After a scald, run cool water over it right away for 20 minutes, and don't put on toothpaste or soy sauce

In a real emergency, call 911 first, then read this.

Cost

Free. It takes 20 minutes.

What you get

Australia followed 2,495 children with burns and scalds. For children who ran cool water over the injury for 20 minutes within 3 hours, the odds ratio for later needing a skin graft was 0.6, 95% CI 0.4–0.8 (the plausible range). This means a lower chance of needing a skin graft, but it can't be read directly as the chance being only 60% of that of children who did not. A combined analysis of 7 studies likewise found that "20 minutes of cool running water within three hours of injury significantly lowered the chance of needing a skin graft and surgical wound care." The 2025 first aid guidelines of the International Red Cross state not to rinse with ice water or apply ice, because it worsens the injury. The UK National Health Service (NHS) states to take off clothing and jewelry near the scald, but not to touch anything stuck to the wound, and not to put any ointment, oil or butter on the scald

Notes

Use cool water, not ice water, because ice makes the injury worse. If clothing is stuck to the wound, don't tear it off; after rinsing, cover it with a clean cloth and go to the hospital. Don't put on toothpaste, soy sauce, sesame oil or flour; the NHS states not to put any ointment or oil on a scald. Rinsing within three hours still helps. For how to avoid scalds when bathing a baby, see §20.17 (cold water first, then add hot).

Evidence grade

A : Specific numbers from meta-analyses, large cohorts or randomized trials; for law and policy, the statute or official text.

Sources

1. 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
2. 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
3. International Federation of Red Cross and Red Crescent Societies (2025). International First Aid, Resuscitation and Education Guidelines 2025, page 289: "Do not use ice-cold water" "Do not apply ice, as this may aggravate the injury". https://www.ifrc.org/sites/default/files/2026-03/IFRC%20International%20First%20Aid,%20Resuscitation%20and%20Education%20Guidelines%202025.pdf
4. NHS. Burns and scalds: "do not remove anything that is stuck to the affected area" "do not put any creams, oils or butter on burns or scalds". https://www.nhs.uk/conditions/burns-and-scalds/treatment/

Translated from the Chinese original. Original book, section 13, tip 14. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer