Chemical burns: first aid, treatment and when to call 999

Burns are usually thought of as caused by heat, but the NHS explains that burns can also be caused by electricity or chemicals. An acid or chemical burn happens when a harmful acid or chemical gets on the skin or in the eyes. The damage continues for as long as the substance remains in contact with tissue, which is why the first aid is to remove and dilute it as quickly as possible, rather than simply cooling the skin.

The NHS lists examples including bleach, household cleaning products such as toilet, oven and drain cleaners, battery acid, washing detergents, ammonia and chemicals used in farming, manufacturing, construction and laboratories. It adds that many products carry a label saying whether they are harmful and whether there is a risk of burns.

The NHS advises calling 999 for medical help, and says an acid or chemical burn needs immediate first aid. Wear gloves to protect yourself when helping if possible, carefully remove any clothing that has the chemical on it, and carefully brush dry chemicals off the skin. Then put the affected area under cool or lukewarm running water, or pour lots of water over it, for about 1 hour. Do not put anything on the burn, such as skin creams or other chemicals.

This differs from the first aid for a heat burn or scald, for which the NHS advises holding the burn under cool running water for 20 minutes within 3 hours and laying cling film over it. For chemical burns the longer rinse is aimed at washing the chemical away. The NHS also says that burns or scalds caused by an acid or chemical, or by electricity, are among those needing a 999 call or A&E.

• Call 999 and say that a chemical or acid is involved.

• Protect yourself with gloves if you can.

• Remove contaminated clothing carefully.

• Brush off dry chemicals, then rinse with plenty of cool or lukewarm water for about an hour.

• Do not apply creams, oils or other substances.

The NHS includes chemicals in the eyes in its advice to call 999 and give immediate first aid with running water. Because the eye is delicate, any splash of a chemical to the eye should be treated as an emergency in the same way: call 999 and follow the first aid advice of the call handler, which will focus on rinsing with water. Do not delay while looking for further information.

The NHS says acid and chemical burns need to be checked and treated in hospital. Treatment may include painkillers, antibiotics to treat or prevent infection, and fluids given through a vein. If the burn is severe you may also need surgery to help the wounds heal, reconstructive surgery if the burn affects movement or appearance, and physiotherapy if there is a lasting effect on movement.

Staff will assess how deep and extensive the burn is. It helps to tell them which substance was involved and how long it was in contact with the skin.

For minor burns and scalds in general the NHS says small injuries can often be treated at home and take around 2 weeks to heal, while severe burns that are large or deep may need hospital treatment. After the initial care, the NHS suggests taking painkillers such as paracetamol or ibuprofen, using an emollient on the area if it becomes itchy and dry as it heals, and not putting creams, oils or butter on burns, not using plasters or sticky dressings and not bursting blisters. For chemical burns, follow the specific instructions you are given in hospital, as dressings and follow-up are individual.

A chemical burn can leave scarring or changes in skin colour, and some people need follow-up with a burns or plastic surgery service. Emotional recovery after an accident or assault should not be overlooked, and a GP can help with support.

Read product labels, store cleaning products and batteries out of reach of children in their original containers, wear gloves and eye protection when using strong cleaners or handling industrial chemicals, and never mix products. In workplaces, follow the training and protective equipment provided.

Emergency treatment of chemical burns is delivered by ambulance services and NHS emergency departments, with burns units for more serious injuries. This is not a situation for private appointments or delay. Follow-up of scarring or movement problems may be through NHS burns and plastic surgery clinics, or privately if you choose.