Burn Injury from Hot Caramel: Healing or Complications?

After being burned by caramel, the affected area turned purple-red after taking medication for a period of time?

On February 14th, I burned the top of my foot with freshly made caramel and immediately rinsed it under cold water for about 10 minutes.
The next day, I visited a dermatologist, but the treatment was ineffective.
Because it didn't help, I went to the Veterans General Hospital to see a surgeon, who prescribed a topical ointment called "Burning Star." Since then, I have been regularly disinfecting and applying the ointment.
When I go out, I cover it with gauze, and when I return home, I let it breathe and apply the ointment three times a day.
However, recently, I have noticed purple bruising around the burn area, along with pus and some bleeding.
Is this a sign that it is healing or worsening? Additionally, the two small toes near the wound are not moving well...
(The burn is located centrally on the top of the foot, near the toes, and around the ankle, approximately the size of a one-dollar coin.)

Zhou, 20~29 year old female. Ask Date: 2016/02/22

Dr. Ke Fangxu reply Surgery

A scald from hot caramel is likely a third-degree burn.
Initially, using a burn ointment is the standard treatment protocol.
However, this ointment may produce a yellow-brown exudate, which is often mistaken for pus.
In reality, this is a phenomenon where the wound exudate mixes with the ointment.
The silver ions in the ointment combine with the proteins in the exudate to form a film, which, when mixed with blood, appears purplish-red covering the wound, resulting in the observed phenomenon.
This should be considered a normal part of the wound healing process.
A third-degree burn cannot heal within a week, so it is recommended that you visit the hospital for a check-up every two to three days.
Once the wound stabilizes, you can change the dressing on your own.

Reply Date: 2016/02/22

More Info

Burn injuries, particularly those caused by hot substances like caramel, can vary significantly in severity and healing time. In your case, it appears that you have sustained a burn that is likely at least a second-degree burn, given the symptoms you describe, including the presence of bruising, pus, and limited mobility in your toes.
First and foremost, it's crucial to understand the classification of burns. Second-degree burns typically affect both the outer layer of skin (epidermis) and the underlying layer (dermis). They can cause pain, redness, swelling, and blistering. In some cases, they may also lead to complications such as infection, which seems to be a concern in your situation given the presence of pus and bruising.

The immediate first aid you provided—cooling the burn with running water for about 10 minutes—was appropriate. This helps to reduce the temperature of the burn and can minimize tissue damage. However, after the initial treatment, ongoing care is essential for proper healing. The use of topical medications, such as the one prescribed to you (灼膚星), is common in managing burn wounds. These medications can help to prevent infection and promote healing.

However, the development of purple bruising and pus indicates that there may be an underlying issue, such as an infection or improper healing. The fact that you are experiencing limited mobility in your toes is also concerning. This could be due to swelling, pain, or even nerve involvement, especially if the burn is deep enough to affect the nerves in the area.

Here are some recommendations based on your situation:
1. Seek Medical Attention: Given the symptoms you are experiencing—particularly the bruising, pus, and limited mobility in your toes—it is essential to seek medical attention as soon as possible. An evaluation by a healthcare professional can determine if there is an infection or other complications that need to be addressed.

2. Wound Care: Continue to keep the wound clean and dry. If you notice increased redness, swelling, or discharge, these could be signs of infection. Change the dressing as recommended by your healthcare provider, and avoid using any products not specifically prescribed for your burn.

3. Pain Management: If you are experiencing significant pain, over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage discomfort. However, consult with your doctor before taking any medication, especially if you have other health conditions or are taking other medications.

4. Monitor for Changes: Keep an eye on the burn site for any changes. If the bruising spreads, the pain worsens, or you develop a fever, these are signs that you should seek immediate medical attention.

5. Physical Therapy: If the mobility in your toes does not improve, or if you experience stiffness, consider consulting a physical therapist. They can provide exercises and treatments to help restore movement and function.

In summary, while some bruising and discharge can occur during the healing process, the symptoms you describe suggest that you may be experiencing complications. It is vital to consult with a healthcare professional to ensure that your burn is healing properly and to prevent any long-term issues. Prompt and appropriate care is essential for optimal recovery from burn injuries.

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