How Different Degrees of Burns Are Treated

The seriousness, or severity, of a burn usually depends on two key factors: how deep it goes (how far into the layers of skin the burn damage extends) and how wide it is (how much total body surface area it covers).

This article will discuss how to determine a burn's severity, how to treat a non-serious burn yourself, and when to get emergency care.

Degrees of Burns
Verywell / Cindy Chung

Burn Degrees

The severity of a burn depends on how deep it is, which is measured in degrees. First-degree burns are superficial (on the surface) while second- and third-degree burns extend deeper into the layers of the skin.

First-Degree Burns

Symptoms of first-degree burns include:

  • Dry skin that may have a raised area or welt
  • No blistering
  • Lower layers of skin are not exposed

Treatment

First-degree burns can usually be treated at home and don't require emergency treatment or hospitalization.

The first action after a burn should be to run cool (not cold) water over it or apply cold compresses for at least 10 minutes. Once the area is cooled down, you can clean the burn with mild soap.

Don't ice a burn! Using something too cold can cause more damage to the skin's tissues.

You can use petroleum jelly or aloe vera to help cool a burn and ease the pain. Topical antibiotic ointments are okay if there's no allergy to the product. Don't use creams, lotions, or oils.

Ignore the myths about applying butter or toothpaste—they don't help. In fact, they can trap heat inside the skin, and they invite infection.

Then apply a sterile bandage that won't stick to the burn. Over-the-counter (OTC) pain relievers can help ease the discomfort.

Summary of First-Degree Burn Treatment

  • Use cool running water or a cold compress.
  • Apply petroleum jelly, aloe vera, or an antibiotic ointment.
  • Cover with a nonstick bandage.
  • Take OTC pain relievers, if needed.

Second-Degree Burns

Symptoms of second-degree burns include:

  • Blistering of skin
  • Distinct layers of skin are visible around the well-defined edge of the burn
  • Blisters spread into one another until the very thin epidermis falls away, exposing the raw dermis layer underneath.
  • Severe pain caused by exposed nerve cells of the dermis
  • Severe second-degree burns may have a glossy, red appearance without blisters, and drops of liquid may form on the surface.

Treatment

To treat second-degree burns, follow the same steps as for a first-degree burn, being careful not to break any blisters. The blisters are part of the healing process, and opening them can lead to infection.

If you think the burn may require emergency treatment, do what you can to cool it while waiting for an ambulance, and use a cool compress on the way to the hospital. That can keep the damage from becoming worse.

When using an over-the-counter (OTC) pain reliever, choose an anti-inflammatory type as second-degree burns can cause swelling. OTC anti-inflammatories include Advil (ibuprofen) and Aleve (naproxen).

You can also elevate the area above the heart to lower inflammation. Your healthcare provider may prescribe an antibiotic cream such as silver sulfadiazine to prevent infection while you heal.

Third-Degree Burns

Third-degree burns, also called full-thickness burns, don't always look the same. Symptoms may include:

  • Dry and leathery skin
  • Black, white, brown, or yellow skin
  • Yellow fatty tissues where layers of skin are gone
  • Swelling
  • Lack of pain because nerve endings have been destroyed

Treatment

Intravenous (IV) fluids are often given to patients who have third-degree burns. This combats dehydration and shock and stabilizes the person. Other lifesaving measures may also be necessary, depending on the severity of the burn, such as fasciotomy and ensuring airway protection.

Eventually, skin grafts taken from undamaged areas of the body may be used to replace the burned skin.

Severe burns can result in long hospital stays. Multiple procedures may be required. The person needs to be monitored for complications such as:

  • Dangerously low blood pressure
  • Excess fluid buildup and swelling (edema)
  • Organ failure
  • Pneumonia
  • Severe infection
  • Sepsis
  • Heart rhythm abnormalities (in electrical burns only)

Fourth-Degree Burns

Fourth-degree burns go through both layers of the skin, underlying tissue, and deeper tissue, possibly involving muscle and bone. Similar to third-degree burns, there is no feeling in the area because nerve endings are destroyed.

Treatment

Along with the treatments for third-degree burns, surgery and skin grafting occur as soon after the injury as possible to reduce the risk of infection.

Fourth-degree burns can be life-threatening and may require amputation due to the severity of the burn injury. Fourth-degree burns often result in permanent disability and may require lengthy rehabilitation.

Signs of Infection

Get prompt medical treatment if your burn becomes infected. Symptoms to watch for are:

  • Drainage or pus from the burned skin
  • Fever
  • Increased pain
  • Red streaks spreading from the burn
  • Swollen lymph nodes

What Not to Do

Knowing what you shouldn't do is just as important as what you should. In the case of burns:

  • Do not use household products as burn treatments—such as butter, oil, ice, or eggs.
  • Do not remove clothing that's stuck to the burn.
  • Do not pop blisters or remove dead skin.
  • Do not use cold water on a burn.
  • Do not blow or breathe on the burn.
  • Do not put the person's head on a pillow if their airway has been burned from something they inhaled.
  • Do not allow the person to eat or drink if they have a severe burn.

When to Get Emergency Treatment

A first-degree or mild second-degree burn doesn't usually require immediate medical attention. However, certain factors can complicate healing and lead to more problems down the road. Get treatment right away if any of the following apply:

  • The burn is more than 3 inches across.
  • The burn covers a large area (3% or more for adults, 2% or more for children). One quick estimate is that the size of a person's hand (palm and fingers) is 1% of the body area, so burns covering the area of three hands for adults or two for children need immediate treatment.
  • The burn is on a baby, elderly person, or someone with diabetes or a weakened immune system (they may have impaired healing).
  • The burn is on the face, hands, feet, or genitals.
  • The burn goes all the way around a limb or extremity (even for first degree burns, as this can result in compartment syndrome)
  • The burn covers a joint.
  • The burn is from a fire, electricity, chemicals, or inhalation.

Get emergency medical treatment for all third-degree and fourth-degree burns as well as for severe second-degree burns. Some second-degree burns can be treated at urgent care instead of the emergency room. If you have any doubt about the severity, go to the hospital.

Summary

Burns are categorized as first, second, third, and fourth-degree burns depending on how deep they penetrate into the layers of the skin, tissues, muscle, and bone.

First-degree burns are not serious and can be treated at home. Second-degree burns are considered serious and require medical attention. Third and fourth-degree burns are considered a medical emergency.

10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Library of Medicine Medline Plus. Burns.

  2. American Academy of Dermatology Association. How to treat a first-degree, minor burn.

  3. Cleveland Clinic: healthessentials. Should you put ice on a burn (or not)?

  4. Cleveland Clinic. Burns.

  5. Children's Hospital of Philadelphia. Third-degree burns.

  6. University of Rochester Medical Center. Classification of burns.

  7. Shriner's Childrens. Fourth degree burn symptoms and treatment.

  8. Burn Survivor Resource Community. Fourth degree burns.

  9. University of Michigan, Michigan Medicine. Home treatment for second-degree burns.

  10. MedlinePlus. Burn evaluation.

Additional Reading
Rod Brouhard, EMT-P

By Rod Brouhard, EMT-P
Rod Brouhard is an emergency medical technician paramedic (EMT-P), journalist, educator, and advocate for emergency medical service providers and patients.