Put the burn under the nearest running tap straight away and keep it there for 20 minutes. Ordinary tap water is exactly right — do not lose seconds looking for colder water. Take off clothing over the area, or pour the water over the clothes if a large area is burned. No ice, turmeric, egg white or ointment.
How does a chai scald happen?
You are having a well-deserved cup of hot chai after a long, hard day at work. The phone or the doorbell rings, and you get up to answer it. Absentmindedly, you leave the cup at the edge of the table with the handle jutting out.
Just then your toddler comes along, sees a nice, attractive, colorful object, reaches up and pulls at the handle. The hot liquid scalds him, and it follows a typical pattern: the palm, the inner aspect of the forearm and the arm, and the side and front of the chest, or some variation of it.
I see this fairly commonly in the children who come to me at Nathani Clinic in Chembur, Mumbai. It is the most common burn injury I treat in the one to two-year age group, and almost every one of them was preventable.
What do I do in the first 20 minutes?
- Do not panic: this is the hardest instruction on the list, and the most important. I want you to read this before it happens, which is exactly why I wrote it.
- Get the burn under the nearest running tap: do it now, not in a minute, and keep the water running over the burned area for 20 minutes. This cools the tissue and stops the burn from going deeper.
- Remove clothing over the burn: take it off before you start. If a large area is burned, do not stop to undress the child — pour the water over the clothes.
- Cover it loosely: a sterile dressing if you have one. Never use cotton wool or any material that sheds lint into the wound.
- Then have it seen: if the burn is significant, go straight to a specialized burns center. If it is not, your pediatrician or pediatric surgeon can assess it.
Does the water have to be cold?
No. It has to be running, it has to start now, and it has to go on for 20 minutes. Ordinary tap water in a Mumbai home is cool enough, and that is all the burn needs.
Do not send anyone to the fridge and do not stop to look for ice. Every second the burn is not being cooled, it is still burning, and the time lost hunting for colder water does more harm than the few degrees ever gain.
If the only tap that runs in your house runs hot, use whatever stored water you have — a bucket, a filled jug, the water drum — and keep pouring it over the area steadily for the full 20 minutes.
Should I put ice on a burn?
No, ice increases the pain and can damage the tissue further. Water straight from the tap is what you want — not iced water, not an ice pack, not anything from the freezer.
Does turmeric or egg white help a burn?
No, and both make things worse. Turmeric, egg white, toothpaste, butter, oil, and the various household pastes all do the same two things: they add nothing useful, and they coat the wound so that the doctor cannot see how deep the burn actually is.
A fresh burn does not need protecting from germs in the first hour. It needs cooling. Anything you put on it has to be cleaned off later, and cleaning it off hurts the child a second time.
How do I tell whether the burn is serious?
Three things decide it: how much area was burned, what caused the burn, and the location of the burn.
- Area: More than 10% of the body surface is a significant burn. As a rough guide, the area covered by the child’s own hand, fingers included, is about 1% of that child’s body surface.
- Cause: chemicals, acids, direct flame, or any burn with smoke inhalation — all of these are far more serious than a scald from hot liquid.
- Site: the hands, the feet, across a joint, the face or the genitals — these need special care, however small the area looks.
What happens when your pediatric surgeon sees the child?
I assess the depth and the area, clean the wound, and dress it. Most chai scalds in toddlers affect partial thickness and heal well if proper cooling occurs in the first few minutes — which is why the tap plays a more crucial role than anything that happens afterwards.
I will also check whether a tetanus booster is due. A scald does not count as a dirty wound in the usual sense, but you should still bring a child whose schedule has slipped up to date.
How do I stop this happening at all?
- Turn every handle — cup, pan, kettle — inwards, away from the edge.
- Keep hot drinks off low tables and off the arm of a sofa. A cup of tea stays hot enough to scald a child for about fifteen minutes.
- Do not carry a hot drink and a child at the same time.
- Keep the kettle and its cord well back on the counter.
- Do not let a toddler near the kitchen while cooking is going on — a gate or a closed door beats supervision on a busy evening.
- Have the number and address of your nearest burn center written on your emergency contact list. Do it tonight, not on the night you need it.
What about Diwali burns?
Diwali brings a unique set: firecracker burns, diya and oil-lamp burns, and burning clothing. The first aid for the skin is the same — the nearest running tap, for 20 minutes, and nothing else on the wound — but any burn involving flame, smoke or the face should go to a burns center rather than to me first.
There is more on keeping the festival safe in have a fun Diwali, but be safe.
When to go straight to casualty or a burns center
- The burn covers over 10% of the body — over ten times the size of the child’s own hands.
- It was caused by flame, a chemical, an acid, or there was smoke.
- It is on the face, the hands, the feet, the genitals, or across a joint.
- The skin is white, leathery or charred, or the child does not feel it being touched.
- The child is under one year old.
- The child is drowsy, breathing oddly, or you simply cannot settle him.
Call the clinic: 98676 94813 · WhatsApp the clinic: +91 22 4006 0134. If it is one of the above emergencies, do not wait for us — go to the nearest burns center or Casualty.
Written by Dr. Rajesh Nathani, pediatric surgeon, in practice since 1989, Nathani Clinic, Chembur, Mumbai. Reviewed September 2026.