Degrees Of Burns

To distinguish a minor burn from a more serious burn, determine the degree of damage to body tissues. Use these three classifications to help you decide emergency care.

First-Degree: Minor
The least serious burns are those in which only the outer layer of skin (epidermis) is burned. The skin is usually reddened, and there may be swelling and pain; however, the outer layer of skin has not been burned through. Unless such a burn involves substantial portions of the hands, feet, face, groin, buttocks or a major joint, treat it as a minor burn (see below).

Second-Degree
When the first layer of skin has been burned through and the second layer of skin (dermis) also is burned, the injury is termed a second-degree burn. Blisters develop, and the skin takes on an intensely reddened appearance and becomes splotchy. Severe pain and swelling are accompanying symptoms. If a second-degree burn is limited to an area no larger than 2 to 3 inches in diameter, treat it as a minor burn (see below). If the burned area of the skin is larger, or if the burn is on the hands, feet, face, groin, buttocks or a major joint, get medical help immediately.

For minor burns, including second-degree burns limited to an area no larger than 2 to 3 inches in diameter, take the following action:

• Cool the burn. Hold the burned area under cold running water for 15 minutes. If this step is impractical, immerse the burn in cold water or cool it with cold compresses. Cooling the burn reduces swelling by carrying heat away from the skin.
• Consider a lotion. Once a burn is completely cooled, a lotion, such as one that contains aloe vera, or a moisturizer prevents drying and increases your comfort.
• Cover the burn with a sterile gauze bandage. (Don’t use fluffy cotton.) Wrap it loosely to avoid putting pressure on burned skin. Bandaging keeps air off the area, reduces pain and protects blistered skin.
• Take an over-the-counter pain reliever such as aspirin, acetaminophen, ibuprofen, naproxen.

Minor burns usually heal in about 1 to 2 weeks without further treatment, but watch for signs of infection, such as increased pain, redness, fever, swelling or oozing. If infection develops, get medical help immediately.

Caution

• Do not use ice. Putting ice directly on a burn can cause frostbite and further damage your skin.
• Never break blisters. Fluid-filled blisters protect against infection. If blisters break, apply an antibiotic ointment and a gauze bandage. Clean with mild soap and water and change dressings daily.

Third-Degree: Severe
The most serious burns are painless and involve all layers of the skin, including nerves. Fat, muscles and even bones also may be affected. Areas that are charred black or appear a dry white also usually occur.

For major burns, call 911 immediately in the U.S. and Canada. (For other countries, see our First Aid page for the emergency number.) Until an emergency unit arrives, follow these steps:

• Do not remove burnt clothing!!! — but do make sure that the victim is not still in contact with smoldering materials.
• Make certain that the burn victim is breathing. If breathing has stopped or you suspect that the person’s airway is blocked, try to clear the airway or do CPR.
• Cover the area of the burn with a cool, moist sterile bandage or with a clean cloth.

Chemical Burns

1. Remove the cause of the burn. Flush the chemicals off the skin surface with cool running water for 20 minutes or more. (If the burning chemical is a powder like substance such as lime, brush it off your skin before flushing.)
2. Remove clothing or jewelry that has been contaminated by the chemical.
3. Wrap the burned area with a dry, sterile dressing (if possible) or a clean cloth.
4. Wash the burn again for several more minutes if the victim complains of increased burning after the initial washing.

Minor chemical burns usually heal without further treatment.

Get emergency medical help if:

• The chemical burned through the first layer of skin and the resulting second-degree burn covers an area more than 2 to 3 inches in diameter.
• The chemical burn occurred on the hands, feet, face, groin, buttocks or a major joint.

Electrical Burns

An electrical burn may appear minor, but the damage can extend deep to the tissues beneath the skin. If the amount of electrical current that passed through the body was large, internal damage such as a heart rhythm disturbance or cardiac arrest can occur. Sometimes the jolt associated with the electrical injury can cause you to be thrown or to fall, resulting in fractures or other associated injuries. If this is the case, get emergency medical care!

While waiting for medical help, follow these steps:

1. Make sure the person is breathing. If breathing has stopped or you suspect the person’s airway is blocked, attempt to clear the airway and begin CPR.
2. If the person is breathing, cover any burned areas with a sterile gauze bandage (if available) or clean cloth. Don’t use a blanket or towel. (Fluffy fibers can be irritating.)
3. Stay with the person until emergency medical personnel arrive.