Burns seem to have attracted their fair share of folk remedies, but after looking through the evidence Claudia Hammond explains what you should do and why.

Using butter to treat burns is an old folk remedy that has been around for centuries. It gained credibility when the Prussian Surgeon General Friedrich Von Esmarch recommended in his influential 19th Century handbook on battlefield medicine that burnt surfaces should be covered with an oil, grease or butter. The idea was to seal the burn off from the air, keep it clean, prevent infection and help the healing process. Von Esmarch may be widely credited with coming up with the concept of “first aid”, but was he right about butter?

Plenty of us still use folk remedies, and for some reason burns seem to have attracted more than their fair share of myths and exotic treatments. Perhaps this is because the immediacy of the pain makes us more desperate for a solution. Ancient Egyptian papyrus dating back to 1500BC describes the use of mud, excrement, frogs boiled in oil and fermented goat dung. Greeks from the 4th Century BC preferred rendered pig fat while the Romans used a mixture of honey and bran followed by cork and ashes.

Far more recently surgeons at a hospital in the British city of Sheffield noticed a series of cases of children with burns being brought into its casualty department still wearing hot clothes, when removing these and any jewellery is the first thing that should be done as they can trap heat against the skin.

This inspired them to investigate parents’ beliefs about burn remedies. They asked them to imagine what they would do if they’d just found a two-year-old child who had pulled a saucepan of boiling water over onto themselves. Only 10% gave an answer considered to be ideal and some suggested remedies which don’t work, including the use of butter, milk, cooking oil and toothpaste. The researchers were concerned that as this was a hypothetical question posed in a calm situation, the parents might be even less likely to take the correct steps in real-life emergencies.

A Turkish study found that only just over a quarter of the families had put cold water on a child’s burn (the recommended approach), while half had used inappropriate alternatives including yogurt, toothpaste, tomato paste, ice, raw egg whites, or sliced potato.

It’s easy to see why these folk remedies take hold. Any new burn exposed to the air is incredibly painful and it is true that covering it with any cool substance will slightly easy the agony. But this relief won’t last and sealing the air off can even hold the heat in, causing the skin to continue to burn. Since superficial burns heal quickly by themselves, we wrongly assume these solutions work when in fact the burn would have got better by itself anyway.

So what should you do instead? First-aid guidelines vary from country to country, but the general advice is that after removing any clothing and jewellery, the key is to get cold water onto the burn and to run it under the cold tap for longer than you think – for at least 20 minutes. This helps anything up to three hours after the person received the burn.

Initially the cold water helps to numb the area by cooling it, but it also prevents the skin from continuing to burn. It also seems to help the wound to heal, although researchers are still debating the exact mechanism by which this happens. Some people immediately head for the freezer to get some ice, but water is safer because the extreme cold can injure the tissue further. Finally the burn should be covered with a clean cloth or cling film to prevent it from becoming infected. 

As for butter, save that for your bread, unless you find yourself in one very specific situation. If you have the misfortune to get hot tar on your skin, a fatty substance like butter can help to remove it, reducing the pain and making it easier for doctors to assess the severity of the burn.

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