A burn is damage to the skin and sometimes to the underlying tissues. Burns can range from mild to severe. Some are fatal.
There are four main types of burns:
First degree—mild, affect the outer layer of skin
Second degree—deeper into the outer layer of skin
Third degree—serious, all layers of skin are damaged
Fourth degree—very serious, damage goes to nerves, muscle, tendon, and/or bone
Classification of Skin Burns
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Burns can be caused by:
Heat or flame, such as:
- Hot foods, drinks, water, oil, or grease
- Direct heat such as stoves, heaters, or curling irons
- Direct flame
Chemicals, such as:
- Cleaning products
- Battery fluid
- Pool chemicals
- Drain cleaners
Sunlight (sunburns) or tanning beds
Radiation—nuclear, x-rays or radiation treatments for cancer
Burns are more common in males, children, and older adults. Other things that raise the risk are:
- Alcohol use
- Illegal drug use
- Absent or non-working smoke detectors
- Older housing
- Not watching children closely
- Using tap water hotter than 120°F (48.8°C)
Burn symptoms and signs vary. It depends on the type of burn.
First Degree Burn
- Burned area turns red and is painful
- The area turns white when pressed
- There may be swelling but no blistering
Second Degree Burn
- The area is moist, red, and weeping—or waxy dry
- The area may turn white when pressed
- Usually painful to air and temperature
Third and Fourth Degree Burn
- Skin can appear waxy white, leathery gray—or charred and blackened
- May feel deep pressure but no pain
The doctor will check your symptoms and health history. A physical exam will be done.
Testing is based on how severe the burn is. Tests may include:
- Blood tests
- Imaging—to see how deep the burn is, or if it has affected the inside of the body
- ECG—for electrical burns
Burns needs to be treated right away. Treatment depends on the severity and extent of the burn. The goal is to reduce damage to the tissues and prevent infection.
Minor burns are treated with first aid measures—such as cooling and covering the burn.
Serious burns need medical help right away. Treatment may include:
- CPR and first aid
- Airway and breathing support—with oxygen or mechanical ventilation
- Pain medicines
- Ointments and dressings—to promote healing and prevent infection
- IV fluids—to replace those lost from the burn
- Surgery, such as skin grafts—if burns are unlikely to heal
- Physical therapy—if burns are large
Most burns are from accidents. To reduce the risk:
Watch children and protect them from hazards, such as:
- Stove burners, hot water, hot water faucets, and hot food and drinks
- Matches, lighters, candles, cigarettes
- Gas, chemicals, and firecrackers
- Electric cords and outlets
- Use smoke detectors and make sure they work
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First aid for burns: Parent FAQ. Healthy Children—American Academy of Pediatrics Healthy Children website. Available at: https://www.healthychildren.org/English/safety-prevention/all-around/Pages/First-Aid-For-Burns.aspx. Accessed March 3, 2021.
Litt JS. Evaluation and management of the burn patient: a case study and review. Mo Med. 2018;115(5):443-446.
Major burns. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/major-burns. Accessed March 3, 2021.
Minor burns. EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/condition/minor-burns. Accessed March 3, 2021.
Protect the ones you love: burns. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/SafeChild/Fact_Sheets/Burns-Fact-Sheet-a.pdf. Accessed March 3, 2021.
Topical treatment and dressing of burns. EBSCO DynaMed. Available at: https://www.dynamed.com/management/topical-treatment-and-dressing-of-burns. Accessed March 3, 2021.
Last reviewed January 2021 by
EBSCO Medical Review Board
Marcin Chwistek, MD
Last Updated: 3/3/2021