Fire Department

Burns are primarily divided into three categories: First-degree or superficial burns, second-degree, or partial thickness burns, and third-degree or full thickness burns. Proper treatment is critical.

The severity of the burn is dependent on many factors including location, percentage of skin involved, depth of the burn, and the age of the burn victim.

Here's how to identify different kinds of burns and what to do about them:

First-Degree Burns affect the top layer of skin (epidermis) and are usually associated with things like sunburn. The skin is usually still intact but may appear to be red, very warm or hot to the touch, and painful.

What to do about First-Degree Burns:

• Remove all jewelry, watches, rings, and clothing around the burned area as soon as possible to prevent further contamination of the burn.
• Cool the wound with room temperature or cool (not cold) running water for at least 5 minutes. Alternatively, you may also apply a wet gauze or a towel to the wound to help alleviate pain. This may be left in place for up to 30 minutes. Avoid applying ice or very cold water directly to the wound as this also may cause additional tissue damage.
• Leave any blisters intact.
• Over-the-counter pain relievers may provide relief. NSAIDs such as Ibuprofen can be especially helpful as they will help to improve inflammation related to the burn.
• Clean the wound gently with soap and water. Avoid using hydrogen peroxide or other skin disinfectants to cleanse the wound as these can also cause further damage.
• Cover the burn with a sterile gauze bandage or clean cloth. Wrap the burned area loosely to avoid putting too much pressure on the burn tissue.
• The wound may be left open or covered with a dressing. If a dressing is applied, use a thin layer of antibiotic ointment to cover the wound so the gauze or dressing does not stick to the wound. Make sure to remove the dressing to expose the wound to air and prevent excessive moisture building, softening/breaking down of the wound, and infection.
• Seek medical attention if there is persistent fever not relieved by medication or redness that may extend beyond the border of the burn or pain is not controlled by ibuprofen or acetaminophen.
• See a doctor right away if the burn is larger than the size of your hand or if there’s any question as to the severity of the burn.

Second-Degree Burns occur when the second layer of skin (the dermis) is burned, in addition to the epidermis. They do not extend across the entire thickness of the skin. Second-degree burns are typically very red or white, extremely painful, and result in blisters and swelling.

What to do you about Second-Degree Burns: If the area burned is larger than 2-3 inches, or involves functional parts of the body like the feet, face, eyes, ears, groin, or major joints, seek medical attention immediately. If the affected area is smaller than 2-3 inches, it may be treated as a minor burn.

Third-Degree Burns are very serious burn that extend through all layers of the skin and may involve subcutaneous tissues, muscle, bone, or internal organs and may cause permanent tissue damage. The burned area is dry and leathery and may appear white, dark brown, or even charred. All third-degree burns should be immediately evaluated by a healthcare provider.

Even minor burns can become serious in people with other medical problems including diabetes, peripheral vascular disease, or people who are immunocompromised. These patient should seek medical care for even minor burns as the risk of complications significantly increases.

Healing from Burns

Following a burn, it's important to observe the affected area for infection. Look out for redness extending beyond the burned area, changes in appearance of the wound, or even slight fever not relieved by acetaminophen.

As your skin begins to heal, you may also notice that it will itch, which can be uncomfortable at times. This is normal and will eventually decrease. Frequent application of lotion can help keep the skin hydrated and minimize the itching process. Over the counter medications like Benadryl may be helpful in easing discomfort from severe itching.

The wound should be kept clean with daily dressing changes. If you have any concern or questions, consult your healthcare provider. Once the burn is healed, limit the exposure of the burn to direct sunlight. Always wear sun protection.

Disclaimer: This material is for informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment.

Sources: Dr. Megan Gussick, Madison Fire Department Medical Director; American Burn Association; National Fire Protection Association

Photo: Marco Verch (CC: BY 2.0)