10 Types of Second-Degree Burns

Variations in appearance, cause, and severity

Second-degree burns, also called partial-thickness burns, compromise the outermost layer of skin (epidermis) and extend to the middle skin layer below (dermis). The degree of a burn is a classification of how severe it is based on how many layers deep it goes through the epidermis, dermis, and fatty tissues of the subcutaneous (under the skin) layer. While the severity of 2nd-degree burns is similar from one to another, their appearance can vary, depending on the cause, size, and exact depth.

A second-degree burn that affects less than 10% of the skin's surface can usually be treated on an outpatient basis with antibiotic ointments and changes in sterile dressing two or three times a day (depending on the severity of the burn). Larger burns should receive medical attention.

SEVERITY EPIDERMIS DERMIS SUBCUTANEOUS
1st-degree burn   
2nd-degree burn
3rd-degree burn
Source: National Institutes of Health: MedlinePlus

Scalding

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Scalding hot water spilled onto this reader's hand, causing blisters consistent with 2nd degree burns

Nordyke

This 2nd-degree burn was caused by scalding with hot water. The woman involved was carrying a pot of boiling water and lost grip of one handle, spilling the water on her left hand.

Scalds are burns from hot liquids. They almost never cause full-thickness (third-degree) burns, but they do blister extensively and quickly.

According to statistics from the Centers for Disease Control and Prevention, over 350,000 Americans are treated for burns in emergency rooms each year, while over 40,000 are hospitalized as a result of their injuries.

Open Flame Burn

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Partial thickness burn from an unloaded potato gun

Shells

An unloaded potato gun gave this person a second-degree burn. A potato gun is a novelty device that uses hairspray as the explosive agent to propel a potato into the air. In this instance, the flaming hairspray caused the skin damage and not the potato.

Symptoms of a second-degree burn include pain, deep redness, blistering, and areas of exposed tissue that are moist and shiny.

Chemical Heat Pack Burn

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Second degree burn from a reusable heat pack

Nise

A reusable chemical heat pack caused this burn to the neck. In this case, the individual placed the pack in the microwave for 60 seconds, even though the instructions said to heat it for 30 seconds.

Unlike other 2nd-degree burns, there is no evidence of blistering here. Blisters indicate that the epidermis is damaged and not obliterated. In this instance, the destruction of the outer layer causes areas of whiteness and discoloration common with many 2nd-degree burns.

Chemical Heat Pack Burn (Five Weeks Later)

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Healing 2nd degree burn

Nise

After sustaining a burn from a chemical heat pack, the individual was treated with topical anesthetics to numb the skin. This picture shows how the burn looks five weeks after the injury.

Even after significant healing, burns this severe tend to have significant pain for weeks. Oral analgesics like Tylenol (acetaminophen) can usually help.

Candle Wax Burn

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Hot wax under a faucet exploded, causing these burns

Cmoore

Hot candle wax is a common cause of second-degree burns. In this case, the candle wax exploded and splattered wax onto the hand of the woman.

When water comes into contact with the pool of hot wax near the burning wick, it causes the wax to explode outward. The type of candle and/or wax can make a big difference in the severity of the injury you sustain.

Paraffin wax melts at around 120 degrees F, votive candles at around 135 F, and taper candles at 140 F or higher. The most serious burns come from beeswax, which melts at 145 F or higher. To avoid burns, the wax temperature should be well below 125 F (such as that used for body waxing).

Steam Iron Burn

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Steam and hot water from an iron caused this large blister

Cheryl H.

After burning herself with the steam from a household iron, this woman developed a relatively small but painful second-degree blister on her pinky finger.

People often underestimate the dangers of hot steam. When your car overheats, for example, the steam escaping from the radiator will be between 190 F and 220 F, enough to cause a severe burn in less than a second.

If the jet of hot steam hits your eye, you can sustain severe corneal damage, including scarring, perforation of the eye tissue, and, in extreme cases, blindness.

Hot Oil Burn

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Hot Oil Burn

Sarah

Hot oil burns are common in the kitchen, especially in children, with a frequent cause being deep fryers. Any water that spills into a deep fryer can cause a massive splatter. Even fat splattering from a hot frying pan can cause significant and sometimes serious burns. In this instance, a woman dropped hot oil onto her knee from a campfire frying pan.

Cooking oil can easily exceed 375 F, but it is not the only source of non-water liquid burns. Motor oil can reach 275 F and cause injury if you try to change the oil soon after the car engine has stopped running. Even worse is molten sugar used for making candy, which can easily exceed 340 F.

Sloughing

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Sloughing

Shelley Saunders

Once a second-degree blister has popped or is torn, the epidermis will begin to fall away in sheets. This is a normal process referred to as sloughing. This example of sloughing was caused when the woman spilled hot water from a pot of pasta onto her foot.

Depending on the severity of the burn, sloughing may start several days after the injury. Those occurring soon after an injury are usually severe since the underlying tissue will not have begun to heal. In such cases, oral antibiotics may be needed to reduce the risk of a secondary infection.

Sunburns

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Second Degree Sunburn

Jayjay

Sunburns are usually thought to cause redness, stinging, and the eventual peeling of the skin. However, if you stay out long enough or fall asleep under the sun without UV protection, you can easily get a severe second-degree burn.

The problem with second-degree sunburns is that large areas of skin are involved. The blistering can be extensive and cause excruciating pain.

Moreover, the vast area of exposed tissue can cause rapid dehydration, fever, chills, and weakness while increasing the likelihood of a secondary infection. In rare cases, people with sunburn can go into shock.

Second-degree sunburns take longer to heal and increase the lifetime risk of developing skin cancer, including melanoma

Friction Burn

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Friction Burn

Dawn H.

A friction burn is a type of abrasion that causes the loss of the epidermis and the damage to the dermis below. Despite the fact this doesn't involve heat, it is still considered a second-degree burn and is treated in the same way as a thermal burn. The most common types of friction burn are road rash and rug burns.

While topical antibiotic ointments and twice-daily changes of dressing can usually help prevent infection, oral antibiotics may be prescribed for more severe cases.

How to Treat a 2nd-Degree Burn

The first thing you should do for a 2nd-degree burn is cool the skin to keep the burn from getting worse. You can do this by:

  • Running cool water over it
  • Putting the burned area in a container of cool water
  • Applying a cool compress

Continue cooling the skin until it no longer hurts when you remove the source of the cold, which may take as long as 30 minutes.

No Ice!

Don't use ice or ice water to cool your skin after a burn as those low temperatures may further damage the tissues.

Treatments for a 2nd-degree burn may include:

  • Antibiotic cream, over-the-counter (OTC) or prescription
  • Bandaging with gauze or something else that won't stick to the burn
  • Over-the-counter pain medication such as Tylenol (acetaminophen) or Advil (ibuprofen)
  • Elevation to prevent inflammation and lessen pain

When to Get Medical Help

Get medical attention for a 2nd-degree burn if:

  • The burn is blistered
  • You have severe pain
  • You develop a fever or other signs of infection
  • The burn doesn't improve in two weeks
  • Fluid is leaking from the burned area
  • Swelling or redness increase
  • The burn is more than 2-3 inches wide
  • The burn is on the hands, feet, face, genitals, buttocks, or over a major joint

Frequently Asked Questions

How long does it take a second-degree sunburn to heal?

Within one to three weeks, a second degree sunburn should be fully healed if it's treated appropriately and an infection doesn’t develop. Your skin may still be discolored at this point, and there's a risk of permanent scarring.

How often do you change the dressing for a second-degree burn?

Change the dressing within 48 hours after the wound is first bandaged. If it's healing well after that, change the dressing every three to five days. However, if the burn area is painful or there’s an odor, change the bandages immediately.

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Article Sources
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