Burn injuries require immediate and correct action to minimize damage and promote healing. A second-degree burn, also known as a partial-thickness burn, is a moderately serious injury that damages the outer layer of skin and the layer beneath it. Understanding the proper first aid and subsequent care for this type of burn is important for a successful recovery.
Identifying a Second-Degree Burn
A second-degree burn damages the epidermis (outer layer) and extends into the dermis (underneath layer). These burns cause intense pain because the nerve endings in the dermis are still intact and exposed. The affected area looks red, swollen, and often has a shiny, moist, or wet appearance.
The most distinctive feature is the presence of blisters, which may be intact or broken. If the burn is deep, the skin may appear mottled, waxy, or white, making it difficult to distinguish from a third-degree burn. If you are uncertain about the burn’s severity, treat it as a serious injury and seek professional medical advice.
Immediate Cooling and First Aid
The first step after a second-degree burn is to stop the burning process and cool the tissue immediately. Place the burned area under cool, running tap water for 10 to 20 minutes. This rapidly reduces skin temperature, limiting the spread of heat and preventing the burn from worsening. The continuous flow of cool water also provides significant pain relief.
Use cool water, not ice-cold water or ice, because extreme cold can cause further tissue damage or lead to hypothermia. Promptly remove any jewelry or restrictive clothing from the affected area before swelling begins. After cooling, cover the burn loosely with a sterile, non-adherent dressing or a clean cloth to protect the exposed tissue.
Avoid applying common home remedies like butter, oils, or powders, as these trap heat and increase infection risk. Do not use cotton wool or other fluffy materials, as fibers can stick to the wound. Do not apply pain-relief skin sprays, which can also trap heat. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can manage discomfort and inflammation.
Ongoing Wound Care and Dressing Changes
After initial cooling and covering, wound care focuses on preventing infection and maintaining a moist healing environment. Gently clean the burned area daily with mild soap and lukewarm water during dressing changes. This removes dead skin cells, drainage, and old ointment.
Blisters serve as a natural barrier against infection and should not be intentionally popped or drained. If a blister breaks, clean the area gently. If directed by a healthcare professional, trim away the dead skin around the edges to prevent further tearing.
Apply a thin layer of a topical agent to the burn surface. Use a petrolatum-based product or an over-the-counter antibiotic ointment like bacitracin or triple antibiotic ointment to help keep the wound moist and prevent bacterial growth. Apply the ointment to a sterile, non-adherent pad, placing the pad on the burn with the ointment touching the wound. Change dressings at least once a day, or more frequently if they become soiled or saturated.
Indicators for Emergency Medical Attention
While small second-degree burns can be managed at home, certain circumstances require immediate professional medical intervention. Seek emergency care if the burn covers a large surface area (larger than the injured person’s palm). Prompt evaluation is also needed for burns that encircle a limb or are located on sensitive areas: the face, hands, feet, major joints, or groin.
Immediate medical attention is necessary for any suspected third-degree burn, which may appear white, black, or leathery, and is often painless due to nerve damage. Watch for signs of infection, including increasing redness or swelling beyond the border, fever, or the presence of pus or foul-smelling drainage. Burns resulting from chemicals or electricity should always be evaluated due to the potential for deeper, unseen internal damage.