Cool a burn under cool running water for 20 minutes; do not apply toothpaste or soy sauce
Twenty minutes of cool running water within 3 hours of injury was associated with skin-grafting odds about 60% of those without this first aid. Use cool, not ice-cold, water; ice can worsen injury. Do not tear off stuck clothing. After cooling, cover with clean cloth and seek care. Avoid toothpaste, soy sauce, sesame oil and flour. Cooling can still help if begun later within the three-hour window.
What it takes
Free; 20 minutes.
What you may gain
An Australian cohort followed 2,495 children with burns. Twenty minutes of cool running water within 3 hours was associated with an odds ratio of 0.6 for skin grafting, 95% CI 0.4–0.8. A meta-analysis of 7 studies likewise found significantly lower likelihood of grafting and surgical wound management with this first-aid regimen.
Context & considerations
Use cool water, not ice. Leave stuck clothing in place, cover with clean cloth after cooling and seek medical care. Toothpaste, soy sauce, sesame oil and flour interfere with assessing depth and can introduce infection. Cooling within 3 hours remains useful even if not immediate.
Research & references
Griffin BR, Frear CC, Babl F, Oakley E, Kimble RM (2020). Cool Running Water First Aid Decreases Skin Grafting Requirements in Pediatric Burns: A Cohort Study of Two Thousand Four Hundred Ninety-five Children. Annals of Emergency Medicine, 75(1), 75-85. https://doi.org/10.1016/j.annemergmed.2019.06.028; Griffin B, Cabilan CJ, Ayoub B, et al. (2022). The effect of 20 minutes of cool running water first aid within three hours of thermal burn injury on patient outcomes: A systematic review and meta-analysis. Australasian Emergency Care, 25(4), 367-376. https://doi.org/10.1016/j.auec.2022.05.004