Basics of burn care: Degrees, essential treatment

Basics of burn care: Degrees, essential treatment

Ahmed Raza

Burns are common injuries caused by heat or chemicals. However, burns can differ significantly by their cause and seriousness. A minor burn heals quickly and without intervention, while a severe burn causes significant physical and psychological damage.

The American Burn Association states that approximately 486,000 patients receive medical treatments for burns each year1. However, minor burns can be cared for at home. This article will cover the major types of burns, when to seek professional care, and the medical treatment for burns.


“Sunburn” by philkates is licensed under CC BY-SA 2.0

What causes a burn?

A burn is caused by a transfer of energy to the body. There are several different things that can cause a burn, like thermal (heat), cold (ice), chemical, electrical, or radiation2.

Types of burns

Burns are labeled from first to the fourth degree, depending on severity3. There are three layers of skin called the epidermis, dermis, and hypodermis. The epidermis is the first layer of skin, provides a barrier to infection, and regulates water loss. Next, the dermis is the next layer that primarily consists of connective tissues to protect the body from stress. Finally, the hypodermis, also known as the subcutaneous layer, is the border that connects the skin to the fibrous tissue of the bones and muscles.

Structure of mammalian skin

Structure of mammalian skin by Sean P Doherty is licensed under CC BY-SA 4.0

First degree

A first-degree burn affects only the first layer of the skin called the epidermis. These burns are usually caused by:

Healing can take anywhere from three days to three weeks. As your skin heals, it may peel. If your symptoms worsen or last longer than three weeks, consult a healthcare provider.

First Degree

“First Degree” by Lachlan Hardy is licensed under CC BY 2.0

Second degree

Second degree burn after 2 days

“File: Second-degree burn after 2 days.JPG” by Themidget17 is licensed under CC BY-SA 4.0

The second-degree burn involves redness, severe pain, and blistering to the affected area. Second-degree burns benefit from being covered with sterile, non-stick gauze to protect the site and also may need antibiotic ointment.


3rd degree burn with latex

“3rd degree burn with latex” by B L U S H is licensed under CC BY-ND 2.0

A third-degree burn penetrates the second layer of the skin called the dermis. You may need to wear tight clothing called compression garments to help skin heal. For third-degree burns, some patients need a skin graft of healthy skin to place over burned skin. A physical therapist may help to strengthen and stretch the affected areas.

Fourth degree

A fourth-degree burn is down to the muscle and the most severe. If you experience a fourth-degree burn, you should raise the injured body part above the heart. Chemical burns should be flushed. Do not apply ice, burn cream, or remove clothing that is stuck to the burn.

The professionals will clean the burn and remove dead tissue. You will get:

Fourth-degree burns increase the risk of shock from the major inflammatory response. They are serious and affect more than the skin. However, the sooner that you seek treatment, the better. Some of the treatments are similar to a third-degree burn, such as skin grafts and physical therapy.


Burns that cover a large body area (more than 30%) cause cardiovascular, respiratory, metabolic, and immunological effects 3. To determine the burn percentage, health care professionals use the rule of nines that divides the entire body’s entire surface into 11 areas, each given a value of 9%. The additional 1% is credited to the groin. This differs in children because the rule of nines provides a child’s head with a more significant percentage of surface area on the body than adults.

513 degree of burns

513 degree of burns by OpenStax College under license of CC by 3.0

The three zones of a burn are

When to seek professional care

It is possible to manage minor burns without seeking emergency care. These involve:

Signs of infection include:


You can treat most burns in the comfort of your home4 . There are some crucial steps to follow to treat your burns.

For major burns, call for emergency services immediately.

Severe burns require giving intravenous fluids, known as fluid resuscitation. This process will manage shock, intravascular volume depletion, and end-organ perfusion.

Be prepared

While it’s a common household injury, prevention is the best initial step. Unfortunately, burns happen, despite our best intentions. The best way to prepare yourself to care for burns is to become first aid certified.

Cleveland Clinic: Here’s a similar article about the types, complications, and treatment of burns.

Works cited

Written by on Jul 1, 2021

Caitlin Goodwin, DNP, RN, CNM, is a Board Certified Nurse-Midwife, Registered Nurse, and freelance writer. She has over twelve years of experience in nursing practice.

Last reviewed and updated by on Apr 5, 2022

Caitlin Goodwin, DNP, RN, CNM, is a Board Certified Nurse-Midwife, Registered Nurse, and freelance writer. She has over twelve years of experience in nursing practice.

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