Answering the Question: What is Burn Cream Made Of?

October 7, 2025 •

4 min read

In the United States, there are approximately 450,000 burn injuries that require medical treatment each year [1.8.2]. For many of these injuries, topical creams are a first line of defense, but what is burn cream made of to make it effective?

Quick Summary

Burn creams are composed of a vehicle base, like petrolatum, and active ingredients. Prescription versions often use antimicrobials like silver sulfadiazine, while OTC options may contain antibiotics like bacitracin and pain relievers.

Key Points

Two Main Components: Burn creams consist of an inactive base (like petrolatum) and active medicinal ingredients [1.7.1].
Prescription Strength: Severe burns are often treated with prescription creams containing powerful antimicrobials like Silver Sulfadiazine or Mafenide Acetate to prevent sepsis [1.2.5, 1.6.3].
OTC Options: Over-the-counter creams for minor burns typically use antibiotics like Bacitracin and Neomycin, and often include pain relievers like Lidocaine [1.11.2, 1.4.1].
Silver Sulfadiazine: A common prescription ingredient, it combines silver and a sulfa drug to act on the bacterial cell wall and membrane [1.5.5].
Base Function: The cream's base acts as a vehicle for the active ingredients and provides a moist, protective barrier over the wound [1.7.1, 1.3.1].
Natural Ingredients: Some products incorporate natural ingredients like Aloe Vera and medical-grade honey for their soothing, healing, and antibacterial properties [1.9.1, 1.10.1].
Pain Relief: Anesthetics such as Lidocaine are frequently included in OTC burn creams to temporarily numb pain and reduce discomfort [1.4.2].

Understanding Burn Cream Composition

Burn creams are specialized topical treatments designed to prevent infection, soothe pain, and create a moist environment conducive to healing for skin damaged by thermal, chemical, or electrical injuries [1.4.2, 1.6.4]. Their formulation is a sophisticated blend of two primary types of components: a base (or vehicle) and one or more active ingredients [1.7.1]. The base provides the substance of the cream and helps deliver the medication, while the active ingredients perform the therapeutic work, such as fighting bacteria or numbing pain [1.4.2]. The specific composition varies significantly between prescription-strength medications used for severe burns and over-the-counter (OTC) products intended for minor burns [1.4.2, 1.2.5].

The Dual Components: Base and Active Ingredients

A burn cream's effectiveness relies on the synergy between its components.

The Base (Vehicle): This is the non-medicinal foundation of the cream. Common base ingredients include white petrolatum, lanolin, stearyl alcohol, propylene glycol, and water [1.2.1, 1.3.1]. These substances create an emollient, often greasy, semi-solid preparation that is easy to spread [1.7.2, 1.2.1]. The base serves several critical functions: it acts as a carrier for the active ingredients, provides a protective, occlusive layer to prevent moisture loss, and keeps the wound hydrated, which can help reduce scarring [1.11.4, 1.7.1]. Creams are typically emulsions of oil and water, which makes them less greasy and more easily washed off than ointments [1.7.3, 1.2.1].
Active Ingredients: These are the pharmacologically active substances that target specific aspects of the burn injury. They can be broadly categorized into antimicrobials, antibiotics, pain relievers, and skin protectants. The choice of active ingredient depends on the severity and type of the burn [1.3.3].

Active Ingredients in Prescription Burn Creams

For second and third-degree burns, doctors often prescribe powerful antimicrobial creams to prevent or treat serious infections, which are a major risk in severe burn cases [1.2.5].

Silver Sulfadiazine

For decades, 1% silver sulfadiazine cream (often known by the brand name Silvadene) has been a mainstay in burn care [1.2.5]. Each gram of the cream contains 10 mg of micronized silver sulfadiazine [1.2.1]. This compound combines the antibacterial effect of the sulfonamide antibiotic with the antimicrobial action of silver [1.2.2]. It has a broad spectrum of activity, proving bactericidal against many gram-positive and gram-negative bacteria, as well as yeast like Candida albicans [1.2.1, 1.5.4]. Its mechanism involves acting on the bacterial cell membrane and cell wall to kill the pathogen [1.5.5]. While highly effective, it can have side effects, including transient leukopenia (a drop in white blood cells) and potential allergic reactions in those with sulfa allergies [1.2.2]. It can also form a pseudo-eschar, which can sometimes make it difficult to assess the underlying wound [1.2.2].

Mafenide Acetate

Another common prescription agent is Mafenide acetate (brand name Sulfamylon) [1.6.3]. This topical antimicrobial is particularly effective at penetrating the tough, dead tissue of a burn eschar [1.2.2]. It is a carbonic anhydrase inhibitor with a broad antibacterial spectrum [1.2.2]. Unlike silver sulfadiazine, it is available as a cream or a solution for application [1.6.2]. A notable side effect is that it can cause significant pain or a burning sensation upon application [1.6.3, 1.2.2].

Common Over-the-Counter (OTC) Ingredients

For minor first-degree burns and some superficial second-degree burns, OTC products are widely available. These typically focus on preventing infection in minor wounds and providing pain relief [1.4.2].

Topical Antibiotics: Many OTC ointments are triple-antibiotic formulas containing Bacitracin, Neomycin, and Polymyxin B [1.3.4, 1.11.2]. Bacitracin works by stopping bacterial growth, while the combination found in products like Neosporin can also kill existing bacteria [1.11.1]. Some people may have an allergic reaction to neomycin, in which case a single-antibiotic bacitracin ointment may be a better choice [1.11.1].
Pain Relievers: To soothe the pain of a minor burn, many creams include a topical anesthetic. Lidocaine is a common active ingredient used for this purpose [1.4.2, 1.4.1]. It provides temporary relief from pain and itching [1.4.4].
Skin Protectants & Natural Ingredients: Petrolatum and lanolin not only act as a base but are also considered skin protectants that help hold in moisture [1.3.1]. Many products also incorporate aloe vera for its soothing and moisturizing properties [1.4.2]. Studies have shown that topical aloe vera can significantly accelerate healing time for second-degree burns [1.9.1]. Additionally, medical-grade honey is gaining acceptance for its natural antibacterial, anti-inflammatory, and wound-healing properties [1.10.1, 1.10.2].

Comparison Table: Prescription vs. OTC Burn Creams


Feature	Prescription Burn Creams	Over-the-Counter (OTC) Burn Creams
Primary Use	Moderate to severe (2nd/3rd degree) burns [1.2.5]	Minor (1st degree) burns, cuts, and scrapes [1.4.2]
Key Active Ingredients	Silver Sulfadiazine, Mafenide Acetate [1.2.5, 1.6.3]	Bacitracin, Neomycin, Polymyxin B, Lidocaine [1.3.4, 1.4.1]
Mechanism of Action	Potent, broad-spectrum antimicrobial action to prevent sepsis [1.2.1, 1.2.2]	Prevents infection in minor wounds and provides pain relief [1.11.3, 1.4.2]
Availability	Requires a doctor's prescription [1.6.2]	Available at drugstores and supermarkets [1.4.5]
Example Brands	Silvadene, Sulfamylon [1.2.2, 1.6.3]	Neosporin, Polysporin, various first-aid brands [1.11.2, 1.4.1]

Conclusion: Tailored Formulations for Healing

In summary, what a burn cream is made of depends entirely on its intended purpose. Prescription creams used in hospital burn units are powerful antimicrobial agents like silver sulfadiazine, formulated in a cream base to fight life-threatening infections in severe burns [1.2.5]. In contrast, the creams and ointments in a home first-aid kit use a combination of topical antibiotics and anesthetics to protect minor wounds and ease pain [1.4.2]. From complex silver compounds to soothing aloe vera, each ingredient is chosen for the specific role it plays in protecting damaged skin and promoting a safe healing process. For any burn more severe than a minor, superficial injury, it is crucial to seek professional medical evaluation.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a healthcare professional for the diagnosis and treatment of burns.

American Burn Association

Frequently Asked Questions

The main active ingredient in Silvadene cream is 1% silver sulfadiazine, a potent antimicrobial agent used to prevent infection in second and third-degree burns [1.2.1, 1.2.5].

Ointments are typically semi-solid and oil-based (e.g., petroleum jelly), making them greasy and occlusive [1.7.2]. Creams are emulsions of oil and water, making them less greasy and easier to wash off [1.7.3, 1.2.1].

Yes, products like Neosporin, which contain the antibiotics bacitracin, neomycin, and polymyxin B, are often used to help prevent infection in minor cuts, scrapes, and burns [1.11.1].

Mafenide acetate cream is known to sometimes cause pain or a burning sensation upon application [1.6.3]. This is thought to be related in part to the high osmolarity of the cream formulation [1.6.5].

Yes, studies have shown that topical aloe vera can be effective for burn wound healing. A meta-analysis found that for second-degree burns, aloe vera treatment resulted in significantly faster healing times compared to other treatments [1.9.1].

Many over-the-counter burn creams contain a topical anesthetic to relieve pain. A common active ingredient used for this purpose is lidocaine [1.4.2, 1.4.1].

Medical-grade honey, such as Manuka honey, is sterilized honey used in wound dressings. It helps heal burns through its natural antibacterial, anti-inflammatory, and antioxidant properties, and it creates a moist healing environment [1.10.1, 1.10.3].