Burn neck, head, treatment

[meghar]

I am recently scalded the back of my neck & head w/ water I had just taken off the stove. I went to the ER & was told that I was lucky, there were no blisters, and given me a shot of morphine & loratab precrip.  The next day, the burn area was red but not particularly painful. The 2nd day, the area was more tight & still very red.  Later that day, I felt areas of dried pus in my hair. I read that burns can mature and, if blisters form, infection is a concern so the 3rd day I went to urgent care. The dr there was surprised the ER had not given me any antibiotics & confirmed area was getting infected. He prescribed augmentin & merylpred.  He also said we can try to avoid a cream for now b/c of the awkward placement of my burn and I would essentially be putting it in my hair.  

My questions: is there anything else I can do to speed up recovery? It does not really hurt but the area/hair is tight & bothersome. The dr said just to wash it as normal. I have long hair - is is better to wear it up to let the air hit it? Does it matter? Should i wash it more or less than once a day? What can I expect in regard to further healing or potential problems? I am worried that I have damaged my hair since the blisters seem to be at the roots of my hair on the lower part of my head & neck.  

In regard to the meds, I read the merylpred can suppress the immune system.  I did not think to tell the dr but I was recently diagnosed with herpes & completed a 10 day treatment w/ Valtrex about 6 days ago.  I also recently finished a 20 day cycle of amox-clav for a sinus infection about one month ago. will the merylpred be affected by my recent use of valtrex or possibly cause a herpes outbreak? Will my recent 20 day use of amox-clav effect that med in any way such as decrease its effectiveness? Also, I am getting worried about how all these meds and their impact on my body, particularly the continued use of antibiotics.  Do the meds I have been prescribed for the burn seem appropriate?

[Jeffrey S Guy, M.D., M. Sc.]

The antibiotics were never needed then nor are they needed now.  Skin regenerates from the hair follicle.  Shaving the hair is not a requirement but does solve the problems that you have now with the flaking etc.  A scald like this is will not effect the growth of skin in the area in the future as long as the burn was not third degree.

[meghar]

Thank you for reading & answering my lengthy question - I ran out of room to say that when I first wrote it.  I have since finished the 6 day pack of methylpred which i guess the dr prescribed to reduce any swelling/redness/inflammation. I still have several days left of the antiobiotic. The wound is healing well i think. It was tight for a day or so and now the skin is flaking away in most of the area although it is hard to tell bc much of it is in my hair. Shaving it and applying an ointment is not really an option.  It does itch a bit and the new skin is very sensitive.

Do you think it is okay for me to stop the antiobiotic? Also is there anything else I should be doing or be aware of in regard to the area healing.  Lastly (i promise) I am concerned about the hair in the areas of the burn. A lot of the flaking is from areas at the root of my hair. Could a scald like this effect the future growth or look of my hair?  Thank you again for your responses. It is difficult to find answers to my ?s  

[Jeffrey S Guy, M.D., M. Sc.]

There is no need for oral antibiotics in the burned you described.  The puss the second doctor said was infection was likely the protein exudates (fluid) released by the second degree burn and is normal.  If the burn is above the hairline, it is typically better to shave the area and apply topical antibiotic ointment directly to the area.  The topical antibiotics  applied directly to the areas will provider much greater antibiotic coverage than taking a small pill twice a day that gets to float around the entire body.  Furthermore, if the burns to the scalp are deep, the oral or even IV antibiotics are not helpful or even useless as the antibiotics are not capable of penetrating the burned tissue—hence the reason burn surgeons use topical antibiotics.  Yes they can be awkward.  
  
Steroids are also not indicated for the treatment of burns.  Steroids slow wound healing and increase you risk of infection.