of dry sterile bandage or clean dry cloth to the burned and already washed area

5. Last but not least. Drink water to avoid dehydration. Give peace and rest, exclude active movements and further work


A dozen points about first aid for chemical eye damage

1. Wipe the eyelids, the skin around the eyes with a sterile gauze swab in the direction "from the eye";
2. Remove contact lenses if they have been worn
3. Rinse your face thoroughly with clean water
4. Rinse your eyes with clean cool water for at least 30 minutes
5. Rinse thoroughly and rinse your mouth and nasopharynx with clean water.
6. Stop working, go out into the fresh air, put on sunglasses if photophobia manifests itself (bright light causes pain or discomfort).
7. DO NOT use creams, ointments with a fat base - this will only keep the irritant
8. DO NOT rub the affected areas of the eye and the skin next to them.
9. DO NOT put a blindfold on the eyes and the skin next to them.
10. You can use a 5% solution of unithiol, sodium thiosulfate, instillation of sodium azapentacene polysulfonate (0.015%).

What's next?
Depends on the severity. As we know, burns of 1st and 2nd a) degrees, if they are not extensive and not deep, can heal without problems. It`s not necessary to seek medical help because of them. However, if the damage has covered a large area, or burns can be classified as 2nd b), 3d or 4th degrees, it`s worth urgently seeking specialized help. I don't want to think about such a scenario - but it's worth having a plausible legend for this case, or an understanding competent doctor among friends.

If a scab has formed, it cannot be cut or torn off, it must move away by itself. Proteolytic enzymes are used to stimulate rejection. With acid burns, the necrotic scab disappears after about 10 days. As a rule, in this case, scar deformities are not observed. Alkali damage is often accompanied by granulating wounds that heal slowly and lead to the formation of rough scars.

After the scab is removed, anti-inflammatory and regenerative ointments can be applied. Spot deep burns (for example, when splashed with acid or alkali) can be closed independently. With a significant area of the wound surface, skin plastic surgery is required after cleansing the wound.

Non-opioid analgesics are used to eliminate pain. Or opioids, if the first ones don't help. You may also need antibiotics. In case of extensive injuries, infusion therapy is performed. Nutrient solutions, glucose, and medications are introduced to restore acid-base balance.

With severe burns of the extremities, it makes sense to create immobilization, apply a plaster splint until complete healing - this will help avoid the appearance of contractures. After healing, regular exercises are necessary with a gradual increase in complexity.

With extensive wound surfaces and the development of disfiguring or movement-disrupting scar deformities, patients require additional surgical interventions.

Prevention of burns and their complications
Everything is simple here, and everyone should understand it. However, I will still outline simple rules.

1. Know what you are working with. Be interested in what can harm you. No one else needs it.
2. Work in a sober state.
3. Wear protection. Not only the skin, but also the eyes, respiratory organs.
4. Equip the workplace - hood, access to clean running water, neutral and reliable storage facilities, spare protection kits.
5. Keep a first aid kit handy. Ideally, have access to a doctor or get basic medical care skills in courses.


Thank you for your time. If you notice flaws in the text, want to share your methods of prevention, care and treatment, or just tell a story on the topic, I invite you to a dialogue.
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