First Aid for Partial-Thickness Burn (Second-Degree Burn)

What is a partial-thickness burn?

Partial-thickness burns are more serious than superficial (first-degree) burns because a deeper layer of skin is burned. They can become infected more easily. Also, if the burn affects more than 10% of your body, you may go into shock because you can lose a lot of fluid from the burned area.

All partial-thickness burns more than 2 to 3 inches wide should be treated by a medical professional. Smaller burns can usually be treated at home.

Partial-thickness burns affect a deeper layer of skin, but they do not hurt muscle or bone. They are also sometimes called second-degree burns.

What causes a partial-thickness burn?

Partial-thickness burns are usually caused by:

• overexposure to the sun
• contact with a hot object, such as an iron or skillet
• contact with hot liquids or steam
• exposure to flames
• burning gasoline or kerosene
• contact with chemicals
• contact with electricity.

What are the symptoms?

The skin is bright red and has 1 or more blisters. The blisters usually turn white. There may be some swelling. With larger burns, you may have nausea or headache, too.

How is it treated?

After the cause of the burn has been removed or controlled, the goals of treatment for partial-thickness burns are easing the pain and preventing infection.

For burns with closed blisters:

• Try not to break the blisters. If the blisters break, the exposed skin can become infected.
• Flush the burn with cool running water or apply cold moist cloths until the pain lessens. Do not use ice or ice water, which can cause more damage to the skin.
• Remove jewelry or tight clothing from the burned area before the skin begins to swell. If you cannot do this, emergency rooms have special tools for removing jewelry or clothing.

For burns with open blisters:

• Do not remove clothing if it is stuck to the burn.
• Run cool water over the burn unless the burn is several inches in size. Running water over a large burn might increase the risk of shock.

For chemical burns, follow these first-aid steps while making sure to avoid more contact with the chemical:

• Immediately remove any clothing and jewelry on which the chemical has spilled.
• Flush liquid chemicals from your skin thoroughly with running water for 20 minutes. Be sure to avoid splashing the chemical in your eyes. After flushing, call the Poison Control Center for further advice, or have someone else call while you are rinsing the chemical off. It helps to have the chemical container with you when you make the call to make sure you give the correct name for the chemical.
• Brush dry chemicals off the skin if large amounts of water are not available. Small amounts of water will activate some chemicals, such as lime, and cause more damage. Be careful not to get any of the chemicals in your eyes.
• Do not try to neutralize a chemical. For example, putting an alkali chemical onto skin that has been exposed to an acid will often produce a large amount of heat and may increase the burning.
• Once all of the chemical has been removed, cover the burn with a sterile or clean, loose bandage and get medical care.

For all partial-thickness burns:

• Cover the burn with a clean (sterile, if possible), dry, nonfluffy bandage such as a gauze pad if it is more comfortable. Do not put tape on the burn.
• It's not necessary to cover the blisters unless clothing or something else is rubbing against them. If you need to cover a blister, put on a loose bandage. Be sure that the tape or adhesive does not touch the blister. Avoid wearing clothes or shoes or doing activities that rub or irritate the blisters until they have healed. Do not wrap tape completely around a hand, arm, foot, or leg. This could interfere with the blood supply if there is more swelling.
• Do not put ointments, grease, petroleum jelly, butter, or home remedies on the burn. These substances can hold the heat in, making the burn worse.
• Take aspirin or ibuprofen to relieve pain and inflammation, or take acetaminophen to relieve pain.
• Keep burned arms or legs propped up higher than your heart as much as possible for the first day or 2. This will help reduce pain and swelling.

Get medical care right away for partial-thickness burns more than 2 to 3 inches wide or for partial-thickness burns on the hands, face, penis, buttocks, or vaginal area.

• You will need extra fluids to replace the large quantities of fluids your body loses through the burned area. Your healthcare provider may give you fluids intravenously (through a tube into your vein).
• Your provider may prescribe antibiotics because the burned skin can no longer protect your body from infection by airborne bacteria.
• Your provider will either lightly bandage the burned area with an antibacterial dressing or leave it unbandaged, depending on the size and location of the burn.
• Your provider will prescribe medicine to kill the pain.
• Your provider may recommend a skin graft to lessen scarring.
• Your provider may give you a tetanus booster.

How do I keep taking care of a burn?

For a small burn, after you have cleaned and bandaged the burn, leave it alone for at least 24 hours to allow the healing process to begin.

If your healthcare provider has told you to change your bandages, follow these procedures to help prevent infection:

• Wash your hands carefully with soap and water.
• Open the clean bandage, but leave it in its package until you are ready to put it on the burn.
• Take off the old bandage gently. Soak it off if it sticks to the burn.
• Wash the burned area gently with mild soap and warm water. Do not use deodorant soap.
• Check for any changes or worsening of the burned area, such as pus, swelling, or increased redness.
• Put a thin layer of the antibiotic cream provided to you by your provider on the burn. Use a clean cotton swab. Do not touch the tube of antibiotic cream to the burned area. If you need more cream or ointment, use a new cotton swab.
• Cover with a sterile nonstick bandage.

Also:

• Protect the burn from pressure and friction.
• Do not bump or overuse the burned area.
• Drink plenty of water or juice to prevent dehydration.
• Avoid exposure to sun and to extreme hot and cold temperatures.
• Keep your follow-up appointments with your provider.

Call your healthcare provider right away if your burn does not heal in 10 days to 2 weeks or you have any of the following:

• fever over 101.5°F (38.6°C)
• puslike drainage from the burned area
• a lot more swelling of the burned area
• pain that is getting worse
• more redness of the skin
• a blister filled with greenish or brownish fluid or one that becomes hot again or turns red.

How long will the effects last?

Usually, partial-thickness burns heal in 10 days to 2 weeks. Large burns may take 3 to 4 weeks to heal. There may be little or no scarring if the burn was not too extensive and if infection is prevented.

How can I help prevent burns?

Some examples of things you can do to help prevent burns are:

• Turn your water heater setting down to 120°F (48.8°C).
• Keep pot handles turned away from the stove front.
• When you are outdoors, always use a sunscreen with an SPF of 15 or greater and wear protective clothing. Use a broad-spectrum sunscreen that protects against both UVA and UVB rays. It's best to put the sunscreen on your skin 30 to 60 minutes before you go out into the sun. Avoid being out in the sun for a long time, especially in the late morning and early afternoon.