Chemical and Acid Burns

Chemical burns—otherwise known as caustic burns—occur when the skin comes into contact with an acid, base, alkali, detergent, or solvent, or the fumes produced by these corrosive materials. They most commonly affect the eyes, face, arms, and legs, but can cause serious damage to the mouth and throat if a corrosive material is ingested.

Fortunately, most chemical burns don’t do major damage to the skin. In fact, many are caused by common household or workplace materials and can be treated in outpatient settings—only about 5 percent of patients seeking emergency medical care for a chemical burn are admitted to the hospital. Highly caustic materials, however, can hurt deep layers of tissue, and the damage isn’t always immediately apparent.

Because the materials that cause chemical burns are so prevalent in homes, schools, and workplaces, it’s important to know what to do if you, a loved one, or a coworker come into contact with caustic materials.

The symptoms of a chemical burn depend on a few basic but important factors:

1. What substance caused the chemical burn
2. Where the substance came into contact with living tissue
3. How long the tissue was exposed to the corrosive substance
4. Whether the substance was inhaled or ingested

Household bleach coming into contact with your skin, for example, will have a much different effect than bleach coming into contact with your eyes.

Although symptoms can vary widely, common signs and symptoms of a chemical burn include:

• Pain, redness, irritation, burning, or numbness at the site of contact
• The development of blisters or dead, blackened skin at the site of contact
• Blurry vision or total loss of vision if the materials came into contact with the eyes
• Coughing, wheezing, and shortness of breath if the substance was inhaled or ingested

In very severe chemical burns or if a corrosive substance was swallowed, you may experience symptoms like:

• Weakness, dizziness, or fainting
• Headache
• Muscle spasms or seizures
• Low blood pressure, irregular heartbeat, or even cardiac arrest

If the caustic substance is ingested or if the chemical burn is very deep, more than 3 inches in diameter, or affects the eyes, face, groin, buttocks, or a joint, seek emergency medical care.

Chemical burns are most commonly caused by exposure to acids or bases in the home, workplace, or at school—they can occur in any place where caustic and corrosive materials are handled. Chemical burns can affect anyone, but people who work in manufacturing facilities, children, and older adults are at the highest risk of injury.

Some common products that can cause chemical burns include:

• Everyday household cleaners like bleach, ammonia, and drain or toilet cleaners
• Skin, hair, and nail care products, and teeth whitening kits
• Car batteries
• Pool chlorine and pool cleaning systems

If possible, read the warnings and medical information on the labels of corrosive products before handling. In many cases, consumer education and proper use can prevent a serious medical emergency.

Although most chemical burns are caused by the accidental misuse of a corrosive substance, they can also be used in assaults. Worldwide, attacks with caustic materials are more likely to occur against women. 

Like symptoms of a chemical burn, diagnoses can vary widely. Your healthcare provider will conduct a physical exam to assess the immediate tissue damage caused by the chemical burn, and ask a series of questions to assess any potential damage. Be sure to tell your doctor about the substance that caused the chemical burn, how long it was in contact with the skin, and the affected body parts.

If you have a severe chemical burn, your doctor may conduct a blood test to determine whether or not hospitalization is required.

After a physical exam and interview, the chemical burn will be categorized as:

• A First-Degree or Superficial Burn: These types of burns affect only the epidermis or the outer layer of the skin. Minor discoloration of the skin is a common symptom of a first-degree burn.
• A Second-Degree or Partial Thickness Burn: Affecting the epidermis and dermis (second) layers of the skin, these burns can be very red, inflamed, and painful, and can blister.
• A Third-Degree or Full-Thickness Burn: The most severe, these burns cause extensive damage to the epidermis and dermis, as well as bones, tendons, muscles, and nerve endings.

Your doctor or healthcare provider will recommend treatment options based on the category of your chemical burns.

Typically, chemical burns do not require hospitalization or specialized treatment. 

For a minor chemical burn, basic first aid can alleviate pain and reduce tissue damage. When treating a minor chemical burn, be sure to:

• Remove yourself, your loved one, or your coworker from the accident area.
• Remove any contaminated clothing.
• Flush the affected tissue with water for at least 20 minutes.
• Remove any foreign objects from the affected area, especially the eyes.

After first aid has been administered, most people with chemical burns simply need to talk to their doctor about follow-up care.

If you or the person affected by a chemical burn begins to experience dizziness, wheezing, difficulty breathing, or other severe symptoms, call 911 immediately.

Some treatments for serious chemical burns include:

• IV fluids to regulate heart rate and blood pressure, or IV medications or antibiotics to treat pain or prevent infection
• Antidotes to counteract the effects of the caustic substance
• Professional cleaning and bandaging
• Pain management through an IV or other pain medications
• A tetanus booster to prevent bacterial infections

Chemical burns rarely result in death, but it’s important to take the steps necessary to avoid infection and protect and heal damaged tissues. If you’ve been treated for a chemical burn, be sure to arrange follow-up care with your doctor or healthcare provider within 24 hours of sustaining the injury.

Chemical and acid burns can be painful, but the good news is that most can be treated with basic first aid and follow-up care. Whenever you’re handling corrosive or caustic substances, be sure to read any warning labels and use extra care to avoid contact with your skin, eyes, or mouth. Oftentimes, proper consumer education can prevent serious medical emergencies.