Local burn and damaged-skin care
Superficial or partial-thickness burn (first or second degree) – thermal, chemical, sunburn or radiation. Standard adult care: cool the area with clean running water for 20 minutes, non-greasy panthenol or silver sulfadiazine creams as indicated, non-adherent dressings and analgesia with paracetamol or ibuprofen. Deep (third-degree) burns, burns of face, hands, feet, perineum and burns covering more than 5% of body surface area require medical assessment. In Russia, sea buckthorn oil is registered by the Ministry of Health (GRLS) as a medicinal product for topical use in burns, radiation skin injury and trophic ulcers. In Spain and most EU countries sea buckthorn has no such registration.
ICD-10 T20-T325 drugs
Also known as: First-degree burn, Second-degree burn, Burn wound care, Superficial burn healing, Radiation dermatitis
Drugs used for this condition
- CDimetindeneAdd-on therapy · Antihistamine for topical useThe AEMPS ficha técnica includes small sunburns and small superficial burns among the indications: the gel reduces itching and gives a cooling sensation. The limits, though, are firm. It may only be applied to intact skin – with blisters, weeping or an open surface the gel is not used. Extensive burns need a doctor's assessment rather than a pharmacy product. The gel contains benzalkonium chloride, which itself irritates skin, and it is not applied to mucous membranes. Treated areas must be kept out of the sun. If the burn covers a large area, has blisters, involves a child or an older person, or affects the face, hands, feet, perineum or joints, an examination is needed.
- CPovidone-iodineAdd-on therapy · Broad-spectrum antiseptic, iodine productFor a small burn povidone-iodine is used as an antiseptic, and the AEMPS ficha técnica names that indication directly. How much antiseptics change burn outcomes is less clear: the 2017 Cochrane review gathered 56 studies and concluded that the evidence is of low and very low quality, and that confident judgement about the effect of antiseptics on healing and infection cannot be drawn from it. The practical conclusion is not «do not use» but «do not overrate»: first the burn is cooled under running water for 20 minutes, then covered with a clean dressing. Iodine on an extensive burn surface is separately dangerous – absorption rises and the thyroid responds, which is why the ficha limits use with burns over 20 percent of the body. Blisters, a deep burn, the face, hands and joints are a reason to see a doctor.
- CSea buckthornAdd-on therapy · Herbal preparation, sea buckthorn berries and seeds (Hippophae rhamnoides); in Russia sea buckthorn oil is a registered medicinal product for topical useIn Russia sea buckthorn oil is registered by the Ministry of Health as a medicinal product for topical use in first- and second-degree burns, radiation skin injury, trophic ulcers and pressure ulcers. The oil is applied as a thin layer to the damaged surface twice daily until epithelialisation. The evidence base is small Soviet-era clinical studies, not Western-style RCTs. The ISBI Practice Guidelines for Burn Care (Burns 2016) do not mention sea buckthorn – the international standard for superficial burn care rests on cooling, panthenol gels, silver sulfadiazine creams and non-adherent dressings. In Spain and most EU countries sea buckthorn oil is not registered as a burn medication. If a patient is in Russia and a doctor prescribed sea buckthorn oil for a superficial burn, the use follows the national pharmacopoeia. In deep burns, burns of face, hands, feet or covering more than 5% of body surface, sea buckthorn does not replace specialised burn-centre care.
Marketing claims without evidence base
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
- DHypericum perforatumNot recommended · Antidepressants. Other antidepressants of herbal originSt. John's wort oil is used topically for minor wounds, burns, grazes and skin irritation. The EMA accepts this use by tradition only, without evidence of efficacy; the few small trials of hyperforin creams in dermatitis are inconsistent. Systemic interactions are unlikely with topical use, but the herb raises skin sensitivity to sunlight – treated areas are better kept out of the sun.
- FIsopropanolNot recommended · Skin antiseptic and disinfectantAlcohol on a burn is one of the commonest household mistakes. Burned skin has lost its protective barrier, alcohol penetrates deeper, intensifies pain and damages tissue, and as it evaporates it dries the surface further. The AEMPS ficha técnica does not include burns among the indications and asks to avoid application to damaged skin and mucous membranes. First aid for a burn looks different: cooling under running water at room temperature for 20 minutes, removing rings and jewellery, a clean non-adherent dressing. Ice and fats are not needed either. The 2017 Cochrane review of antiseptics for burns showed that the evidence for their benefit is of low and very low quality, so even suitable antiseptics play no decisive role. If alcohol was advised to be poured on a burn, consider seeking a second opinion.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit