Sick Becomes Seriously Ill—Scald Injuries due to Domestic Medical Self‐Treatment: A Six‐Year Single Center Retrospective Study

ABSTRACT

Self‐treatment of benign symptoms using hot water bottles, steam inhalation or hot tea is common in households and poses risks of severe scald injuries. This study aims to investigate associated hazards and identify high‐risk patient groups to facilitate targeted prevention. A retrospective, single‐center descriptive study was conducted on adult burn patients with scald injuries from hot water bottles, steam inhalation or hot tea. Demographic information, injury mechanism and outcomes were analysed. A total of 43 patients (mean age: 37.5 years; female:male ratio 23:20) were included. Injuries were caused by hot water/tea (37.2%), steam (34.9%) and hot water bottles (27.9%). The average burned total body surface area (TBSA) was 4%, with 79.1% of injuries being superficial partial‐thickness burns. Surgical intervention was required in 13.9% of cases. Hot water bottle injuries predominantly affected young females (75%, mean age 32.6 years), with a high incidence of genital burns (58.3%). Hot tea‐related injuries were more frequent in older males (62.5%, mean age 41.6 years), involving greater TBSA (6.5%) and a higher necessity for skin grafting (18.8%). Common self‐treatment strategies can cause serious scalds, particularly in specific demographic groups, thereby burdening healthcare systems. Awareness of these risks is pivotal for effective education and prevention.

1.

Summary.

• Scald injuries from household self‐treatment practices such as hot water bottles, steam inhalation, and hot tea can result in clinically relevant burns.

• Distinct demographic patterns were identified: hot water bottle scalds primarily affected young female patients with a high rate of genital involvement, whereas hot tea–related injuries were more common among older males and demonstrated greater severity.

• Although most injuries were superficial partial‐thickness burns, 13.9% of patients required surgical intervention, highlighting the potential risk of these injury mechanisms.

• Improved public awareness and targeted prevention strategies could potentially reduce the incidence of these injuries and their burden on healthcare systems.

2. Introduction

Burn trauma is globally ranked as the fourth most prevalent type of trauma with an estimated 180 000 deaths annually, according to the World Health Organisation (WHO) [1]. In 2022, the German Burn Registry reported a total of 717 adult patients with burn injuries admitted to intensive care units (ICU) in Germany, Austria and Switzerland [2]. While the majority of burn incidents are classified as minor and often do not require extensive treatment, more severe burns frequently lead to considerable mortality and morbidity, and necessitate treatment in specialised centers [3].

Scald injuries rank as the second leading type of burn injuries with 31% in the USA in 2019 according to the National Burn Repository, and 21% in German‐speaking countries in 2022, according to the National Burn Registry [2, 4]. The majority of scald injuries occur as domestic accidents. Moreover, in regard to age distribution, children constitute a significant portion of the patient population [5]. Scald injuries present a particular subgroup of burn injuries and require special attention as the increased heat capacity of water often results in more severe injuries and ‘secondary deepening’ of the burn wound is a common complication [6]. This is particularly relevant in patient groups that already have preexisting medical conditions.

Frequent home remedies to treat medical symptoms, including cold symptoms, coughs, abdominal pain, menstrual pain or back pain, often involve the utilisation of hot water in hot water bottles, hot steam inhalation or hot tea [7, 8, 9]. Common accident mechanisms reported are an accidental spillage of the hot water container in the case of hot steam inhalation, accidental spillage of the mug in the case of hot tea, and material malfunction in the case of hot water bottles [7, 10, 11]. Accidents caused by these seemingly innocuous domestic self‐treatment practises can lead to severe burn trauma resulting in hospital admission, necessity for surgical necrectomy, and autologous skin grafting and postoperative pain and scarring [8, 12].

Scald injuries resulting from home treatments involving hot water represent a common type of trauma and are regularly seen in the emergency department of our burn center.

However, comprehensive studies including demographic information, clinical data and patient outcomes are limited. This study aimed to offer a broad descriptive analysis of the impact and outcome of scald injuries resulting from apparently harmless domestic self‐treatment practices. Furthermore, the aim was to identify specific patient groups at increased risk in order to facilitate targeted education about the risks and possibly prevent further accidents.

3. Materials and Methods

3.1. Design and Data Collection

A retrospective single‐center observational study of the clinical characteristics and related outcomes of patients with scald injuries due to medical treatments at home was conducted. A total of 43 patients were included that presented to the emergency department of the adult burn center of the Department of Plastic, Reconstructive, Hand and Burn Surgery between January 2017 and December 2023.

All patients of > 18 years of age that reported having suffered a scald injury due to self‐treatment of medical symptoms (e.g., cold symptoms, sore throat, abdominal pain, menstrual pain) with either (1) hot water bottles, (2) inhalation of hot water steam or (3) cooking of hot water for a beverage/tea were included in the study. A scald injury was defined as a superficial, partial thickness, or full thickness burn resulting from hot water.

The following demographic and clinical data were included: age, gender, burn mechanism, burned percentage of total body surface area (TBSA), burn wound thickness, involvement of genitals, type of definite therapy, number of operations required, length of stay and preexisting comorbidities/conditions (cardiovascular, metabolic, neurological/psychiatric, nicotine abuse other chronic conditions). Primary outcome was defined as in‐hospital mortality.

All patient information was pseudonymized and the confidentiality of patient data was maintained.

3.2. Statistical Analysis

All analyses were performed using Microsoft Excel Version 16.34 (Microsoft, Albuquerque) and IBM SPSS Statistics 22.0 (IBM, New York City) software. Data were presented as either the total number with the respective percentage, the mean with the standard deviation or the median with the 25th and 75th percentile. Data were analysed using descriptive statistics.

3.3. Ethics Statement

All procedures were performed in compliance with relevant laws and institutional guidelines and the ethics commission (Project No. S‐239/2023) has approved them.

4. Results

4.1. Demographic Data

Between 2017 and 2023, 43 patients with scald injuries from hot water bottles, steam inhalation, or hot water presented to our emergency department (Table 1). The group included 20 male (46.51%) and 23 female (53.49%) patients, with a mean age of 37.48 years (SD: 16.29). A total of 13 patients (30.22%) reported chronic medical conditions: 5 (11.63%) had cardiovascular diseases (e.g., hypertension, chronic heart disease), 5 (11.63%) had metabolic conditions (e.g., diabetes, hyperlipidemia), 3 (6.98%) had neurological/psychiatric conditions (e.g., migraine, depression) and 6 (13.95%) had other chronic diseases (e.g., sleep apnea, arthrosis). Additionally, 3 patients (6.98%) reported regular tobacco use.

TABLE 1.

Demographic data.

	N
Age (mean; SD)	43 (37.48; 16.29)
Sex
Male	20 (46.51%)
Female	23 (53.49%)
Preexisting medical conditions
None	30 (69.78%)
Cardiovascular	5 (11.63%)
Metabolic	5 (11.63%)
Neurological/psychiatric	3 (6.98%)
Nicotine abuse	3 (6.98%)
Other chronic conditions	6 (13.95%)

Note: Demographic data of patient cohort.

Abbreviation: SD, standard deviation.

4.2. Injury Mechanism

Among the 43 patients, scald injuries were most often caused by hot water (37.21%), followed by steam inhalation (34.88%) and hot water bottles (27.91%) (Table 2, Figure 1). Reported causes included spillage or malfunction (hot water bottles), container spillage or falls (steam inhalation), and accidental spills of teapots or mugs (hot water). The mean age was lowest in patients with hot water bottle injuries (32.58 years, SD: 11.4) compared to steam inhalation (37 years, SD: 16.49) and hot water (41.63 years, SD: 18.9). Injuries from hot water bottles occurred mostly in females (75%), while hot tea injuries were predominantly in males (62.5%) (Table 4).

TABLE 2.

Clinical data.

	N
Scald mechanism
Hot water bottle	12 (27.91%)
Inhalation	15 (34.88%)
Hot water/tea	16 (37.21%)
TBSA (%) (median, 25–75 percentile)	43 (4, 2.5–8)
TBSA (%)
0.01–3	15 (34.88%)
3.1–6	11 (25.58%)
6.1–9	6 (13.95%)
9.1–12	3 (6.98%)
> 12	8 (18.61%)
Burn thickness
Superficial	1 (2.33%)
Superficial partial	34 (79.06%)
Superficial to deep partial	5 (11.63%)
Deep partial	2 (4.65%)
Deep partial to full	1 (2.33%)
Full	0
Involvement genitalia	22 (51.16%)

Note: Clinical Data of patient cohort.

Abbreviation: TBSA, total body surface area.

FIGURE 1.

Distribution of scald mechanisms in the patient cohort (n = 43). The diagram depicts the absolute number of patients injured by the different scald mechanisms: hot water bottle (12), inhalation (15), and hot water (16).

TABLE 4.

Distribution of patient characteristics in different injury mechanisms.

	Hot water bottle	Inhalation	Hot water
Age in years
Mean; SD	32.58; 11.4	37; 16.49	41.63; 18.9
< 18	0 (0%)	2 (13.33%)	0 (0%)
18–30	5 (41.67%)	3 (20%)	5 (31.25%)
30–40	5 (41.67%)	4 (26.67)	5 (31.25%)
40–50	1 (8.33%)	2 (13.33%)	0 (0%)
> 50	1 (8.33%)	4 (26.67)	6 (37.5%)
Sex
Male	3 (25%)	7 (46.67%)	10 (62.5%)
Female	9 (75%)	8 (53.33%)	6 (37.5%)
TBSA (%)
Median, 25–75 percentile	4 (3.23–6.25)	4 (2.55–7)	6.5 (1.38–13.59)
0.01–3	3 (25%)	6 (40%)	6 (37.5%)
3.1–6	6 (50%)	4 (26.66%)	1 (6.25%)
6.1–9	2 (16.67%)	3 (20%)	1 (6.25%)
9.1–12	0 (0%)	1 (6.67%)	2 (12.5%)
> 12	1 (8.33%)	1 (6.67%)	6 (37.5%)
Burn thickness
Superficial	0 (0%)	0 (0%)	1 (6.25%)
Superficial partial	10 (83.34%)	13 (86.67%)	11 (68.75%)
Superficial to deep partial	1 (8.33%)	2 (13.33%)	2 (12.5%)
Deep partial	0 (0%)	0 (0%)	2 (12.5%)
Deep partial to full	1 (8.33%)	0 (0%)	0 (0%)
Full	0 (0%)	0 (0%)	0 (0%)
Involvement of genitals
Yes	7 (58.33%)	7 (46.67%)	8 (50%)
No	5 (41.67%)	8 (53.33%)	8 (50%)
TBSA in % (median, 25–75 percentile)	0.5 (0.25–0.5)	1 (0.75–1)	0.75 (0.4–1.06)
Therapy
Cortisone cream	0 (0%)	0 (0%)	1 (6.25%)
Fatty gauze and polyhexanide‐gel	3 (25%)	4 (26.66%)	4 (25%)
Specialised burn wound dressing	7 (58.34%)	10 (66.67%)	8 (50%)
Skin graft	1 (8.33%)	0 (0%)	1 (6.25%)
Combination dressing and skin graft	1 (8.33%)	1 (6.67%)	2 (12.5%)
Necessity skin grafts
Yes	2 (16.67%)	1 (6.67%)	3 (18.75%)
No	10 (83.34%)	14 (93.33%)	13 (81.25%)
Number of operations
Mean; SD	1.33; 0.49	1.2; 0.41	1.19; 0.65
LOS in days
Mean; SD	8.17; 7.3	5.36; 4.16	8.31; 8.57
0	0 (0%)	2 (13.33%)	3 (18.75%)
1–5	5 (41.67%)	8 (53.33%)	4 (25%)
6–10	4 (33.33%)	3 (20%)	5 (31.25%)
11–15	2 (16.67%)	2 (13.33%)	1 (6.25%)
> 15	1 (8.33%)	0 (0%)	3 (18.75%)

Note: Distribution of demographic data, clinical data, therapy and outcome in different scalding mechanism. SD: standard deviation. TBSA: total body surface area.

4.3. Total Body Surface Area (TBSA)

In our patient cohort, the median TBSA was 4% (IQR, 2.5%–8%) (Table 2). The lowest TBSA was 0.01% and the highest TBSA was 22%. Overall, 18.61% of patients sustained a scald injury affecting more than 12% of TBSA. With respect to the different scald injury mechanisms, the median TBSA in injuries caused by hot water bottles (4%, IQR, 3.23%–6.25%) was the same as in injuries caused by hot steam inhalation (4%, IQR, 2.55%–7%). In scald injuries caused by the spillage of hot water the median TBSA was higher and the distribution of the different TBSA percentages showed a higher variability (6.5%, IQR, 1.38%–13.59%). According to our data scald injuries with a high percentage of TBSA were typically seen in injuries caused by the spillage of hot water compared to hot steam inhalation and particularly to hot water bottles (Table 4, Figure 2).

FIGURE 2.

Distribution of burned total body surface area (TBSA) in different scald mechanisms. The boxplot diagram depicts the median TBSA and the 25th to 75th percentile. Hot water bottles: 4% (3.23–6.25). Inhalation: 4% (2.55–7). Hot water: 6.5% (1.38–13.59).

4.4. Burn Wound Thickness

In our patient group the majority of patients had a scald injury of superficial partial thickness (79.06%). In 11.63% of cases, patients presented with a burn wound that showed a mix of superficial and deep partial thickness (Table 2). This general distribution of burn wound thickness with the particular predominance of superficial partial thickness wounds could also be observed in the different injury mechanisms, which showed a similar distribution (Table 4). The most severe scald injury in terms of wound thickness was seen in a patient that suffered from an injury caused by a hot water bottle (deep partial to full thickness burn) (Figure 3).

FIGURE 3.

Distribution of burn wound thickness in different scald mechanisms. The diagram depicts the absolute number of patients injured by the different scald mechanisms categorised by wound thickness.

4.5. Involvement of Genitals

Genital affection could be observed in approximately half (51.16%) of patients within our patient group (Table 2). This trend could also be seen in patients who suffered a scald injury from hot steam inhalation (46.67%) and hot water (50%), whereas patients who got an injury from a hot water bottle tended to show a slightly increased occurrence (58.33%) of genital scald injuries. In terms of the TBSA in the different burn mechanisms, injuries caused by hot steam inhalation showed the highest median TBSA (1%, IQR, 0.75%–1%), followed by hot water (0.75%, IQR, 0.4%–1.06%) and hot water bottles (0.5%, IQR, 0.25%–0.5%) (Table 4, Figure 4).

FIGURE 4.

Distribution of burned total body surface area (TBSA) of genitals in different scald mechanisms. The boxplot diagram depicts the median TBSA and the 25th to 75th percentile. Hot water bottles: 0.5% (0.25–0.5). Inhalation: 1% (0.75–1). Hot water: 0.75% (0.4–1.06).

4.6. Type of Therapy

Most burn wounds (58.14%) were treated with debridement and specialised burn dressings (e.g., Dressilk, Suprathel, Biobrane Epicite), while 25.58% were managed with fatty gauze and polyhexanide gel. Six patients (13.95%) required surgical burn excision and skin grafting (Table 3). Skin grafts were more common in injuries from hot water (18.75%) and hot water bottles (16.67%) compared to steam inhalation (6.67%) (Table 4, Figure 5). The average number of operations per patient was 1.23 (SD: 0.53). A first surgical debridement upon initial presentation to the emergency department was carried out in all scald injuries except in superficial burn wounds. Burn wounds that showed deep tissue damage and the necessity for eschar removal either underwent enzymatic debridement or surgical burn wound excision and consecutive coverage with specialised burn wound dressings or skin grafts. The mean number of operations was similar across injury types: hot water bottles (1.33, SD: 0.49), steam inhalation (1.2, SD: 0.41), and hot water (1.19, SD: 0.65) (Table 4).

TABLE 3.

Clinical course.

	N
Therapy type
Cortisone cream	1 (2.33%)
Fatty gauze and polyhexanide‐gel	11 (25.58%)
Specialised burn wound dressing	25 (58.14%)
Skin graft	2 (4.65%)
Combination dressing and skin graft	4 (9.3%)
Necessity of skin grafts
Yes	6 (13.95%)
No	37 (86.05%)
Number of operations (mean; SD)	43 (1.23; 0.53)
LOS (mean; SD)	43 (7.29; 6.97)
LOS in days
0	5 (11.63%)
1–5	17 (39.53%)
6–10	12 (27.91%)
11–15	5 (11.63%)
> 15	4 (9.3%)

Note: Therapy and length of stay (LOS).

Abbreviation: SD, standard deviation.

FIGURE 5.

Distribution of definite therapy in different scald mechanisms. The diagram depicts the absolute number of patients injured by the different scald mechanisms categorised by type of therapy.

4.7. Length of Stay (LOS)

Among our patient group the mean length of stay was 7.29 days (SD: 6.97). The majority of patients (67.44%) stayed in the hospital for a duration ranging between 1 and 10 days. Patients with hot steam inhalation injuries had a shorter mean stay (5.36 days, SD: 4.16) compared to those injured by hot water bottles (8.17 days, SD: 7.3) or hot water (8.31 days, SD: 8.57). Most patients with scald injuries from hot steam inhalation (53.33%) and hot water bottles (41.67%) had a length of stay between 1 and 5 days. The majority of patients with injuries from hot water (31.25%) had a length of stay of 6 to 10 days. Furthermore, all the patients with injuries from hot water bottles (100%) had to be admitted to the hospital, whereas, a portion of the patients, who got injured from hot steam inhalation (13.33%) or hot water (18.75%), could be discharged (Table 4, Figure 6).

FIGURE 6.

Distribution of length of stay (LOS) in different scald mechanisms. The diagram depicts the absolute number of patients injured by the different scald mechanisms categorised by the length of stay.

5. Discussion

In this study, results suggest that scald injuries resulting from domestic accidents involving seemingly innocuous self‐treatment practices can lead to severe injuries and subsequent extensive hospital treatment. This study could potentially serve to spread awareness of the risks associated with self‐treatment strategies including hot water and consequently aid in preventing further domestic accidents. Moreover, effective prevention of these types of accidents could possibly mitigate the financial strain and facilitate a more efficient allocation of resources within healthcare systems.

In our patient cohort, the female‐to‐male ratio was 23:20 (53.49%:46.51%) with a mean age of 37.48 years. This general trend was also observed by Sahu et al. [5], who conducted a study of the general characteristics of a large patient cohort with scald injuries. Their findings revealed that 83.1% of adult patients (> 15 years) fell within the age range of 16 to 45 years although the authors noticed a slightly increased relative number (52.8%) of male patients [5]. Interestingly, regarding sex distribution, epidemiological studies on patient cohorts with burn injuries in general indicate that men are at a higher risk of experiencing burn trauma, with over 65% of patients studied being male [13, 14]. This suggests that female patients, similar to children, tend to be overrepresented in patient cohorts with scald injuries, compared to patient cohorts with burn trauma in general [5].

Our findings show that home remedies involving hot water can cause significant scald injuries, with 18.61% of patients sustaining burns affecting over 12% TBSA. The average TBSA was 4%, with most injuries classified as superficial partial thickness (79.06%). These results align with previous studies. Goltsman et al. reported an average TBSA of 2.41% from hot water bottle injuries in 155 patients, while Scarborough et al. observed an average TBSA of 5.3% from steam inhalation injuries [7, 10]. Both studies identified most burns as partial thickness, though Goltsman et al. noted 25.81% of burns as full thickness [10]. These findings highlight that while most home remedy‐related injuries involve small TBSA, some result in significant burn severity.

Patients with preexisting diabetes mellitus represent a subgroup at particularly high risk for severe burn injuries. The peripheral neuropathy and consecutively decreased sensory pain perception may lead to an increased risk of prolonged exposure to a heat source [15]. Common trauma mechanisms include heat application with hot foot baths or hot water bottles, as reported by Chang et al. [16]. In our cohort, 11.6% of patients presented with a metabolic disorder, including diabetes mellitus, which is consistent with the 11.8% prevalence described by Knowlin et al. in a population of 5539 burn patients [15]. The identification of patients with diabetes mellitus and diabetic neuropathy as a high‐risk population and further targeted education and prevention is crucial as this subgroup exhibits increased overall morbidity, longer hospital stays, higher rates of hospital‐acquired infections, and a greater likelihood of lower extremity amputations following burn injuries [15, 17, 18].

Although self‐harming behaviour was not observed in our cohort, previous studies have shown that individuals with psychiatric disorders, such as depression, are at increased risk of self‐inflicted burn injuries [18]. In our study, 7.0% of patients presented with a psychiatric or neurological condition. This subgroup represents a particularly vulnerable population that requires specific preventive strategies and careful psychosocial evaluation to reduce the risk of intentional injury.

Our study found that patients with extensive scald trauma often required skin grafts (13.95%) and had hospital stays exceeding 11 days (20.93%), with a mean stay of 7.29 days. Similarly, Scarborough et al. reported 16% of patients with steam inhalation injuries requiring grafts but noted a shorter mean stay of 4.3 days [7]. Notably, Goltsman et al. observed a higher skin graft necessity (20.9%) and longer mean hospital stay (11.7 days) in hot water bottle injuries [10]. These findings are consistent with an epidemiological study by Bailey et al., that reported a mean stay of 11.6 days for patients discharged after scald injuries [19]. In conclusion, according to our results and current literature scald injuries from home remedies involving water can potentially lead to a high amount of patients requiring surgery and a mean length of stay of 4.3 to 11.7, posing a considerable burden on healthcare systems [7, 8].

In our patient cohort, more than half of the patients (51.16%) sustained a scald injury that involved the genitals. Although our results indicate that injury to the genitals appears to play a significant role in scald injuries resulting from self‐treatment strategies, studies on this subject, particularly among adult patients, are limited. Multiple studies have characterised genital burn trauma and identified scald injuries as the second most common injury mechanism after thermal burns [20, 21]. In addition, the presence of genital burn injuries has been shown to increase mortality in a large patient cohort by Harpole et al. [21]. The high prevalence of genital burns in our patient group and the consecutively increased mortality, according to recent studies further underlines the substantial health risks caused by seemingly harmless home remedies [21].

Even though multiple studies have investigated scald injuries caused by various domestic self‐treatment options including hot water, research that compares different types of treatment and identifies potential particularities remains limited. Kornhaber et al. conducted a study on the epidemiology and outcomes of patients with burn injuries from hot water bottles, hot wheat bags, and heating pads [22]. Heating pad–related injuries were not included in our cohort; however, such cases are increasingly observed in our clinical practise and may represent an important mechanism of injury to be addressed in future studies. In our study, various home remedies utilising hot water were individually analysed to identify specific patient groups at risk and types of self‐treatment associated with significantly increased health risks and burdens on healthcare systems.

Notable distinctive features of the patient subgroup with injuries from hot water bottles in our study (n = 12) included predominantly female sex (75%), comparatively low mean age (32.58 years), high prevalence of genital burns (58.33%), a considerable portion of patients in need of skin grafts (16.67%), and a long average length of stay (8.17 days). In our clinical experience, a common injury mechanism observed in this patient group is the use of a hot water bottle on the lower abdomen to alleviate menstrual pain. This practise may offer a potential explanation for the specific distribution of sex and age and the increased prevalence of genital burns due to the anatomical proximity. Begum et al. and Goltsman et al. similarly found over 70% of patients with scald injuries from hot water bottles were female but reported older patient populations [8, 10]. Interestingly, Goltsman et al. identified stopper malfunctions or spills while filling bottles as predominant injury mechanisms [10].

In the hot steam inhalation injury group (n = 15), particular characteristics included a balanced male‐to‐female ratio (7:8), a low necessity for skin grafts (6.67%), and a short mean hospital stay (5.36 days). Scarborough et al. reported similar findings, with a mean TBSA of 5.3% and mean length of stay (4,3 days) although a higher number of patients in need of skin grafts (16%) [7]. Similar to our study, the main reported accident mechanism was the accidental knocking over of the container [7]. The placement of the container on a surface, rather than in close proximity to the patient's body, potentially provides individuals with more time to partially avoid contact with the hot water. This could explain the lower proportion of patients sustaining severe injuries in need of skin grafts and a relatively low mean TBSA (4%).

Patients injured by teapot or mug spillage (n = 16) had a higher average age (41.63 years), were predominantly male (62.5%), and exhibited a higher median TBSA (6.25%), with 18.75% requiring skin grafts and a mean hospital stay of 8.31 days. Research on hot beverage‐related scalds is limited; however, Chana et al. reported 30.8% of elderly scald injuries were due to hot coffee or tea [11]. The higher mean age in this group may relate to the promotion of tea's health benefits for age‐related conditions like cardiovascular disease [23]. In our clinical experience, incidents involving hot tea mugs or teapots frequently entail large volumes of hot water and occur when the vessel is held in close proximity to the patient's body. This circumstance could potentially account for the relatively increased TBSA and severity of scald injuries observed in our study. In summary, the study demonstrates that the different injury mechanisms described in this study tend to occur in specific patient groups with distinctive characteristics.

5.1. Limitations

A key limitation of this study is its retrospective design, relying on the accuracy and thoroughness of medical records and documentation. In the case of our study, it was meticulously ensured that only patients were included for whom it was documented that the mentioned therapeutic options were utilised for self‐treatment of medical symptoms. Incomplete documentation led to exclusion and a decreased patient number, reducing the overall significance of the study. Additionally, pediatric cases were largely excluded, as our burn center rarely treats children. Since children represent a significant proportion of domestic scald injuries, this limits the general applicability of our study. In addition, this population is particularly vulnerable, and scald injuries in children may in some cases raise concerns of neglect or abuse, warranting careful evaluation and, when appropriate, the involvement of child protective services. Lastly, as a purely descriptive study without statistical analysis, no conclusions regarding statistical significance can be drawn. The limited sample size precluded more extensive analyses, highlighting the need for larger cohorts in future studies to identify and confirm statistically significant differences between groups.

5.2. Conclusions

In Conclusion, scald injuries from self‐treatment strategies such as hot water bottles, steam inhalation, and hot tea can result in clinically relevant burns, in some cases requiring surgical intervention. Distinctive risk patterns were observed: hot water bottle injuries predominantly affected young females, often involving the genital region and associated with prolonged hospital stays; steam inhalation injuries were typically less severe with shorter hospitalisation; and hot tea‐related burns occurred more often in older males, were associated with larger TBSA, and more frequently required skin grafting. These findings suggest that specific patient groups are particularly vulnerable to certain injury mechanisms. Targeted education addressing these subgroups is essential to reduce the risk of severe burns and to alleviate the associated healthcare burden. For example, preventive strategies could include awareness programs for young women using hot water bottles to relieve menstrual pain. Future studies should focus on developing and evaluating tailored educational campaigns on the safe use of these widely adopted home remedies.

Ethics Statement

All procedures were performed in compliance with relevant laws and institutional guidelines and the Ethic Commission of the University of Witten/Herdecke (Project No. S‐239/2023) has approved them.

Conflicts of Interest

The authors declare no conflicts of interest.

Seyhan H., Akkan J., Schiefer J. L., et al., “Sick Becomes Seriously Ill—Scald Injuries due to Domestic Medical Self‐Treatment: A Six‐Year Single Center Retrospective Study,” International Wound Journal 22, no. 12 (2025): e70789, 10.1111/iwj.70789.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.