Sunburn is a common example of a superficial first-degree burn, in which only the top layer of the epidermis is affected. Blistering and skin sloughing does not occur with first-degree burns, pain is mild to moderate and healing usually occurs in less than a week.
Firework injuries can cause superficial burns like the ones pictured here. Because burns reduce defense to airborne bacteria, infection is a major concern.
Superficial second-degree burns involve both the epidermis and the papillary dermis. They often blister and skin sloughing is common. These burns are often painful, but heal in one-to-two weeks without significant scarring if treated properly.
Deep second-degree burns like the one pictured here, extend deeper into the reticular dermis. These burns can be more difficult to heal, pose a higher risk of infection, and often require surgical excision and grafting.
Also referred to as full-thickness burns, third-degree burns like this one involve all layers of the dermis and extend into the subcutaneous tissue. They are firm, dry, charred and leathery in appearance. This type of burn has a poor healing rate if not treated with early excision and grafting, and poses a high risk for infection and scarring, as well as death, especially if a large total body surface area is involved.
Fourth-degree burns are similar to other full-thickness burns, but differ in that the wound also involves injury to muscle, tendons, nerves, and bone. These underlying structures will be visible and usually appear charred. Fourth-degree burns will not heal with the presence of continued eschar and are at very high risk for infection and often result in amputation of the affected extremity.
Second degree burns are often painful, but heal in one-to-two weeks without significant scarring if treated properly.
Blistering and a beefier-red wound bed are often seen with deep second-degree burns.
The surgical removal of nonviable eschar (shown here) should be performed in a burn center.
Each year 450,000 people receive treatment for a burn injury in a number of different health care settings. Treatment can be complex, and determining which burns are minor and which warrant referral to a specialist is important to ensure the best patient outcomes. Properly categorizing burn injuries is the first step in treatment.