Burns Treatment: First and Second-Degree Burns

First and Second degree burn
Medically reviewed by Dr. Mavra Farrukh

Overview

A burn occurs when hot substances destroy some or all skin layers. It is the 15th leading cause of death. According to WHO, it’s a global public health problem with over 96000 deaths annually from fire-related burns. Smoking and scalding are the leading causes of burns in adults and children. This article will discuss mainly first and second-degree burns and the best way to treat them.

What is a Burn?

Burn is an injury to the skin which causes damage to the tissues primarily caused by excessive heat, radioactivity, friction, electricity, or chemicals. Burns can be minor medical issues or life-threatening emergencies. The burns’ severity depends on the burning substance’s temperature or surface’s duration.

Degrees of Burn

There are three primary degrees of burns: first-degree, second-degree, and third-degree. Each degree depends on the severity of the damage to the tissues. First-degree burns are minor burns, whereas third-degree is the most severe. 

First-Degree Burn

Burns of the first degree are also known as superficial burns. The epidermis is the outermost layer of the skin. The skin consists of three layers, and the epidermis is the thinnest. Hence, a first-degree burn is the mildest form of skin injury and usually doesn’t require medical help. Moreover, long-term tissue damage is rare in first-degree burns. However, some superficial burns can be significant or painful and may require medical treatment. 

Symptoms 

Symptoms of first-degree burns include the following:

  • Minor inflammation
  • Dryness
  • Pain
  • Redness and peeling skin
Consult with our Doctors and get First Aid for First and Second Degree Burns

Causes of First-Degree Burns

Sunburns 

Intensive ultraviolet rays produced by the sun can penetrate the outer layer of skin, causing sunburn. Sunburn can cause redness and blisters on the skin. Additionally, a sunburn usually heals by itself within a few days; therefore, no extensive medical care is necessary.

Scalds 

One of the most common causes of first-degree sunburn in children younger than 5 is scalds. It causes damage to the skin through heat and hot objects. For example, consuming hot food or hot drinks can scald the roof of your mouth, which can cause superficial burns or first-degree burns. It can also occur if you shower in boiling water. Furthermore, higher temperatures can lead to more severe skin issues, especially in children.

Electrical burns

An electric burn is a skin burn that occurs when electricity comes in contact with your skin. Electricity can travel through your body which can damage the tissues and organs. The electric burn damage can be mild or severe. A person can also get burned or electrocuted from exposure to electricity by playing with an electric appliance or by sticking any object into the openings of a socket.

Thermal burns 

Thermal burns may occur from any external heat source, such as hot liquids, flame, hot solid objects, or occasionally steam. Fire may also cause first-degree burns sometimes. 

Treatment 

First-degree burns usually require at-home care. It includes the following:

  • Taking ibuprofen or acetaminophen for pain relief.
  • Applying lidocaine.
  • Using antibiotic ointment and loose gauze to protect the affected area.
  • Cold compresses 

Second-Degree Burns

A second-degree burn is also known as a partial-thickness burn. It affects the epidermis and part of the dermis layer of the skin. It can cause blisters, swelling, and redness, white or splotchy skin. It can also cause severe pain, but it can be relatively minor. Burns that affect large areas can cause severe complications and may be prone to infection. Cancer patients undergoing chemotherapy are also at risk, as are those with a weakened immune system. It takes longer for 2nd-degree burns to heal than first-degree burns. Large areas of the body or face, joints, genitals, or buttocks are more susceptible to 2nd-degree burns.  

Second-degree burns are divided into two categories 

  • Superficial second-degree burn:

It typically heals with conservative care, which requires no surgery at all. It usually takes two to three weeks for healing. In order to treat burn wounds, topical medications are applied. The new epidermis grows in three to four weeks with proper care.

  • Deep second-degree burns:

It appears more pale than pink. The skin is drier, and the sensation of the skin can be diminished. These burns may need surgical treatment, depending on the severity. 

Causes of Second-Degree Burn

Physical heat sources such as sun, stove, and kettle can cause second-degree burns. Certain chemicals, including bleach and other cleaning products, can also cause burns.

Some common causes of second-degree burns include the following:

  • Direct contact with boiling water
  • Accidents with stoves, kettles, or ovens
  • Severe sunburn 
  • Exposure to fire 
  • Certain chemicals

Intentional abuse, such as acid attacks, can also cause a second-degree burn. Such chemical burns are also known as caustic burns.

Third-Degree Burns or Full-Thickness Burns

A third-degree burn is also known as full thickness burn. This type of burn damages the epidermis (outer layer of the skin) and the entire layer beneath. In some cases, it can also damage the hypodermis, which is the innermost layer of the skin. A third-degree burn is more severe than a first and second-degree burn and always requires skin grafts. These burns have very diminished pain. It can cause serious injury requiring immediate medical help because it can damage the nerve endings in the skin responsible for sensing pain.

The burn site may appear white, grey, brown, waxy, or leathery. A person with a third-degree burn may require hospitalization. The treatment will vary depending on the location and severity of the burn.

Symptoms of Third Degree Burn

Symptoms of third-degree burns include the following:

  • Whitish color
  • Blisters that do not develop
  • Waxy or leathery

Causes of Third-Degree Burn

Following are some commonly observed causes of 2nd-degree burns.

Steam 

Steam can cause third-degree burns as it penetrates the epidermis to the lower layers of the skin and tissue. It may also cause infection. 

Flames 

When the skin comes in contact with hot objects for an extended period, such as flames from a fire, it damages the epidermis and the lower layers of skin, causing a third-degree burn.

Flash burns

Flash burns are the most severe consequences of a nuclear explosion. It results from the absorption of radiant energy by the skin. A 1-megaton explosion can cause third-degree burns at distances up to 5 miles. It burns over 25 percent of the body.

Chemical burns

Chemicals can cause third-degree burns if a person comes in contact with a harsh substance such as bleach, disinfectants, or acid. It damages the tissues of your body due to rough or corrosive substances. Swallowing household chemicals can also cause third-degree burns, which may result in serious complications. Mild chemical burns usually heal quickly, but severe chemical burns can be life-threatening and can cause permanent tissue damage.

Treatment 

These wounds recover with severe scarring and spotting without surgery. Other treatments include the following:

  • Antibiotic ointments or creams 
  • Intravenous fluids that contain electrolytes 
  • Early cleaning and debriding 

Difference between First and Second-Degree Burn

Burns are usually classified according to the depth of the injury caused to the layers of the skin. First-degree burns are less severe than second-degree burns. First-degree burns damage the outer layer of the skin, whereas second-degree burns affect the epidermis and the next layer (dermis). The burn site appears red, swollen, blistered, and painful in a 2nd-degree burn. Whereas in first-degree burns, the burn site appears red, dry, and painful with no blisters. For example, mild sunburn. 

Symptoms of First-Degree Burns

First-degree burns usually have only minor symptoms for a week or two after they occur.

  • Skin redness
  • Dryness
  • Pain

Symptoms of Second-Degree Burn

Following are the common symptoms of partial thickness burn.

  • Severe pain
  • Blisters 
  • Redness
  • Swelling
  • Discoloration 

If you experience any of these symptoms, then consult your healthcare provider for testing and treatment. 

Consult with our Doctors and get First Aid for First and Second Degree Burns

Infections Associated with Burns

Staphylococcus 

Staphylococcus is an infection caused by severe skin burns. People with eczema are more likely to get staphylococcus. It lives harmlessly on skin surfaces, especially around the nose, genital area, and mouth. Staph infection spreads through a contaminated surface or from person to person. 

Pseudomonas 

Pseudomonas is among the leading causes of infections in people suffering from severe skin burns. This infection can cause significant delays in a patient’s recovery, leading to fatal issues. It can also spread to people through contaminated surfaces, hands, and equipment. 

Acinetobacter 

Patients with severe skin burns are more prone to infections such as acinetobacter. It can spread directly to a person or environment with bacteria. It is highly contagious. It may lead to delays in wound healing, graft losses, and the development of sepsis.

Anaerobic Infection

Anaerobic bacteria cause anaerobic infection. These bacteria occur naturally in the body. Conditions with anaerobes are rare and typically occur due to electrical burns.

Hypokalemia 

A patient with a burn injury is at a higher risk for sodium and potassium imbalances in both the resuscitation and acute phase, which can cause hypokalemia. The body releases extra potassium in your blood in response to severe burns.

Keloids 

Anything that can leave a scar can cause a keloid. This includes being burned, cut, or having severe acne. Keloids can also develop after you get your body pierced. Keloids sometimes appear for four months or more after your skin is injured. Keloid scars are thick, itchy, and painful. 

Sepsis 

An infected burn can cause sepsis (blood poisoning) or toxic shock syndrome. This condition can be life-threatening if not treated on time. Signs of sepsis include the following:

  • A high temperature 
  • Dizziness 
  • Vomiting 

Sepsis can be treated by topical or systemic antimicrobial therapy, debridement, or wound cleansing. 

Treatment of Burns

Burns are generally preventable, and the treatment depends on the severity of the burn. If the patient is immediately transferred to a burn center, burns are covered with clean and dry dressings. The doctors apply antibiotics at the burn center. Major burns may require prolonged treatment. 

For minor burns, doctors recommend the following ointments 

  • Bacitracin
  • Polysporin
  • Silver sulfadiazine 
  • Neosporin 
  • Mupirocin (it’s only available with a prescription)

Antibiotics are a popular option to apply to burns as they are relatively inexpensive and easy to find. Also, consider s tetanus shot for recovery. 

Skin Grafts 

Full-thickness burns are treated with skin grafting. The purpose of this surgery is to remove dead skin and replace it with healthy skin. It is often treated with an antibiotic ointment or a non-sticky dressing. There are three types of skin grafts.

  • Sheer graft

It is usually applied to the face or hands for a better cosmetic effect. It uses the whole piece of skin without holes. Newly healed grafts are fragile and sensitive. It would be best if you took special care to protect them. Do not rub or scratch them. 

  • Meshed grafts

A meshed graft is used for more significant wounds. During the procedure, a piece of skin is taken from another part of the donor’s skin to close the open area. The donor skin shrinks when it is taken off the body. It is then put through a machine to stretch it. This stretched skin covers a large body but leaves a permanent mesh pattern. A new layer of skin fills the areas between the holes to heal the wound.

Special Dressings

Advanced dressings are pads and strips that have wound-healing products in them. You don’t have to apply ointments with these dressings. Special dressing keeps the skin safe from damage. These dressings also speed up the healing process. But it has one disadvantage, these dressings are relatively more expensive than ointments. Special wound dressings include 

  • Hydrocolloids (DuoDerm)
  • Hydrogels (Aqua clear) 
  • Silver-impregnated drugs
  • Non-adherent gauze 

First-Degree Burns Treatment

First-degree burns can be treated at home. Here are some details on how to treat first-degree burns:

Cool the Burned Area

The first step in treating a first-degree burn is to cool the burned area immediately. You can run the burned area under cool water for 10-15 minutes. Alternatively, you can apply a cold compress to the burned area. This will help to reduce pain and inflammation.

Apply an Ointment

Once you have cooled the burn, apply topical ointment to the affected area. Aloe vera gel or petroleum jelly are good options for first-degree burns. These can help to soothe the burn and prevent the skin from drying out.

Cover with a Clean, Dry Bandage

After applying the ointment, cover the burn with a sterile, non-stick bandage. This will help to protect the burn from infection and further irritation. Be sure to change the dressing daily and keep the area clean.

Take Over-the-Counter Pain Relievers

You can take over-the-counter painkillers like acetaminophen or ibuprofen if the burn makes you feel pain. Make sure to adhere to the dose instructions on the packaging.

Stay Hydrated

After a burn injury, maintaining hydration is crucial because the body may lose fluids via the burned skin. To help prevent dehydration, consume plenty of water and other liquids.

Avoid Sun Exposure

If the burn was caused by sun exposure, stay out of the sun until it has healed. Cover exposed skin with sunscreen and wear protective gear if you must go outside in the sun.

Monitor for Infection

Finally, monitoring the burned area for signs of infection is essential. If you notice redness, swelling, pus, or increased pain, seek medical attention immediately.

Second-Degree Burns Treatment 

Because they affect the deeper layers of the skin, second-degree burns are more severe than first-degree burns. These burns are brought on by prolonged contact with hot objects, fires, or hot liquids. They may result in discomfort, swelling, and blistering. The following information will explain how to treat second-degree burns:

Cool the Burned Area

The first step in treating a second-degree burn is immediately cooling the area. You can run the burned area under cool water for 10-15 minutes. Alternatively, you can apply a cold compress to the burned area. This will help to reduce pain and inflammation.

Do Not Pop Blisters

If blisters have formed, do not pop them. They act as a natural barrier to infection and help the skin to heal. Popping blisters can increase the risk of disease.

Apply an Antibacterial Ointment

Once the burn has healed and cooled, apply an antibacterial cream. Infection can be avoided, and the healing process will be aided. You can also cover the burn with non-stick gauze to prevent further harm.

Take Over-the-Counter Pain Relievers

You can take over-the-counter painkillers like acetaminophen or ibuprofen if the burn makes you feel pain. Make sure to adhere to the dose instructions on the packaging.

Elevate the Burned Area

Elevate the burned area above the heart if it is on a limb. This will help to reduce swelling.

Stay Hydrated

After a burn injury, maintaining hydration is crucial because the body may lose fluids via the burned skin. To help prevent dehydration, consume plenty of water and other liquids.

Monitor for Infection

It is crucial to monitor the burned area for signs of infection. If you notice redness, swelling, pus, or increased pain, seek medical attention immediately.

Seek Medical Attention

If the burn is severe, covers a significant section of the body, or is accompanied by additional symptoms like fever or chills, seek emergency medical attention. Second-degree burns may sometimes require medical treatment, such as antibiotics or skin grafts.

Home Remedies for Burns

Burns, which can be moderate to severe, are frequent household injuries. Even though particular burns might need medical attention, some natural cures might assist in lessening the discomfort and speeding up the healing process for mild burns. The following are some natural cures for burns:

Cool Water 

Drop cool Water over the burned area for at least ten to fifteen minutes. This is the first and most crucial at-home treatment for burns. This will lessen the discomfort and swelling and stop the burn from penetrating further into the skin.

Aloe Vera

Aloe vera has been used for generations to cure burns since it is a natural anti-inflammatory. Use store-bought aloe vera gel or apply fresh aloe vera gel straight to the injured area. Apply the solution a few more times daily until the burn has healed.

Honey

Honey’s natural antibacterial and anti-inflammatory properties help to soothe and heal burns. After being generously covered in honey, the affected area should be wrapped in a sterile bandage. Change the dressing every day until the burn has healed.

Tea Bags

Tea bags have tannins that may be used to relieve and lessen burn pain. Allow hot Water to steep a tea bag for a few minutes before cooling. To treat the region, place the tea bag there and hold it for a few minutes.

Coconut Oil

Burns can be soothed and healed thanks to coconut oil’s antibacterial and anti-inflammatory characteristics. A sterile bandage should be placed over the injured region after applying a thin coating of coconut oil. Until the burn has healed, change the dressing every day.

Vinegar

Due to its astringent and antibacterial qualities, vinegar can help to treat burns more comfortably and lessen their discomfort. Apply white vinegar to the afflicted region with a clean towel after diluting it with equal Water. Apply the solution a few more times daily until the burn has healed.

Oatmeal

Burn irritation can be relieved and reduced with the aid of oatmeal. Apply a paste made of oats and Water to the afflicted area. After 15-20 minutes, leave it on and wash it off with cool Water.

Healing Stages of Burns

The healing process for burns can vary depending on the individual and the severity of the burn. Proper treatment and care can help to speed up the healing process and minimize scarring. Here are the healing stages of first-degree burns and second-degree burns:

First-Degree Burns

The minor burn, first-degree burns, only harm the epidermis. If they receive the proper care, they usually recover within a week.

Initial Reaction

First-degree burns cause the damaged area to become red, painful, and swollen. Additionally, the skin may feel heated to the touch.

Peeling and Flaking

After a few days, the affected skin may peel or flake as it heals.

Scarring

First-degree burns rarely leave scars but can occasionally result in a modest alteration in the color or texture of the skin.

Second-Degree Burns

Second-degree burns attack the deeper layers of the skin, making them more severe than first-degree burns. They may need medical attention and take several weeks to heal.

Initial Reaction

Redness, discomfort, and swelling in the location of the burn sustained in the first stage are typical responses. Blisters could also develop.

Blister Rupture

The blisters may rupture, leaving an open wound vulnerable to infection.

Granulation Tissue

After a few days, granulation tissue may form around the wound. This tissue is a sign that the body is starting to heal.

Scabbing

The wound may then begin to scab over as it continues to heal.

Scarring

Second-degree burns can cause scarring, but the severity of the scarring will depend on the depth and extent of the burn.

Rehabilitation

Rehabilitation exercises and physical therapy may be needed to help restore the range of motion and function to the affected area.

How to Manage Burn Pain?

Burn pain can be excruciating and significantly impact a person’s quality of life. Here are some ways to manage burn pain:

Cool Water

Cool water over the burn for 10-15 minutes can help reduce pain and inflammation. This should be done immediately after the burn occurs.

Topical Pain Relievers

Topical analgesics like lidocaine or benzocaine can be administered immediately after the burn to help ease discomfort. These products come in both nonprescription and prescription forms.

Distraction Techniques

Distraction techniques, such as deep breathing, meditation, or listening to music, can help to take the focus off of the pain.

Hypnotherapy

Hypnotherapy can be a helpful tool for managing burn pain. A trained hypnotherapist can guide a person through relaxation and visualization techniques to help alleviate pain.

Supportive Care

Supportive care, such as wound care, dressing changes, and physical therapy, can help to manage pain and promote healing.

Burn Complications

Burns can result in some issues that may harm a person’s health and well-being. Infection, scarring, contractures, hypovolemia, respiratory problems, psychological discomfort, and dietary shortages are some of these consequences. If any issues develop, it is crucial to seek medical care right away because prompt treatment and care can aid in preventing and managing complications and promoting healing.

What are the do’s and don’ts for 2nd (Second) degree burn?

Here are some do’s and don’ts for 2nd-degree burns:

DO:

  • Cool the burn immediately with cool (not cold) water for 10-15 minutes to reduce pain and swelling.
  • To prevent infection, dress the burn with a sterile, non-adhesive dressing.
  • Use over-the-counter painkillers to treat pain, such as acetaminophen or ibuprofen.
  • Keep the burn elevated to reduce swelling.
  • Stay hydrated by drinking plenty of fluids.
  • Follow the healthcare provider’s instructions for any medications or treatments prescribed.

DON’T:

  • Applying ice immediately to a burn could further harm the skin, so avoid doing so.
  • Do not apply butter, oil, or other home remedies to the burn; they can trap heat and bacteria and worsen the burn.
  • Do not break any blisters that form on the burn, as this can increase the risk of infection.
  • Using tape or adhesive bandages might worsen the burn’s harm to the skin; therefore, avoid doing so.
  • Do not expose the burn to direct sunlight, which can cause further damage and increase pain.
  • Do not try to remove any clothing or material stuck to the burn, as this can cause further damage to the skin.
  • You shouldn’t put a few things on burns, like ice, steroid cream, toothpaste, honey, and dressings that shed fiber.

What should you avoid?

Prevention is the key. There are several recommendations to reduce the burn risk.

  1. Avoid smoking in bed
  2. Limit the height of open flames
  3. Lower the temperature of hot water taps.
  4. Avoid hot spills
  5. Always check that electrical cords are not frayed.
  6. Smoke alarms

Recovery of First and Second-Degree Burn

A first-degree skin burn usually heals within a week, leaving minimal scarring. These burns don’t need any medical attention. The burn may require medical attention and proper treatment if it is severe. Whereas severe burns may take a long time to heal, after appropriate first aid and wound assessment, the procedure may involve medications, wound dressings, therapy, and surgeries. It usually takes more than nine weeks to recover. 

Consult with our Doctors and get First Aid for First and Second Degree Burn

When to Consult a Doctor?

It is suggested to consult a doctor in case of a burn, depending upon the degree of the burns.

In case of first-degree burns, patients must get first aid and treated using OTC tubes.

Regarding second-degree burns, you should talk to your doctor for better treatment.

If you are seeking the proper treatment for burns, your doctor’s online team has a professional doctor’s team that can treat your wound most efficiently!

FAQs About First and Second-Degree Burn Answered By your Doctor Online Team

Can I cover a first-degree burn?

A superficial burn can be treated at home with a clean, non-stick, and sterile bandage. If blisters occur, let them heal on their own.

Do burns need air to heal?

No burns do not need air to heal. Air can further damage the tissues as burns are considered open wounds. They heal better in a moist environment.

Can a second-degree burn be treated at home?

You can treat a second-degree burn at home. Use antibiotic ointments and special dressings to treat a second-degree burn at home.

What is the best ointment for first and second-degree burns?

The best ointment for a burn may depend on the severity of the burn and the individual’s specific needs. Silver sulfadiazine (Silvadene) is a commonly used prescription medication for second-degree burns. At the same time, Bacitracin is an over-the-counter antibiotic ointment that can be used for both first and second-degree burns. Aloe vera and petroleum jelly are natural remedies that can help to reduce pain and inflammation and promote healing.

Should you cover a burn or let it breathe?

In general, it is recommended to cover a burn to promote healing and prevent infection. Covering a burn helps protect the wound from outside bacteria and prevents the burn from drying out, slowing the healing process. It can also help to reduce pain and promote comfort. However, using the proper materials when covering a burn is essential. Non-stick dressings like gauze can cover the burn and promote healing. It is crucial to avoid using adhesive bandages or dressings that can stick to the wound and cause further damage.

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