An Overview of Steam Burns

Burns caused by heat are called thermal burns. A steam burn is a type of thermal burn caused by boiling hot water vapor.

Steam burns are scalds. Scalds can also be caused by hot liquid. The liquid does not have to be boiling in order to scald.

Scalds from hot liquid and steam make up 35% of all burn injuries seen in U.S. burn centers.

Steam burns can occur in people of all age groups, but some groups are at higher risk. These include:

• Children
• Elderly people
• Patients with certain medical conditions

Steam burns can affect any exposed part of the body, including:

• Skin
• Eyes
• The 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.

Causes of Steam Burns

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.

Household Appliances

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:

• Teapots
• Steam irons
• Steam cleaners
• Vaporizers

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.

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.

Risks for Children

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.

Symptoms of Steam Burns

Steam burns look similar to other types of thermal burns. In general, symptoms may include:

• Redness
• Swelling
• Pain
• Blisters
• Sloughing or shedding of the skin
• Leaking fluid from injured areas

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:

• Shortness of breath
• Coughing
• Wheezing
• Difficulty swallowing

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

Diagnosis of Steam Burns

Steam burns are diagnosed based on:

• Appearance
• A description of the incident that led to the burn

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.

First-degree burns are identified by how red they are. A mildly red burn means that only the top layer of skin, called the epidermis, was damaged. First-degree burns also lack blisters.

A second-degree burn occurs when the epidermis is completely damaged. In a second-degree burn, the damage extends into the dermis, which is the next layer of skin.

In most second-degree burns, the top two layers of skin separate. The dermis weeps fluid, which pushes the epidermis up. This is what causes a blister.

In steam burns, a second-degree burn is often made up of many very small blisters. This looks different than burns with other causes.

A burn that extends through both layers of skin is a third-degree burn. This is also called a full-thickness burn.

Treatment of Steam Burns

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

1. Remove the threat.
2. Stop the burning process.
3. Cover the burn injuries.
4. Transport the patient to a burn center, if necessary.

Remove the Threat

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.

Stop the Burn Process

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.

Cover and Transport

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:

• One arm
• One thigh
• One leg below the knee
• Head
  
• Chest
• Abdomen
• Upper back
• Lower back
  

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%. 

At-Home Care

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

• Keep the injury covered in a dry, sterile dressing. Change this daily. Keep a dressing on the burn for at least 10 days. Remove when the injured area looks like it's healing. At this point, the patient should be able to tolerate exposure to air.
• Take over-the-counter (OTC) pain medication.
• 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, call a doctor at once.
• If the person becomes short of breath, seek immediate medical care.

Medical Treatment

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.

Preventing Steam Burns and Other Scalds

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:

• Move all pot handles toward the center of the stove. Children can grab handles that stick out past the edge. They may also be bumped, causing hot liquid spills. This could cause scalds.
• Don't leave food on the stove unattended.
• Set timers when baking or roasting.
• Let food cool in the microwave before removing it.
• Open microwave containers carefully. Pull the lid off facing away from your body.
• Don't microwave baby bottles or anything in sealed containers. Make sure foods in the microwave can vent steam during cooking.
• Use only microwave-safe containers in the microwave.
• Keep kids out of the kitchen during hectic times.
• Don't let kids handle hot liquids.

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.

Summary

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 cause blisters and pain. When you inhale steam, it can cause serious breathing problems.

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.

Minor burns can be cared for at home. More serious burns may need to be treated at a burn center.

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.

A Word From Verywell

Steam is an underestimated cause of burns in all age groups. Kids and older adults are especially susceptible. Steam can be dangerous even in places that seem safe, such as a home sauna.

The most important thing you can do is to prevent burns from happening at all. Take your time and be aware that what you can't see can still hurt you. Move deliberately around hot objects. Take care when removing foods from the microwave. And don't let kids near steam-producing appliances without supervision.