Low-temperature burn

Low-temperature burn
Other names	Low-heat burn, low-temperature scald, slow contact burn
Specialty	Burn surgery / dermatology
Symptoms	Redness, blistering, deep dermal injury
Complications	Infection, delayed healing, hypertrophic scarring, contracture
Causes	Prolonged contact with moderately heated surfaces/devices
Risk factors	Elderly age, neuropathy, reduced sensation, use of heating devices during sleep
Treatment	Cooling, dressings, debridement, skin grafting

Low-temperature burn (also called low-heat burn or low-temperature scald) is a type of burn injury caused by prolonged contact of skin with a heat source of moderate temperature (often ~ 44–51 °C (111–124 °F)) for an extended period, rather than brief contact with very high temperature. These burns may appear superficially mild but often involve deeper dermal or subcutaneous tissue.

Signs and symptoms

Patients typically present with:

• Redness (erythema) of the skin initially
• Blister formation after a delay
• Possible deep dermal involvement even if the surface area looks small
• Pain may be less pronounced initially, especially in people with reduced sensation

Even when burns appear minor, they may be full-thickness injuries requiring medical attention.

Cause

Low-temperature burns occur when skin is in prolonged contact with a moderately heated object or surface. Common situations include:

• Using heating pads, hot water bottles, or electric blankets for warmth or pain relief
• Sitting or lying on heated cushions or floor heating devices (such as traditional radiant floors)
• Therapeutic heat treatments, like warm compresses or moxibustion

These burns usually occur in everyday home settings and are often accidental. The main risk arises when the heat source is left on the skin for a long time, especially for people with reduced sensation, such as the elderly or those with neuropathy.

Pathophysiology

The severity of thermal injury depends on both temperature and duration of exposure. Moderate heat may penetrate deeper tissues before visible skin changes appear, leading to underestimation of burn depth.

Diagnosis

Diagnosis is largely clinical, based on history of contact with a heated surface and examination of skin changes. Deep injury should be suspected even if surface signs appear minor. Imaging (ultrasound, MRI) or consultation with a burn specialist may be needed in uncertain cases.

Management

First aid

• Remove the heat source
• Cool the affected area with running cool (not ice-cold) water for 10–20 minutes
• Cover with a sterile, non-adhesive dressing

Medical and surgical care

Because these injuries often involve deep dermal tissue, surgical management may be required, including debridement, skin grafting, infection control, and rehabilitation.

Prevention

Preventive strategies for low-temperature burns focus on reducing prolonged skin contact with moderately heated surfaces or devices. Recommended measures include:

• Do not keep heating pads, hot water bottles, or electric blankets directly on the skin for a long time, especially while sleeping or if you have reduced sensation.
• Place a towel, cloth, or clothing layer between the device and your skin to prevent burns.
• Check the temperature and limit the time you stay in contact with heated devices.
• Make sure elderly individuals or people with neuropathy understand the risks of leaving heated items on their skin too long.

Epidemiology

Low-temperature burns are commonly reported in home settings. They are frequently associated with domestic heating devices and therapeutic heat applications. Hospital-based studies indicate that these burns account for a notable portion of contact-burn admissions, and delayed recognition of injury is common because the skin may appear superficially normal.

See also

• Burn
• Thermal injury
• Contact burns
• Skin graft
• First aid