Second-Degree Burn

Burns have many accidental causes. You can take these steps to reduce the risk of burns:

Burns

Burns are tissue damage brought on by heat, chemicals, electricity, radiation or the sun. Nearly half a million Americans seek medical care for accidental burns each year. First-degree burns, and most second-degree burns, heal with at-home treatments. Third-degree burns can be life-threatening and require specialized medical care.

Overview

What is a burn?

A burn occurs when heat, chemicals, sunlight, electricity or radiation damages skin tissue. Most burns happen accidentally. There are different degrees of burns. Your healthcare provider determines the seriousness (degree) of a burn based on the depth of the burn and the amount of affected skin. Burns can be painful. Left untreated, a burn can lead to infection.

How common are burns?

Close to half a million people go to the emergency department every year with burn injuries. Children are at high risk for accidental burns. Every day, more than 300 children receive emergency treatment for burn injuries.

Who might get a burn?

Accidental burns can happen to anyone, although children, teenagers and older people are most at risk. These age groups are more prone to burn injuries from cooking, such as spilling a boiling pan of water onto skin. Children and teens are also more likely to mess around with lighters, matches and fireworks or get sunburns.

What are the types of burns?

Healthcare providers classify burns by degrees of severity. Your provider will evaluate the extent of skin damage. Burn degrees include:

• First-degree burns are mild (like most sunburns). The top layer of skin (epidermis) turns red and is painful but doesn’t typically blister.
• Second-degree burns affect skin’s top and lower layers (dermis). You may experience pain, redness, swelling and blistering.
• Third-degree burns affect all three skin layers: epidermis, dermis and fat. The burn also destroys hair follicles and sweat glands. Because third-degree burns damage nerve endings, you probably won’t feel pain in the area of the burn itself, rather adjacent to it. Burned skin may be black, white or red with a leathery appearance.

Symptoms and Causes

What causes burns?

Many things can cause a burn. Thermal sources, including fire, hot liquids, steam and contact with hot surfaces, are the most common causes of burns. Other causes include exposure to:

• Chemicals, such as cement, acids or drain cleaners.
• Radiation.
• Electricity.
• Sun (ultraviolet or UV light).

What are the signs of burns?

Burn symptoms vary depending on the severity or degree of the burn. Symptoms are often worse during the first few hours or days after the burn. Burn symptoms include:

• Blisters.
• Pain.
• Swelling.
• White or charred (black) skin.
• Peeling skin.

Diagnosis and Tests

How are burns diagnosed?

Your healthcare provider will examine the burn to determine the degree or severity. This process involves estimating the percentage of the body affected by the burn and its depth. Your provider may classify the burn as:

• Minor: First- and second-degree burns that cover less than 10% of the body are considered minor and rarely require hospitalization.
• Moderate: Second-degree burns that cover about 10% of the body are classified as moderate. Burns on the hands, feet, face or genitals can range from moderate to severe.
• Severe: Third-degree burns that cover more than 1% of the body are considered severe.

Management and Treatment

How are burns managed or treated?

Burn treatment varies depending on the cause and severity. You need to keep all burns clean and apply proper bandages/dressing depending on the severity of the wounds. Treating the person’s pain is key: inadequate control can interfere with wound care.

Continue to check wounds for signs of infection and other long term issues, such as scarring and tightening of the skin over joints and muscles, which makes them difficult to move.

Treatments by burn type include:

• First-degree burns: Run cool water over the burn. Don’t apply ice. For sunburns, apply aloe vera gel. For thermal burns, apply antibiotic cream and cover lightly with gauze. You can also take over-the-counter pain medication.
• Second-degree burns: Treatment for second- and first-degree burns is similar. Your healthcare provider may prescribe a stronger antibiotic cream that contains silver, such as silver sulfadiazine, to kill bacteria. Elevating the burned area can reduce pain and swelling.
• Third-degree burns: Third-degree burns can be life-threatening and often require skin grafts. Skin grafts replace damaged tissue with healthy skin from another of the uninjured part of the person’s body. The area where the skin graft is taken from generally heals on its own. If the person does not have enough skin available for a graft at the time of injury, a temporary source of graft can come from a deceased donor or a human-made (artificial) source but these will eventually need to be replace by the person’s own skin. Treatment also includes extra fluids (usually given intravenously, with an IV) to keep blood pressure steady and prevent shock and dehydration.

What are the complications of burns?

Third-degree burns that are deep and affect a large portion of skin are very serious and can be life-threatening. Even first- and second-degree burns can become infected and cause discoloration and scarring. First-degree burns don’t cause scarring.

Potential complications of third-degree burns include:

• Arrhythmia, or heart rhythm disturbances, caused by an electrical burn.
• Dehydration.
• Disfiguring scars and contractures.
• Edema (excess fluid and swelling in tissues).
• Organ failure.
• Pneumonia.
• Seriously low blood pressure (hypotension) that may lead to shock.
• Severe infection that may lead to amputation or sepsis.

Prevention

How can I prevent a burn?

Burns have many accidental causes. You can take these steps to reduce the risk of burns:

• Wear sunscreen.
• Set your home’s hot water heater below 120 degrees Fahrenheit.
• Always test the water in a shower or bath before getting in or bathing a child.
• Lock up chemicals, lighters and matches.
• Use the stove’s back burners as much as possible when cooking, turn handles of pots and pans where they won’t be bumped and don’t leave the stove unattended.
• Don’t hold a child when you’re near hot objects, such as the stove.
• Set safeguards around a fireplace and never leave a child unattended.
• Install and regularly test smoke detectors in your home.
• Stock your home with fire extinguishers and know how to use them.
• Cover electrical outlets.

Outlook / Prognosis

What is the prognosis (outlook) for people with burns?

With proper treatment, most first- and second-degree burns heal over two to three weeks. Depending on the burn severity, you may have some scarring, which may fade over time. People recovering from third-degree burns need physical and occupational therapy to maintain joint mobility and improve function. Some people develop post-traumatic stress disorder (PTSD) or depression after a burn event. Thanks to medical advancements, many people who have burns covering even up to 90% of their bodies survive .

Living With

When should I call the doctor?

You should call your healthcare provider if you experience:

• Burns on the hands, feet, face or genitalia.
• Burns that don’t improve after two weeks.
• Blistering.
• Severe pain.
• Fever, yellow or green discharge, or other signs of infection.
• Signs of PTSD or depression.

What questions should I ask my doctor?

You may want to ask your healthcare provider:

• What degree is the burn?
• What is the best treatment for this burn?
• What steps can I take to lower the risk of infection?
• What steps can I take to lower the risk of scarring?
• What steps can I take to lower the future risk of accidental burns?
• Should I look out for signs of complications?

A note from Cleveland Clinic

Burns happen accidentally. Children and older adults are at highest risk. All deep burns require treatment to prevent infection and scarring. Third-degree burns are the most serious type and can be life-threatening. However, first- and second-degree burns are more painful. If you or a loved one has a blistering burn, prompt medical attention can aid healing. Talk to your healthcare provider about ways to lower your family’s risk of accidental burns.

Second-Degree Burn

Second-degree burns are a mild type of burn that causes blistering, shiny skin, pain and skin discoloration. They’re the most common type of burn. If your burn is small, you can treat this type of burn at home.

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Overview

A second-degree burn has a shiny texture, blisters and skin discoloration.

What is a second-degree burn?

A second-degree burn is a mild to moderate burn, and it’s the most common type. A burn is tissue damage caused by a heat, chemical or light source. A second-degree burn damages the outer layer of your skin (epidermis) and the second layer of your skin (dermis). It’s less severe than a third-degree burn. You can treat most second-degree burns at home.

What does a second-degree burn look like?

Features of a second-degree burn include:

• Skin discoloration: deep red to dark brown.
• Blisters.
• Shiny, moist skin.
• Pain or discomfort.
• Swelling.
• Layers of skin peeling away.

How do second-degree burns differ from other types of burns?

There are three main degrees of burns. You can identify what type of burn you have by its appearance. A first-degree burn may only cause skin discoloration. A second-degree burn includes blisters, a darker tone and a shiny, moist appearance. A third-degree burn may cause your skin to turn black and dry out. You may have second-degree burn symptoms with third-degree symptoms in the same area. You can have symptoms of several types of burns in the same place.

Where are common locations of second-degree burns?

The location of a second-degree burn varies based on the cause. Some common locations you could get a second-degree burn include your:

Possible Causes

What are the most common causes of second-degree burns?

There are several ways that you can get a second-degree burn. Some of the most common causes of second-degree burns include:

• Fire flames.
• Hot objects.
• Sunburn (ultraviolet radiation).
• Scalding from steam or boiling water.
• Certain chemicals.
• Electric shock.

What happens to your skin during a second-degree burn?

During a second-degree burn, a heat, chemical or light source destroys and goes through the first and second layers of your skin. This causes damage to the cells in your skin. Cell damage triggers your immune system to activate to prevent further damage to your body. You may experience skin discoloration and swelling, which is a sign that your immune system is actively working to heal your injury. As your body repairs itself after a burn, dead skin cells leave your body as your skin peels and flakes at the site of your burn.

Care and Treatment

How do you treat a second-degree burn?

If you have a small second-degree burn (less than 3 inches in diameter), you can treat it at home:

• Use cool water to gently wash your burn. Try to keep your burn area under water for at least five minutes, up to 30 minutes. Gently pat the burn dry with a clean towel.
• Cover your burn with a clean bandage or wound dressing like non-stick gauze.
• Avoid touching your burn or placing clothing on your skin that can cause friction or rub against your wound.
• Take over-the-counter pain relievers (acetaminophen or ibuprofen) as recommended by your provider if you experience pain.
• Change your bandage at least once daily.

A common prescription cream to treat second-degree burns is silver sulfadiazine (Silvadene®). If you have an infected burn, which is a burn that’s extremely painful, swollen and leaks pus, see a healthcare provider. They may prescribe antibiotics to clear the infection from your body.

Should I let my second-degree burn air out?

You should keep your burn covered for the first few days after the event as you let your skin heal. Make sure your blisters stay closed on your skin. If a blister breaks open, you should keep your burn covered with a bandage to prevent an infection. If the blister isn’t broken, you can let your burn air out or breathe without a bandage.

What are the stages of healing for a second-degree burn?

Your second-degree burn will undergo three stages of healing:

• React: When you get a burn, your body will activate your immune system via inflammation. This causes swelling and skin discoloration, as your immune system works to heal your body.
• Repair: The second stage is happening below the surface of your skin. Your cells are working together to fix the damage to your skin by getting rid of damaged tissue to make room for the new skin and tissue to grow.
• Remodel: The third stage of healing is when your body creates a scar. Your body closes any gaps in your tissue caused by the burn and fills it with collagen, a protein within your skin. Sometimes, your scar is visible and other times, the area where your skin closed together looks natural.

The healing process can take several weeks after a second-degree burn.

How can second-degree burns be prevented?

Burns are preventable. You can prevent burns by:

• Not touching hot surfaces.
• Avoiding open flames.
• Wearing protective gear like gloves when working with hot objects or chemicals.
• Keeping hot items out of reach of children.
• Testing the temperature of your child’s food or beverages before giving them to them.
• Reducing the temperature of the hot water in your home.
• Covering electrical outlets and making sure live cords are out of reach of children.
• Wearing sunscreen when you go outside.

Will my skin scar after a second-degree burn?

Scarring is possible with second-degree burns. Not everyone will get a scar after a burn, and scars are more likely if you have a large, more serious burn. Your skin may appear lighter or darker than your natural skin tone after a burn. This is usually a long-term change to your skin tone that may fade over time.

How long will it take for my second-degree burn to heal?

On average, it can take one week to three weeks for your skin to heal after a second-degree burn. This timeframe can vary based on the size and location of your burn.

When to Call the Doctor

When should second-degree burns be treated by a healthcare provider?

Visit a healthcare provider if your burn:

• Covers a large area of your skin (more than 3 inches in diameter).
• Affects your ability to use certain parts of your body.
• Shows signs of an infection.

Children younger than 5 years old, people above 70 years old or people with a compromised immune system should have their burns treated by a healthcare provider.

What are the symptoms of an infected second-degree burn?

An infected burn needs medical attention. Visit a healthcare provider if your second-degree burn has the following signs of infection:

• Severe pain.
• Burn leaks pus-like fluid.
• Skin discoloration spreads beyond your burn site.
• A foul odor from your burn site.

Visit the emergency room if you develop a fever along with any of these symptoms.

Frequently Asked Questions

What’s the difference between each type of burn?

The main difference between each type of burn is the depth of damage beneath your skin:

• First-degree burn: Only the top layer of your skin has damage.
• Second-degree burn: The top and middle layers of your skin have damage.
• Third-degree burn: The first, second and third layers of your skin have damage, including parts of the fatty layer of subcutaneous fat.
• Fourth-degree burn: The burn reaches past the subcutaneous fat and destroys muscle tissue, nerves and tendons.
• Fifth-degree burn: The burn extends into your muscle.
• Sixth-degree burn: The burn damages your bones.

Each of these burns will look different on your skin. Visit a healthcare provider if you’re unsure what type of burn you have. You can have more than one type of burn at the same time.

A note from Cleveland Clinic

Second-degree burns are the most common type of burn. You may have some discomfort on your skin as the burn heals, and scarring is possible. They’re preventable, but you can treat accidental burns at home if your burn is small. If your burn covers a large area of your skin or if you show signs of an infection, visit a healthcare provider.