An Overview of Steam Burns

Symptoms, Diagnosis, Treatment, and Prevention

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Steam burns are a form of thermal burns caused by boiling hot water vapor. Scalds are thermal burns caused by hot liquid, but the liquid may or may not be hot enough to reach boiling point. According to the Centers for Disease Control and Prevention (CDC), steam burns and scalds cause between 33 to 58 percent of all patients who are hospitalized for burns in the United States.

Steam burns can occur in people of all age groups, but children, elderly people, and patients with certain medical conditions are at a higher risk. Steam burns can affect all exposed surface areas of the body which includes the skin, mucous membranes of the respiratory tree, and eyes.

Learn more about the symptoms, diagnosis, prevention, and treatment of steam burns, as well as the specific steps to take after sustaining a burn.

Steps to take after a steam burn
Illustration by Emily Roberts, Verywell.

Symptoms

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

  • redness.
  • swelling.
  • pain.
  • blisters.
  • sloughing (shedding) of the skin.
  • leaking fluid from injured areas.

Steam burns can lead to complications when the steam is inhaled into the respiratory system or comes into contact with the eyes. These complications can lead to additional symptoms including shortness of breath, coughing, wheezing, difficulty swallowing, and blindness.

Causes

When water reaches boiling point (212 degrees Fahrenheit) and turns to steam, this results in super-heated molecules that can cause nearly instantaneous scalding if they come into contact with body tissues.

Steam is more likely to cause burn injuries than boiling water because of the latent heat of vaporization.

Since water expands to approximately 1,600 times its volume when it turns from liquid to steam, steam often escapes its container when under pressure. It can emerge in a directed stream that can cause additional injury. Indeed, many household appliances count on this phenomenon to work: teapots, steam irons, vaporizers, among others.

As a vapor, steam is easily inhaled and the super-heated molecules can travel deep into the upper respiratory system. Vaporizers are particularly dangerous, especially for children, and have no evidence to support their use in treating respiratory infection or shortness of breath.

Risks for Children

Kids are more likely to put their hands or faces directly in the stream of escaping steam from an appliance, resulting in a steam burn of exposed skin. Kids are also more likely to develop epiglottitis during direct inhalation of steam. Epiglottitis is a potentially fatal condition where tissue forms around the windpipe.

Household Appliances

Microwave ovens use dielectric heating—radio waves agitate water molecules in food, which generates heat. The water molecules can turn to steam and expand, causing ruptures in solid foods. That's why solid foods sometimes "pop" in the microwave, including popcorn kernels.

One study identified eight patients who were injured by steam burns from exploding potatoes and eggs coming out of microwave ovens. In another case, a patient sustained an eye injury while opening a bag of microwave popcorn.

Patients with conditions that can lead to sudden losses of consciousness, such as syncope or seizures, are more likely to develop burns from all household appliances, including steam-generating appliances.

Diagnosis

Identifying steam burns requires obtaining an accurate history of the incident as well as identifying the actual burn. Burns are categorized on a sliding scale of severity based on the size of the burned surface area and how much of the skin's thickness is affected by the burn (called the "degree" of the burn). Classifications are either first, second, or third-degree burns.

First-degree burns are identified by their redness and lack of blisters. A mildly red burn means that only the top layer of the skin (the epidermis) is injured. A second-degree burn occurs when the epidermis is completely damaged and the burn injury extends into the next layer, the dermis. In most cases, a second-degree burn leads to separation of the top two layers of skin and weeping of fluid from the raw dermis underneath.

This loss of fluid pushes the epidermis up, causing a blister. In steam burns, the blister pattern of a second-degree burn is often made up of very small individual blisters compared to other burn causes.

There are no documented cases of third-degree burns from steam injuries or scalds. The heat energy in water does not last long enough to develop third-degree burns after exposure.

Treatment

There are immediate steps to after a steam burn is sustained to the skin.

Steps to Take After a Steam Burn

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

Remove the Threat

The most important treatment step for any burn injury is to eliminate cause for any further injury (whether you are the one who has sustained a steam burn or you are helping someone who has). The first step is to turn off the source of the heat.

Stop the Process

The second step is to stop the burning process by running cool tap water over burned areas until the area is cool to the touch (even if the patient feels relief before this). The cool water reduces the temperature of burn injuries. It might take flushing the area with cool water for up to twenty minutes to completely stop the burning process and make sure the patient is not going to get worse.

Cover and Transport

Next, cover the burn injuries with a dry, sterile dressing.

Finally, in cases where the total burn injury is larger than 9 percent of the entire body (see the Rule of Nines), the patient needs to be transported by ambulance to a burn center. Call 911 if the steam burn or scald includes the patient's face, entire hand, entire foot, or genitalia.

If the patient does not need an ambulance, take the following short-term treatment steps after a steam burn is sustained:

  1. keep the injury covered in a dry, sterile dressing. Change these daily and maintain the dressings for at least 10 days until the injured area appears to be healing and the patient can tolerate exposure to air.
  2. take over-the-counter (OTC) pain medication for pain control.
  3. if the injured area develops signs of infection, contact a physician immediately.
  4. in cases where the patient did not seek medical treatment but becomes short of breath at any time after a steam injury, call 911 immediately. Steam in the throat can lead to swelling in the airway hours later.

If the patient requires immediate treatment for her injuries, the hospital may send her to a burn center. Treatment at a burn center could include debridement (scrubbing away dead tissue) to reduce scarring as well as intravenous pain medication. Patients may be hospitalized for two to three weeks in a burn center.

Prevention

The most common area of the house for any type of burn injury—especially a steam burn or scald—is in the kitchen. Cooking has the most inherent risks due to the use of heat. Taking the proper precautions can mean the difference between enjoying a family dinner and going to the hospital with a burn.

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

  • move all handles toward the center of the stove. Handles sticking out (toward the cook) can easily get caught on someone passing by, or can be reached by a small child, resulting in spillage of hot liquids and 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 by pulling off the lid facing away from your body.
  • don't microwave baby bottles or anything in sealed containers. Make sure foods in the microwave are capable of venting steam during cooking. Only use approved containers in the microwave.
  • keep kids out of the kitchen during hectic times.
  • don't let kids handle hot liquids.

Besides the kitchen, there are other areas of the home where scalds and steam burns can occur. Use caution in the bathroom, the laundry area, and the bedrooms as well.

It is advisable not to use a vaporizer or steam humidifier. There's no evidence of health benefits, and they can cause steam burns of skin and inside the airways.

Set water heaters to 120 degrees Fahrenheit. Any higher temperatures can more easily lead to scalds. Keep bath water to about 100 degrees Fahrenheit for small children. Any hotter, and scalds will become more likely to occur.

A Word From Verywell

Steam is an underestimated cause of burns in all age groups, but kids and older adults are especially susceptible. It 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 especially, don't let kids around steam-producing appliances unattended.

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Article Sources
  • Al Himdani S, Javed MU, Hughes J, et al. Home remedy or hazard?: management and costs of pediatric steam inhalation therapy burn injuries. Br J Gen Pract. 66(644):e193-9. DOI: 10.3399/bjgp16X684289

  • Bagirathan S, Rao K, Al-Benna S, O'Boyle CP. Facial burns from exploding microwaved foods: Case series and review. Burns. 2016 Mar;42(2):e9-e12. DOI: 10.1016/j.burns.2015.02.014

  • Kudchadkar SR, Hamrick JT, Mai CL, Berkowitz I, Tunkel D. The heat is on...thermal epiglottitis as a late presentation of airway steam injury. J Emerg Med. 46(2):e43-6. DOI: 10.1016/j.jemermed.2013.08.033

  • Ansari Z, Brown K, Carson N. Association of epilepsy and burns - a case control study. Aust Fam Physician. 37(7):584-9.

  • Morris AM, Rai S. Sauna bath burn. Br Med J. 1(6117):894-5.