Steam Burns: Symptoms, Treatment, and Prevention

Symptoms, Diagnosis, Treatment, and Prevention

Rod Brouhard is an emergency medical technician paramedic (EMT-P), journalist, educator, and advocate for emergency medical service providers and patients.

Jordana Haber Hazan, MD, is board-certified in emergency medicine and currently works as an academic emergency physician.

Steam burns are a common type of thermal burn caused by boiling hot water vapor or hot liquid. Scalds from hot liquid and steam make up 35% of all burn injuries seen in U.S. burn centers.

Steam burns can happen on any exposed area of skin. They can also affect the eyes or mucous membranes in your mouth, nose, and windpipe.

This article discusses the symptoms, diagnosis, prevention, and treatment of steam burns. It also looks at the steps to take after you or someone else has been burned.

When water reaches the boiling point, it turns to steam. The boiling point is 212 degrees F.

Steam is made up of superheated water molecules. When they contact body tissues, they can scald almost instantly.

Steam can cause worse burns than hot water. This is because when steam touches your skin, it turns back into liquid. When this happens, it releases energy. That energy, along with the heat itself, contributes to how bad the burn is.

This video has been medically reviewed by Casey Gallagher, MD.

When water turns to steam, it expands to approximately 1,600 times its previous volume. Steam can escape under pressure. This means it may come out in a jet that can cause injury.

Many appliances are designed to use steam under pressure, including:

Steam can be easily inhaled. Superheated molecules can travel deep into your nose, mouth, and throat. This is why vaporizers can be dangerous, especially for children.

There is no evidence that vaporizers are helpful for treating viruses or other respiratory infections.

They can also cause steam burns of the skin and airways. For these reasons, they aren't recommended.

In microwave ovens, the water molecules in food can turn to steam. When the steam expands, it can shoot out of solid foods. This is why food sometimes "pops" in the microwave.

Microwaved food can sometimes cause steam burns. One study identified eight patients who were injured by steam from exploding potatoes and eggs that came out of microwave ovens. In another case, a patient's eye was injured while opening a bag of microwave popcorn.

Syncope is a sudden loss of consciousness, also known as fainting. People who have medical conditions that lead to syncope are more likely to be burned by household appliances. This includes appliances that generate steam.

People who have conditions that lead to seizures are at similar risk.

Kids are more likely to put their hands or faces into escaping steam. This can cause a steam burn on exposed skin.

This type of exposure can also cause other serious problems, like epiglottitis. This is a condition where tissue in the windpipe becomes swollen. In children, symptoms can come on quickly. The condition can be fatal and requires immediate medical attention.

Burns are categorized on a sliding scale of severity. The scale is based on the size of the burned area and how deep the burn went into the skin. This is called the "degree" of the burn. Burns are either first, second, or third-degree.

Steam burns can be especially dangerous if the steam is inhaled. This is also true if it contacts the eyes. Symptoms of an inhalation injury include:

People who receive steam burns to the eyes may experience vision loss.

Steam burns are diagnosed based on:

The steam burn will be diagnosed as a first-degree (redness, no blisters), second-degree (often many blisters), or third-degree (skin may slough or shed and area may go numb).

After a steam burn, take these steps at once and in this order:

The most important step for any burn injury is to get rid of the cause. This is true if you have been burned or if you are helping someone else who has been burned.

Turn off or stop the heat source. Move the injured person away from the steam.

The burn process will continue even after the source of heat has been removed. It is very important to cool down the area to stop this process.

Run cool tap water over the burned area. The cool water will reduce the temperature of the burn.

Keep doing this until the burned area feels cool to the touch. It is important to continue even after the patient starts to feel better.

You may need to keep flushing the injury with cool water for as long as 20 minutes. This is the only way to completely stop the burn process and prevent the injury from getting worse.

Call 911 if the steam burn or scald includes:

If the patient becomes short of breath at any time after a steam injury, call 911 at once. Steam in the throat can cause swelling in the airway, even hours after the injury.

Next, cover the burn injuries with a dry, sterile dressing. If the total area of the burn is larger than 9% of the patient's body, call 911. The patient needs to be taken by ambulance to a burn center.

The rule of nines can help you decide if you need to call 911. Under this rule, 9% of the body is roughly equal to:

You can estimate the extent of the burn by adding up all the areas with blisters or worse injuries. If an entire arm is covered in blisters, that's 9%. If it's only half the arm, that's 4.5%.

If the patient does not need an ambulance, take the following steps:

Emergency doctors may decide to send the patient to a burn center. At the burn center, treatment may include debridement. This is a procedure that removes dead tissue to reduce scarring. Intravenous (IV) pain medication may also be needed. This is medication that is given through the veins.

A patient may spend up to two or three weeks in a burn center.

If more than 9% of a person's body has a steam burn or the burn is on the face or another sensitive area, call 911 for transport to a burn center. If a person with a steam burn becomes short of breath, seek immediate medical care.

If there are any blisters that rupture or the skin is peeling, call a healthcare provider to have it evaluated.

It's also important to look for signs of infection. This may include a fever, drainage or pus, or a change in the appearance of the injury. If you suspect an infection, seek urgent medical care.

In the home, most burns happen in the kitchen. This is especially true for steam burns and other scalds. Cooking involves heat, which makes it inherently risky.

Take these steps to prevent steam burns and other scalds in the kitchen:

Steam burns and other scalds can also happen in other parts of the house. Use caution in the bathroom, laundry room, or any part of the home where you use a hot appliance.

Set water heaters to 120 degrees F. For small children, keep bathwater to about 100 degrees F. Higher temperatures may lead to scalds.

Steam burns can be much worse than hot water burns. Steam can cause injury when it escapes in jets. It can also be inhaled. The risk is particularly high for children and adults with certain medical conditions.

Steam burns can be first, second, or third-degree. If you or someone else is burned by steam, remove the heat source and keep the injured area under cool, running water for at least 20 minutes. Cover the wound and call for emergency help if the burn is in a sensitive area or covers more than 9% of the body.

You can prevent most burns by being careful with hot liquids in the kitchen. Keep children away from boiling water and hot appliances. Set your home water heater to no more than 120 degrees F and keep kids' bathwater at 100 degrees F.

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By Rod Brouhard, EMT-PRod Brouhard is an emergency medical technician paramedic (EMT-P), journalist, educator, and advocate for emergency medical service providers and patients.