Scalding is a burn to the skin or flesh caused by moist heat and hot vapors such as steam. When the heat applied is approximately equivalent, a scald is deeper than a burn from dry heat and should be treated as a burn. Healing is slower and scar formation is greater.
Scalding is a second-degree burn which is deeper and results in splitting of skin layers or blistering. Scalding with hot water or a very severe sunburn are common instances of second-degree burns.
Tap water scald injuries are the second most common cause of serious burn injuries in all age groups. Scald burns may be accidental or non-accidental, as in cases of child abuse, and often cover a large area of the body, leading to high rates of morbidity and mortality.
Scald injuries are especially likely to occur in certain populations, particularly children less than five years of age, adults more than 65 years of age, and persons with handicaps such as sensory neuropathies.
Each year, about 112,000 people are treated in hospital emergency rooms with scald burns, and about 6 percent of them are hospitalized. Many of the scaldings are a result of household water heaters being set at temperatures above 120 degrees F. About 80 percent of hot tap water burns are among young children, the elderly, and the physically impaired.
Water temperature may be kept high for a number of reasons. In institutional settings, a large volume of hot water may be required. For dishwasher use, water may need to be kept hot to improve solvent action. Another reason for keeping temperatures higher is prevention of bacterial overgrowth in the water supply. However, tap water delivered at 140 degrees F can cause a full-thickness burn in 10 seconds.
For minor scalding, apply cold water or ice immediately. This reduces the amount of skin damage caused by the burn and eases the pain. The cold should be applied for at least five minutes and continued until pain is relieved, or for one hour, whichever comes first. Be careful not to apply cold so long that the burned area turns numb, since frostbite can occur.
Aspirin or acetaminophen may be used to reduce pain. Blisters should not be broken. The use of anesthetic creams or sprays is not recommended, since they may slow healing.
Any severe burn - or one that continues to be painful for more than 48 hours - should be seen by a physician.
Severe burns require prompt attention and may necessitate hospitalization, antibiotics and skin grafts.
The best approach to this problem is prevention. Many states now require water heaters to be preset at 120 degrees F. However, some consumers insist on changing their preset thermostats to achieve higher water temperatures. This practice is dangerous, especially if there are infants and young children or very elderly adults in the home.
If you move into a new home or apartment, check the water heater temperature or have your landlord check it. If you are unable to do this, contact your local health department or fire department. Representatives from these organizations will often make a no-charge home visit to assess how your water heater is working and what temperature the water is.