A second-degree burn represents a partial-thickness injury that extends beyond the skin’s outermost layer, the epidermis, and damages the second layer, the dermis. Unlike a superficial burn, this injury involves a more significant depth of tissue destruction. Understanding this depth is the first step in ensuring the correct care for the injury.
How to Identify a Second Degree Burn
Second-degree burns are characterized by distinct visual and sensory features. The affected area appears intensely red or splotchy red and white, often looking shiny and moist due to fluid loss from the underlying dermis.
A defining characteristic is the formation of fluid-filled blisters, which may be intact or ruptured. The pain is typically intense because the nerve endings within the dermis are still functional. Swelling is also a common and immediate reaction surrounding the burn.
Initial Steps for Immediate Burn Care
The first action is to immediately remove the source of heat to stop the burning process. The injured area must be cooled down using cool, running water for 10 to 20 minutes. This cooling process reduces swelling, eases intense pain, and prevents the heat from penetrating deeper into the tissue.
Use cool water, not ice or ice-cold water, as extreme cold can cause further tissue damage or hypothermia if the burn is large. Gently remove any constricting items, such as rings or tight clothing, from the affected limb before swelling begins. If clothing is stuck to the burned skin, cut the fabric around the stuck area instead of pulling it away. After cooling, loosely cover the burn with a clean, sterile, non-adhesive bandage to protect it from contamination.
Maintaining the Wound and Preventing Infection
After cooling and initial covering, focus shifts to protecting the exposed tissue and managing healing. The burn should be gently cleaned daily with mild soap and water to remove debris. After washing, carefully pat the area dry with a clean cloth or gauze.
Blisters should be left intact whenever possible, as the blister roof provides a natural, protective barrier against infection. If a blister breaks, gently clean the exposed area and apply a non-stick dressing. To keep the wound bed moist and promote healing, apply a non-stick dressing, such as gauze coated with petroleum jelly or an antibiotic ointment.
Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can manage discomfort. Ibuprofen, a non-steroidal anti-inflammatory drug, may also help reduce inflammation. Change the dressing at least once a day, or whenever it becomes soiled or wet, to maintain a sterile environment and prevent bacterial intrusion.
Recognizing Complications and When to Seek Help
While small second-degree burns can be managed at home, certain factors necessitate professional medical attention. Seek immediate medical evaluation if the burn is larger than two or three inches in diameter or covers a sensitive area. Sensitive areas include the face, hands, feet, genitals, or a major joint. Burns caused by chemicals or electricity also need specialized medical assessment due to potential underlying tissue damage.
A worsening burn or the presence of infection signs are clear indicators to seek help. These signs include increased redness or swelling that spreads beyond the burn site, a foul odor, or pus-like drainage. A fever developing after the injury, or pain not relieved by over-the-counter medication, also suggests a complication requiring a doctor’s care.