<% vol = 15 number = 1 nextlink = 9 prevlink = 5 titolo = "CHEMICAL BURNS BY CALCIUM HYDROXIDE IN SOCCER PLAYERS" volromano = "XV" data_pubblicazione = "March 2002" header titolo %>

Pedro B., Teles L., Cabral L, Cruzeiro C.

Plastic and Reconstructive Surgery Service and Burns Unit, Coimbra University Hospitals, Portugal

SUMMARY.A brief review is made of the physiopathology of burns caused by calcium hydroxide and a clinical case is presented of a soccer player with first- and second-degree burns in the thighs, buttocks, and genitals.


The severity of calcium hydroxide burns is a well-known fact.1 However, burns caused by lime are seldom reported in medical literature, specifically when concerning football players. In Portugal, low-resource soccer clubs sometimes use lime for the marking of the pitch. Lime is composed of calcium oxide, which is not corrosive itself but produces when in contact with water an active compound (calcium hydroxide) that is an alkaline agent (pH ranging between 12.4 and 12.7). A thermal reaction develops, provoking serious skin burns:

CaO + H2O => Ca(OH)2 + 16 Kcal

The usual history is that of an athlete falling on the pitch markings in such a way that his sweat comes into contact with the lime, which sets off the chemical reaction responsible for the burns. The event may be facilitated by the presence of rain. The main body areas affected are those that are more moisturised (Figs. 1, 2). Friction between clothing and the body is a very important adjuvant factor.

<% immagine "Fig. 1","gr0000001.jpg","Calcium hydroxide burns",230 %> <% immagine "Fig. 2","gr0000002.jpg","Calcium hydroxide burns",230 %>

Clinical case

A.J.B., an 18-year-old Caucasian amateur soccer player, arrived at the emergency room of Coimbra University Hospitals presenting painful first- and second-degree burns in the thighs, buttocks, and genitals (Fig. 3), and was admitted to the Burns Unit. The lesions were caused during a soccer match on a rainy day after a fall at the edge of the pitch, which was marked with lime.

After removal of the impregnated clothes and lime residue, the patient was washed with abundant water for almost an hour, until there was some pain relief. The lesions were then covered with silver sulphadiazine in a first stage, followed by fat gauze in a second stage. The patient was discharged three days later and treated as an out-patient for a further two weeks. The lesion caused a two-month-long functional incapacity for sport.

<% immagine "Fig. 3","gr0000003.jpg","Calcium hydroxide burns",230 %>


Alkaline chemical burns produced by calcium hydroxide cause skin lesions by direct irritation, corrosion, and/or heat production. In spite of its rarity, such burns are well documented in the medical literature. Wilson and Davidson3 suggested copious washing with a diluted solution of acetic acid (1%) as a first treatment step, followed by the application of fat gauze on the affected areas. When burns are larger and/or deeper,4 escharectomy may be necessary, either tangential or deeper, according to the clinical situation. Skin grafts may be indicated in the most severe cases.

The use of lime for marking sports pitches is being abandoned in favour of non-corrosive materials, such as thermoplastic inks.

RESUME. Les Auteurs, après avoir considéré brièvement la physiopathologie des brûlures causées par l’hydroxyde de calcium, présentent le cas clinique d’un joueur de football atteint de brûlures de premier et deuxième degré dans les cuisses, les fesses et les parties génitales.


  1. Schwartz, Shirens, Spencer. “Principios de Cirurgia”, 6th edition, vol. I, 238-40, 1996.
  2. Stilwell J.H.: “Chemical Burns. Principles and Practice of Burns Management”, Churchill Livingstone, London, 355-68, 1996.
  3. Mozengo D.W., Smith A.A. et al.: Chemical burns. J. Trauma, 28: 642, 1988.
  4. Muir I. F. K., Barclay T.L.: “Burns and their treatment”, 2nd ed., Lloyd-Luke, London, 144-5, 1974.
<% riquadro "This paper was received on 11 June 2000.

Address correspondence to: Dr Pedro Benjamim, Plastic and Reconstructive Surgery Service and Burn Unit, Coimbra University Hospitals, Portugal." %>

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