Chemical Burns

First aid for a chemical burn

1. Protect yourself. Wear gloves if possible and avoid touching the chemical.
2. Remove the source. Take off contaminated clothing, jewelry and watches. Cut clothing off rather than pulling it over the head.
3. Brush off dry chemicals (such as lime or powdered cleaner) before adding water.
4. Flush with cool running water for at least 20 minutes, longer for alkalis. Use a shower or hose for large areas. Let the water run off, not pool.
5. Do not try to neutralize an acid with an alkali or vice versa; the reaction produces heat and worsens injury.
6. Cover loosely with a clean, non-fluffy dressing or plastic wrap.
7. Get medical help for anything beyond a minor burn. Keep the product container or label for the medical team.

For eye splashes, hold the eyelids open under gently running water and keep flushing on the way to care. See chemical burns of the eye.

For a swallowed chemical, do not make the person vomit, and do not give anything to drink unless Poison Control advises it.

How chemicals damage tissue

Severity depends on the chemical's strength and concentration, the amount, the contact time and the area of the body.

Cement burns

Wet cement is highly alkaline. Kneeling in it or getting it inside boots or gloves can cause deep burns that are painless at first and appear hours later. Rinse immediately after any skin contact.

Symptoms

• redness, irritation or burning pain
• blisters or peeling
• skin that turns white, gray, brown or black
• numbness (from deep burns)
• eye pain, redness, blurred vision, watering
• after swallowing: mouth pain, drooling, vomiting, chest pain, difficulty swallowing
• after inhaling fumes: cough, wheeze, breathlessness, throat tightness

Severity

Like thermal burns, chemical burns are classified by depth:

• Superficial: red, painful, no blisters; heals in about a week
• Partial thickness: blisters, very painful; heals in 2 to 3 weeks if superficial, longer if deep
• Full thickness: white, leathery or charred, often painless; needs skin grafting

Chemical burns can deepen over hours, so initial appearance may underestimate severity.

Medical treatment

• Continued irrigation in the emergency department, sometimes checking skin or eye pH to confirm neutralization
• Removal of solid particles
• Pain relief
• Wound care: cleaning, removing dead tissue, dressings, antibiotic ointments; tetanus vaccine update
• Specific antidotes: calcium gluconate gel or injections for hydrofluoric acid; specialist treatment for phenol and others
• Monitoring of heart rhythm and blood calcium in hydrofluoric acid exposure
• Endoscopy within 24 hours after swallowing a caustic substance, to grade injury to the esophagus and stomach
• Burn center referral for large, deep or high-risk burns
• Surgery and skin grafting for full-thickness burns

Complications

• scarring and contractures that limit movement
• infection
• loss of vision after eye burns
• narrowing (stricture) of the esophagus after swallowing caustics
• lung damage from inhaled fumes, as with chlorine gas exposure
• systemic poisoning with some chemicals

Prevention

• store chemicals in original containers, locked away from children
• never mix cleaning products (bleach plus ammonia or acids releases toxic gases)
• wear gloves, goggles and protective clothing
• read labels and safety data sheets at work
• keep eyewash stations and running water accessible in workplaces

Frequently asked questions

What is the first aid for a chemical burn?

Remove contaminated clothing and jewelry, brush off any dry chemical, and flush the area with cool running water for at least 20 minutes. Do not try to neutralize the chemical. Cover loosely with a clean dressing and seek medical help for anything more than a minor burn.

Are acid or alkali burns worse?

Alkali burns are usually worse because alkalis dissolve tissue and keep penetrating deeper, so damage can be more extensive than it first looks. Acids tend to form a crust that limits spread. Hydrofluoric acid is an important exception and is especially dangerous.

How long does a chemical burn take to heal?

Superficial chemical burns usually heal within a week. Partial-thickness burns take 2 to 3 weeks or longer. Deep burns may need skin grafts and can take months, sometimes leaving scars. Healing depends on the chemical, contact time and treatment.

Should I put vinegar or baking soda on a chemical burn?

No. Neutralizing chemicals on the skin creates heat and can make the burn worse, and it delays proper flushing. Running water is the safest and most effective first aid for nearly all chemical burns.

When should I go to the hospital for a chemical burn?

Go to the ER for any eye exposure, swallowed or inhaled chemical, burns larger than your palm, deep or blistering burns, burns to the face, hands, feet, genitals or joints, and any hydrofluoric acid exposure. Call Poison Control for advice if unsure.