Which antibiotic cream is good for burns? A Guide to Treatment

Approximately 450,000 burn injuries in the United States require medical treatment each year [1.3.2]. When treating minor burns at home, the question often arises: which antibiotic cream is good for burns to prevent infection and promote healing?

Quick Summary

Selecting the right antibiotic cream for a burn depends on its severity. OTC options like Bacitracin or Neosporin are for minor burns, while prescription creams like silver sulfadiazine are for more severe cases.

Key Points

• Identify Severity: First, determine if the burn is first, second, or third-degree as this dictates the treatment approach [1.8.4].

• OTC for Minor Burns: For minor burns, use over-the-counter antibiotic ointments like Bacitracin or Neosporin to prevent infection [1.2.2].

• Prescription for Severe Burns: Severe second and third-degree burns require prescription creams like Silver Sulfadiazine (Silvadene) [1.4.3].

• Allergy Awareness: Be aware of potential allergies, especially to neomycin, an ingredient in triple antibiotic ointments like Neosporin [1.5.5].

• Proper Application is Key: Always clean the burn with mild soap and water before applying a thin layer of cream and covering it with a sterile bandage [1.7.3].

• When to See a Doctor: Seek immediate medical attention for third-degree burns, second-degree burns larger than 3 inches, or burns on sensitive areas [1.8.4].

• Pain Relief: Some burn relief formulas, like specific Neosporin products, contain pain-relieving ingredients such as pramoxine HCl [1.2.1].

Understanding Burn Severity

Before choosing a treatment, it's crucial to identify the burn's severity. Burns are classified into three main degrees [1.8.4, 1.2.5].

• First-Degree Burns: These are the least severe, affecting only the outer layer of skin (epidermis). They cause redness, minor pain, and swelling. A common example is a mild sunburn [1.8.4, 1.2.5].
• Second-Degree Burns: These burns affect both the epidermis and the second layer of skin (dermis). They are characterized by blisters, severe pain, and red or splotchy skin [1.8.4, 1.8.5].
• Third-Degree Burns: The most severe, these burns destroy both layers of skin and may damage underlying tissues, fat, and even nerves. The skin may appear white, black, or charred, and there might be numbness instead of pain [1.2.5, 1.8.4].

Any second-degree burn larger than three inches, or any third-degree burn, requires immediate medical attention [1.8.4]. You should also see a doctor for any burns on the hands, feet, face, groin, or a major joint [1.8.1].

Over-the-Counter (OTC) Antibiotic Creams for Minor Burns

For first-degree and small second-degree burns, over-the-counter antibiotic ointments can be used to prevent infection and keep the wound moist, which aids healing [1.2.3, 1.7.5]. Popular options include Bacitracin, Neosporin, and Polysporin [1.2.2].

Bacitracin

Bacitracin contains a single antibiotic that works by stopping the growth of bacteria [1.5.2]. It's a good option for people with allergies to ingredients found in combination ointments [1.2.3].

Neosporin (Triple Antibiotic Ointment)

Neosporin contains three antibiotics: bacitracin, neomycin, and polymyxin B [1.2.5]. This combination not only stops bacterial growth but can also kill existing bacteria, offering broader protection [1.5.1]. However, neomycin is a common allergen, so individuals with sensitive skin should be cautious [1.5.5]. Some Neosporin formulations also include a pain reliever like pramoxine hydrochloride [1.2.1].

Polysporin (Double Antibiotic Ointment)

Polysporin contains bacitracin and polymyxin B but omits neomycin [1.2.3]. This makes it a suitable alternative for those with a neomycin allergy who still want broader coverage than single-antibiotic bacitracin [1.2.5].

Prescription Antibiotic Creams for Severe Burns

Severe burns, particularly second and third-degree ones, are often treated with prescription-strength topical antibiotics to prevent life-threatening infections [1.4.1].

Silver Sulfadiazine (Silvadene)

Silver sulfadiazine is a powerful antibacterial cream widely used for second and third-degree burns [1.4.3, 1.2.3]. It works by killing a broad spectrum of bacteria and stopping their growth [1.4.1]. It is available only by prescription and should be used exactly as directed by a doctor [1.4.3]. This cream must be applied continuously to keep the burn covered, and it is not recommended for pregnant women or infants under two months old [1.4.4, 1.2.2]. Some research suggests it might slow wound healing, so its use should be discussed with a healthcare provider [1.4.2, 1.4.6].

Mafenide Acetate (Sulfamylon)

Mafenide acetate is another prescription antibiotic used to prevent infection in severe burn wounds [1.6.5]. It is effective at penetrating dead skin (eschar) and has a wide spectrum of antimicrobial activity [1.6.4]. It is typically applied once or twice a day [1.6.2]. A common side effect is a burning sensation or pain upon application [1.6.2].

Comparison of Common Burn Creams

Cream	Type	Active Ingredient(s)	Best For	Considerations
Bacitracin	OTC	Bacitracin [1.5.3]	Minor burns, cuts, and scrapes	Good for those with neomycin allergies; only stops bacterial growth [1.5.2].
Neosporin	OTC	Bacitracin, Neomycin, Polymyxin B [1.2.5]	Minor burns, cuts, and scrapes	Kills existing bacteria and stops growth [1.5.1]; higher risk of allergic reaction to neomycin [1.5.5].
Polysporin	OTC	Bacitracin, Polymyxin B [1.2.5]	Minor burns, cuts, and scrapes	Alternative for those with neomycin allergies [1.2.5].
Silver Sulfadiazine	Prescription	Silver Sulfadiazine [1.4.3]	Second and third-degree burns [1.4.3]	Broad-spectrum antibacterial [1.4.1]; can slow healing [1.4.2]; not for infants or pregnant women [1.2.2].
Mafenide Acetate	Prescription	Mafenide Acetate [1.6.1]	Severe burns [1.6.5]	Penetrates eschar [1.6.4]; may cause pain/burning on application [1.6.2].

How to Properly Apply Antibiotic Cream

Proper wound care is essential to prevent infection and ensure proper healing.

1. Wash Hands: Always wash your hands thoroughly before treating a burn [1.7.2]. Wearing sterile gloves is recommended for severe burns [1.4.3].
2. Cool the Burn: For minor burns, run cool (not cold) water over the area for several minutes [1.8.4]. Do not use ice [1.7.2].
3. Clean the Area: Gently wash the burn with mild soap and water to remove any debris [1.7.3]. Pat the area dry with a clean cloth [1.7.2].
4. Apply Ointment: Apply a thin layer of the antibiotic ointment to the burn [1.7.5]. This keeps the wound moist and prevents infection [1.7.3]. The ointment also helps prevent a bandage from sticking to the skin [1.7.3].
5. Cover the Burn: Use a sterile, non-stick dressing or bandage to cover the burn loosely [1.7.3, 1.7.2].
6. Reapply: Change the dressing and reapply the cream once or twice daily, or whenever the dressing gets wet or dirty [1.7.3].

Conclusion

Choosing the right antibiotic cream depends on the burn's severity. Over-the-counter options like Bacitracin and Neosporin are suitable for minor first-degree and small second-degree burns to prevent infection [1.5.2]. For more severe second and third-degree burns, a healthcare professional must be consulted; they will likely prescribe a stronger cream like Silver Sulfadiazine or Mafenide Acetate to manage the high risk of infection [1.4.3, 1.6.5]. Always clean a burn properly before applying any cream and seek medical attention for any major burn or if signs of infection appear [1.8.1].

For more detailed information on burn care, consult a healthcare professional or visit an authoritative source like the American Burn Association.

Frequently Asked Questions

Should I put Neosporin on a burn?

Yes, you can use Neosporin for minor, uncomplicated first-degree or small second-degree burns to help prevent infection [1.2.5, 1.5.2]. For severe burns, you should seek medical care.

Is silver sulfadiazine cream better than Neosporin for burns?

Silver sulfadiazine is a prescription cream used for more severe second and third-degree burns, while Neosporin is an over-the-counter ointment for minor burns [1.2.4]. They are intended for different levels of burn severity.

What is the difference between Bacitracin and Neosporin for burns?

Bacitracin contains one antibiotic that stops bacterial growth. Neosporin contains three antibiotics that both stop growth and kill existing bacteria, offering broader protection but also carrying a higher risk of allergic reaction to one of its ingredients, neomycin [1.5.1, 1.5.5].

Can I use antibiotic cream on a sunburn?

For a mild sunburn (a first-degree burn), treatments like aloe vera are typically recommended [1.4.2]. If a sunburn is severe and results in blisters (a second-degree burn), a doctor may recommend an antibiotic cream to prevent infection [1.4.2].

How often should I apply antibiotic ointment to a burn?

Typically, you should apply a thin layer of antibiotic ointment one to three times daily, usually when you change the dressing [1.2.1, 1.7.4]. Always follow the product directions or your doctor's advice.

Do I need a prescription for burn cream?

For minor burns, you can use over-the-counter antibiotic creams like Neosporin or Bacitracin [1.2.2]. For severe burns, a doctor will prescribe a stronger medication like silver sulfadiazine or mafenide acetate [1.4.3, 1.6.1].

What are the signs of an infected burn?

Signs of an infected burn include drainage or pus from the wound, increased pain, redness spreading from the burn, swollen lymph nodes, and fever [1.8.1]. If you see these signs, seek medical attention immediately.