Chemical Burns

What is a chemical burn?

A chemical burn is damage to tissue on your body due to a harsh or corrosive substance. You can get chemical burns on your skin, eyes or inside of your body. Most chemical burns are the result of accidentally spilling a chemical on yourself. But it’s also possible to swallow chemicals or get exposed to them in other ways.

Chemical burns range from mild to severe. Mild chemical burns usually heal quickly, but severe chemical burns can cause permanent tissue damage, scarring or death. Chemical burns require immediate medical treatment.

Who’s at risk for chemical burns?

Anyone who works with chemicals is at risk for chemical burns, including:

• Construction workers.
• Factory workers.
• Farmers.
• Laboratory technicians.
• Mechanics.
• Military personnel.
• Plumbers.

It’s important to note that children (especially toddlers) are at a high risk for burns caused by household chemical products. They may accidentally touch or swallow detergents, bleach or cleaning products.

How common are chemical burns?

Between 2005 and 2014, about 3% of all adults admitted to burn centers in the U.S. had chemical burns. One study shows that, over a 17-year period, about 40,000 children (or 2,300 children per year) were admitted to the emergency department with a chemical burn from a household cleaning product.

What causes chemical burns?

When harsh chemicals come into contact with your skin, eyes or any tissue in your body, they can destroy cells. The damage may go past the superficial layers of skin or tissue and cause deep damage. Chemical burns can be far more serious than thermal (heat) burns. Chemicals often stay on your skin for long periods of time, eating away at your tissue.

There are a lot of substances that can cause chemical burns. Some of the most common include:

• Battery acid.
• Bleach.
• Detergents.
• Drain cleaners.
• Fertilizers.
• Hair relaxers.
• Metal cleaners and rust removers.
• Paint removers.
• Pesticides.
• Sanitizers and disinfectants.
• Swimming pool chemicals.
• Toilet bowl cleaners.
• Wet cement.

What are the symptoms of chemical burns?

Chemical burns on your skin may cause:

• Blisters or scabs.
• Cracked, dry skin.
• Pain.
• Peeling skin.
• Redness.
• Skin discoloration.
• Swelling.

Chemical burns in your eyes may cause:

• Blurry vision.
• Eyelid swelling.
• Pain.
• Redness.
• Stinging or burning.
• Watery eyes.
• Blindness (in severe cases).

Chemical burns from ingestion (swallowing) may cause:

• Chest pain.
• Cough.
• Difficulty speaking (dysphonia).
• Drooling.
• Hoarseness.
• Low blood pressure (hypotension).
• Nausea and vomiting, or vomiting blood.
• Pain in your mouth or throat (especially when swallowing).
• Perforations (holes) in your stomach, esophagus (the tube connecting your stomach and throat) or cornea (the outermost lens of your eye).
• Shortness of breath (dyspnea).
• Upper airway swelling (edema).

How are chemical burns diagnosed?

Your healthcare provider can usually diagnose chemical burns on your skin by examining the size, depth and other characteristics of the burn. They may also use other tests to diagnose burns on your skin or in your eyes or from swallowing a chemical, including:

• Blood tests: Swallowing chemicals can affect how your organs work. You can also absorb chemicals in your body through your skin or eye burns. Your healthcare provider may do a complete blood count (CBC) and other lab tests to check your kidney, liver, lung and metabolic function for any type of chemical burn.
• Endoscopy: If you swallow a chemical, you may need an endoscopic evaluation. During an upper endoscopy, your healthcare provider uses a thin, flexible tube with a video camera on one end (endoscope). They guide the tube into your mouth and down your esophagus. Pictures of your throat, esophagus and stomach appear on a video monitor. They can check for burn damaged tissue.
• Eye exam: An ophthalmologist or optometrist (eye care specialist) examines chemical burns to your eyes. They’ll likely flush your eyes out with water. Then, they’ll check for signs of vision loss and examine the depth of the burn. They may also put a special dye into your eye to look for areas of damaged tissue.
• Imaging: Imaging exams help identify damage inside of your body from swallowing a chemical, especially perforations in your esophagus or stomach. You might receive a chest X-ray or CT (computed tomography) scan, which can help spot internal tissue damage.

How are chemical burns treated?

Chemical burns require immediate treatment. Call 911 and then:

• Remove clothing: Use gloves to protect your hands. Cut away any clothing contaminated with the chemical. You want to prevent it from touching other areas of your body.
• Remove the chemical: Still wearing gloves, brush away any remaining dry traces of the chemical, but don’t wipe the chemical away. Wiping can spread it to other areas of your skin.
• Rinse with water: Rinse the burned area of your skin or eyes with cool water. Continue rinsing for at least half an hour, as chemicals can continue damaging your skin after contact. Try to keep the contaminated water from touching other parts of your skin. Certain chemicals should not be rinsed with water, including carbolic acid or phenol, sulfuric acid, dry powders and metal compounds.
• Drink water: If you swallowed a chemical substance, drink water to dilute it in your stomach. Don’t take anything to make yourself vomit. Vomiting a chemical substance can cause more damage as it comes back up through your esophagus.

Then, get to a hospital. The American Burn Association recommends that anyone with a chemical burn should seek care at a burn center or call the National Poison Control Hotline (1-800-222-1222) immediately for information on treatment. A burn center is a unit of a hospital dedicated to burn treatment. If you go to the emergency department, they may refer you to a burn center.

Once you arrive at the hospital, your healthcare team will:

• Evaluate the severity of your burn.
• Continue rinsing your burn.
• Give you pain relievers if you’re uncomfortable.
• Apply antibiotics to your skin to prevent infection. Or, they’ll give them to you through a vein in your arm.
• Apply a dry dressing or bandage to mild or moderate burns.

If you have a severe burn, you may need surgery to remove the burned portion of your skin. Some people need a skin graft. A surgeon takes healthy skin from elsewhere on your body and attaches it to the burned area. Surgery can also repair perforations in your gastrointestinal tract.

Are chemical burns preventable?

Reduce your risk of chemical burns by taking the proper safety precautions:

• Find alternative products to use that aren’t as harsh.
• Keep chemicals stored in their protective containers.
• Know what chemicals you’re working with and their risks.
• Store chemicals in a secure place, not accessible to children.
• Wear protective clothing or equipment such as gloves, goggles and face shields.

What’s the prognosis (outlook) for people with chemical burns?

Most mild chemical burns heal without leaving permanent scars. However, long-term effects of severe chemical burns may include:

• Cancers of your skin, stomach or esophagus.
• Esophageal strictures (narrowed esophagus, sometimes due to scarring).
• Perforations (holes) in your stomach, esophagus or cornea.
• Scars.
• Skin discoloration.
• Vision loss.

When should I contact my doctor about a chemical burn?

Seek help right away for any type of chemical burn. If you have a burn that’s healing, contact your doctor if the burn:

• Causes severe pain.
• Has yellow or green discharge.
• Is getting worse.
• Looks infected.

What questions should I ask my doctor?

You may want to ask your healthcare provider:

• Are there any risks of long-term complications from a chemical burn?
• How can I reduce the risk of infection and scarring as the chemical burn heals?
• How severe is the chemical burn?
• How can I reduce my risk of getting a chemical burn in the future?

A note from Cleveland Clinic

Chemical burns can happen if you work with chemicals or other harsh substances for your job. People, especially children, can also get chemical burns if they accidentally touch or swallow certain household chemicals. You should seek medical attention from your healthcare provider for any chemical burn, even if it seems mild. Unlike heat burns, chemical burns can continue causing tissue damage even after you come into contact with them. Immediate treatment is essential to prevent scarring or complications.