Second-Degree Burn

A second-degree burn affects the 2 outer layers of skin. The outer layer (epidermis) and the layer underneath it (dermis) are both burned. Another name for this type of burn is a partial thickness burn. A second-degree burn may be called minor or major. This depends on the size of the burn. It also depends on what parts of the skin are burned. Minor burns may be treated with first aid. Major burns are a medical emergency.

A second-degree burn is worse than a first-degree burn, but not as bad as a third-degree burn. A first-degree burn affects only the epidermis. A third-degree burn goes through all the layers of skin. A second-degree burn usually heals in 3 to 4 weeks. A minor second-degree burn usually does not leave a scar. Deeper second-degree burns may lead to scarring of the skin or contractures over joints. Contractures are scars that form over joints and may lead to reduced mobility at those joints.

CAUSES

  • Heat (thermal) injury. This happens when skin comes in contact with something very hot. It could be a flame, a hot object, hot liquid, or steam. Most second-degree burns are thermal injuries.

  • Radiation. Sunlight is one type of radiation that can burn the skin. Another type of radiation is used to heat food. Radiation is also used to treat some diseases, such as cancer. All types of radiation can burn the skin. Sunlight usually causes a first-degree burn. Radiation used for heating food or treating a disease can cause a second-degree burn.

  • Electricity. Electrical burns can cause more damage under the skin than on the surface. They should always be treated as major burns.

  • Chemicals. Many chemicals can burn the skin. The burn should be flushed with cool water and checked by an emergency caregiver.

SYMPTOMS

Symptoms of second-degree burns include:

  • Severe pain.

  • Extreme tenderness.

  • Deep redness.

  • Blistered skin.

  • Skin that has changed color. It might look blotchy, wet, or shiny.

  • Swelling.

TREATMENT

Some second-degree burns may need to be treated in a hospital. These include major burns, electrical burns, and chemical burns. Many other second-degree burns can be treated with regular first aid, such as:

  • Cooling the burn. Use cool, germ-free (sterile) salt water. Place the burned area of skin into a tub of water, or cover the burned area with clean, wet towels.

  • Taking pain medicine.

  • Removing the dead skin from broken blisters. A trained caregiver may do this. Do not pop blisters.

  • Gently washing your skin with mild soap.

  • Covering the burned area with a cream. Silver sulfadiazine is a cream for burns. An antibiotic cream, such as bacitracin, may also be used to fight infection. Do not use other ointments or creams unless your caregiver says it is okay.

  • Protecting the burn with a sterile, non-sticky bandage.

  • Bandaging fingers and toes separately. This keeps them from sticking together.

  • Taking an antibiotic. This can help prevent infection.

  • Getting a tetanus shot.

HOME CARE INSTRUCTIONS

Medication

  • Take any medicine prescribed by your caregiver. Follow the directions carefully.

  • Ask your caregiver if you can take over-the-counter medicine to relieve pain and swelling. Do not give aspirin to children.

  • Make sure your caregiver knows about all other medicines you take. This includes over-the-counter medicines.

Burn care

  • You will need to change the bandage on your burn. You may need to do this 2 or 3 times each day.

  • Gently clean the burned area.

  • Put ointment on it.

  • Cover the burn with a sterile bandage.

  • For some deeper burns or burns that cover a large area, compression garments may be prescribed. These garments can help minimize scarring and protect your mobility.

  • Do not put butter or oil on your skin. Use only the cream prescribed by your caregiver.

  • Do not put ice on your burn.

  • Do not break blisters on your skin.

  • Keep the bandaged area dry. You might need to take a sponge bath for awhile. Ask your caregiver when you can take a shower or a tub bath again.

  • Do not scratch an itchy burn. Your caregiver may give you medicine to relieve very bad itching.

  • Infection is a big danger after a second-degree burn. Tell your caregiver right away if you have signs of infection, such as:

  • Redness or changing color in the burned area.

  • Fluid leaking from the burn.

  • Swelling in the burn area.

  • A bad smell coming from the wound.

Follow-up

  • Keep all follow-up appointments. This is important. This is how your caregiver can tell if your treatment is working.

  • Protect your burn from sunlight. Use sunscreen whenever you go outside. Burned areas may be sensitive to the sun for up to 1 year. Exposure to the sun may also cause permanent darkening of scars.

SEEK MEDICAL CARE IF:

  • You have any questions about medicines.

  • You have any questions about your treatment.

  • You wonder if it is okay to do a particular activity.

  • You develop a fever of more than 100.5° F (38.1° C).

SEEK IMMEDIATE MEDICAL CARE IF:

  • You think your burn might be infected. It may change color, become red, leak fluid, swell, or smell bad.

  • You develop a fever of more than 102° F (38.9° C).