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Treatment of Burn Wounds

What is a burn?

A burn is damage to the skin or tissues caused by hot liquids, fire, hot objects, friction, or an electrical current. Burns can be classified as First, Second, Third, and Fourth degrees.

First-Degree Burns

First-degree burns involve only the outer layer of skin, which is the epidermis. These burns usually appear red and may be swollen with no blistering but may be painful. Theses burns are commonly associated with prolonged sun exposure*; however, can be seen after burns from hot liquids or fire. These burns typically heal in less than a week with minimal to no scarring.

*To learn more about the symptoms, care, and prevention of burns due to sun exposure, please visit our Sunburn 101 page.

Second-Degree Burns

Second-degree burns involve the epidermis and some or all of the dermis. (The dermis is the layer below the epidermis.) Blistering is usually noted with second-degree burns, which are pink in color, moist and/or shiny in appearance, and are often quite painful. However, a deep second-degree burn may appear white in color and may not be painful. Second-degree burns typically heal in 7-14 days, but deep second degree burns may take up to 21 days to heal. More often than not, second degree burn wounds heal without any significant scarring; however, they may be “discolored” for months and/or develop “puffy” scarring if they take longer than 21 days to heal.

Third-Degree Burns

Third-Degree Burns involve the entire dermis and destroy the hair follicles and sweat glands. These burns are white in appearance, dry, and not painful. Third degree burns require skin grafting to heal properly due to a significant risk of infection and contracture formation. Fourth-degree burns occur when the injury extends to the bone or other deep tissues, and are often seen with electrical burns and contact burns from super-heated metal object (i.e. mufflers)

What requires immediate medical attention?

  • Second, third, and fourth degree burns in any age group.
  • Burns that involve the hands, face, feet, perineum, major joints, or genitals.
  • All electrical and chemical burns.
  • All burn injuries in patients with pre-existing medical conditions (i.e. Diabetes Mellitus, Hypertension, Coronary Artery Disease, Peripheral Vascular Disease, etc.).

How is a first-degree burn treated?

  1. Cool the burn under running, room temperature water for several minutes.
  2. Soothe the area with Aloe Vera cream or burn ointment.
  3. Take Tylenol or Ibuprofen per the bottle directions for pain.
  4. Monitor site for blistering, if this occurs, should be evaluated by a physician.
  5. If you have concerns or questions about the burn site, contact your primary care physician.

Rarely requires burn center follow-up.

How is a second-degree burn treated?

  1. May place burn wound under running water that is room temperature. Do not place burn under cold running water or submerge in cold water because this can increase the depth of the burn.
  2. Cover burn with a clean dressing and have the burn wound evaluated by a trained burn physician, since inadequate or incorrect wound care may lead to infection or prolonged wound healing.

What can be done to prevent burns?

  • Supervise children closely when grilling, cooking in the kitchen, campfires, burning brush or leaves, running baths or water, and around electrical outlets.
  • Have smoke alarms installed in your home, test frequently, and ensure to change batteries per manufacturer's recommendations.
  • Have a fire extinguisher available in your home.
  • Set your water heater at 120° F or less; set even lower if small children are present in the home.
  • Teach children to stop, drop and roll.
  • If a person is on fire, smother the fire with a blanket or other clothing item.

When in doubt or if you have any questions or concerns, please feel free to call.

En Español

This information, although based on a thorough knowledge and careful review of current medical literature, is the opinion of doctors at The University of Texas Medical School and is presented to inform you about surgical conditions. It is not meant to contradict any information you may receive from your personal physician and should not be used to make decisions about surgical treatment. If you have any questions about the information above or your child's care, please contact our doctors.