Superficial burn (also called first-degree burn)
- Mildest type of burn
- Often caused by ultraviolet light, or very short (“flash") flame exposure
- Affects only the outer layer of the skin (epidermis)
- Normally does not cause scarring
- Takes about 3-6 days to heal
Superficial partial-thickness burn (also called second-degree burn)
- Often caused by a scald (spill or splash) or short (“flash”) flame exposure
- Affects the outer layer of the skin more deeply, usually causing blistering
- May or may not cause scarring, but often does cause long-term skin color changes
- Takes about 1-3 weeks to heal
Deep partial-thickness burn (also called second-degree burn)
- Often caused by a scald (spill), may involve flame, oil, or grease
- Affects the outer and underlying layer of skin (dermis), causing blistering
- Usually causes scarring
- Usually takes more than three weeks to heal
Full-thickness burn (also called third-degree burn)
- Very serious
- Often caused by scald (immersion), may involve flame, steam, oil, grease, chemicals, or high-voltage electricity
- Damages all layers of the skin, and may involve the tissues underneath (muscle and bone)
- Causes scarring
- Will heal only at the wound edges by scarring, unless skin grafting is done
|Classification of Skin Burns|
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Heat or flame (thermal burns)
- Hot foods or drinks such as boiling water, tea, or coffee
- Hot oil or grease
- Hot tap water
- Direct heat such as stoves, heaters, or curling irons
- Direct flame
- Flammable liquids such as gasoline
Chemicals (chemical burn)—strong acids or strong bases such as:
- Cleaning products
- Battery fluid
- Pool chemicals
- Drain cleaners
- Sunlight ( sunburn ) or tanning beds
- Damaged electrical cords
- Electrical outlets
- High-voltage wires
- Radiation (radiation burn)
- Age: less than four years
- Sex: male
- Low socioeconomic status
- Alcohol use
- Illegal drug use
- Absent or non-functioning smoke detectors
- Substandard or older housing
- Unsupervised or improperly supervised children
- Using tap water hotter than 120° F
- Burned area turns red and is painful
- The area blanches (turns white) when you press on it
- The area may swell, but it is dry and there is no blistering
Superficial Partial-Thickness Burn
- The area is moist, red, and weeping
- The area blanches (turns white) when you press on it
- Painful to air and temperature
Deep Partial-Thickness Burn
- Blisters, usually loose and easily unroofed
- The area can be wet or waxy dry
- The skin color can vary from patchy, to cheesy white, to red
- The area does not blanch (turn white) with pressure
- May or may not be painful, can perceive pressure
- Skin can appear waxy white, leathery gray, or charred and blackened
- May not be painful if nerves have been damaged, the only sensation may be deep pressure
- Cooling the burn with running water or a cold damp cloth. Do not use ice—this may result in more damage to the skin.
- Do not use butter, grease, oils, or ointments on the burn.
- Cover the burn with sterile gauze or a clean cloth.
- Do not use a fluffy cloth such as a towel or blanket.
- Take an over-the-counter pain reliever, like acetaminophen (Tylenol).
- Do not break or pop any blisters. This may result in an infection.
If you see signs of an infection, get medical attention. Signs of infection include:
- Increased pain
- Oozing of pus
- Do not take off any clothing that is stuck to the burn.
- Make sure the victim is not near, or in contact with, any smoldering materials or exposed to further smoke or heat.
- Do not soak the burn in water, but you can cover the area with a cool, moist sterile bandage or clean cloth.
- As with any severe injury, make sure the person is breathing and administer CPR if necessary.
- Age: younger than five years or older than 55 years
- Suspected child abuse
- Very small, deep burns on the hands, face, eyes, feet, or perineum (groin/genital area)
- Extensive burn: using TBSA and age charts
- Burns that may require complicated dressing changes, elevation, or continued physician observation
- High-voltage injury or burn
- Suspected or known inhalation injury
- Circumferential burn
- Other medical problems that predispose a person to infection, such as:
Medical Treatment for Major Burns
- Teach children about fire prevention and keep dangerous materials out of reach.
- Make sure smoke detectors are installed and in working order. Replace batteries twice a year (one way to remember to do this is to change the batteries the same days you change the clocks for daylight savings time).
- When cooking, keep pot handles turned toward the back of the stove.
- Supervise young children in the kitchen and around fireworks.
- Set the temperature on the water heater to less than 120° F and test the bath water before your child gets in.
- Make sure children’s sleepwear is flame-resistant.
- Don’t hold children in your arms or lap while cooking, serving, or eating hot foods or liquids.
- Do not leave matches, lighters, candles, or burning cigarettes unattended.
- Wear protective gloves and clothing when handling caustic chemicals.
- Put protective covers on electrical outlets.
- Do not wear loose-fitting sleeves while cooking.
- Keep children and pets away from the stove while cooking.
- Make sure electrical cords are not hanging over the edge of countertops.
- Store chemicals and cleaners in a locked cabinet.
- Children younger than one year can sustain partial-thickness burns from hot seat belt straps or buckles in car seats. Make sure car seats are not hot before putting a child in the seat. If you park in the sun, cover the seat with a towel.
American Burn Association http://www.ameriburn.org
National Library of Medicine - National Institutes of Health http://www.nlm.nih.gov
Canadian Burn Foundation http://www.canadianburnfoundation.org
Health Canada http://www.hc-sc.gc.ca
Behrman R, Kliegman R, et al. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: Saunders; 2007.
Beers MH. The Merck Manual of Medical Information . 2nd ed. London, England: Simon and Schuster, Inc; 2003.
Child safety: how to prevent burns. Mayo Foundation for Medical Education and Research website. Available at: http://www.mayoclinic.com/health/child-safety/CC00044 . Updated February 2009. Accessed July 22, 2009.
Goldman L, Ausiello D, eds Cecil Textbook of Internal Medicine. 23rd ed. Philadelphia, PA: Saunders; 2008.
Marx J, Hockberger R, et al. Rosen's Emergency Medicine. 7th ed. St. Louis, MO: Mosby; 2009.
Parenting corner Q&A: burns. American Academy of Pediatrics website. Available at: http://www.aap.org/publiced/BR%5FFireSafety%5FBurns.htm . Updated September 2007. Accessed July 22, 2009.
Protect the ones you love: burns. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/SafeChild/Fact%5FSheets/Burns-Fact-Sheet-a.pdf . Accessed July 22, 2009.
Shriners Hospital for Children website. Available at: http://www.shrinershospitalsforchildren.org . Accessed July 22, 2009.
Taking care of burns. American Academy of Family Physicians website. Available at: http://www.aafp.org/afp/20001101/2029ph.html . Updated November 2000. Accessed July 22, 2009.
- Reviewer: Peter Lucas, MD
- Review Date: 09/2012 -
- Update Date: 09/30/2012 -