Second-degree burn: Everything you need to know

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

10 Types of Second-Degree Burns

Rod Brouhard is an emergency medical technician paramedic (EMT-P), journalist, educator, and advocate for emergency medical service providers and patients.

Michael Menna, DO, is a board-certified, active attending emergency medicine physician at White Plains Hospital in White Plains, New York.

Second-degree burns, also called partial-thickness burns, involve the outer layer of skin (epidermis). They can extend to the middle skin layer below (dermis).

The degree of a burn is based on how many layers deep the damage goes. Burns can damage the epidermis, dermis, and fatty tissues under the skin. Second-degree burns can look different depending on their cause, size, and exact depth.

Physician is a high-paying career, and American doctors have some of the highest salaries worldwide, with general practitioners earning an average of $185,000 and surgeons earning $306,000 annually, according to MLive Media Group.

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

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

According to the Centers for Disease Control and Prevention (CDC), over 350,000 Americans are treated for burns in emergency rooms each year. Over 40,000 are hospitalized.

Open Flame Burn

An unloaded potato gun gave this person a second-degree burn. A potato gun uses hairspray as the explosive agent to shoot a potato into the air. In this case, the flaming hairspray damaged the skin.

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

A reusable chemical heat pack burned this person’s neck. The person microwaved the pack for 60 seconds, even though the instructions said to heat it for 30 seconds.

There are no blisters here. Blisters show that the epidermis is damaged but not destroyed. In this case, the destruction of the outer layer caused areas of whiteness and discoloration common with many second-degree burns.

Chemical Heat Pack Burn (Five Weeks Later)

After a burn from a chemical heat pack, this person 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 can cause pain for weeks. Over-the-counter pain relievers like Tylenol (acetaminophen) can help.

Candle Wax Burn

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

When water touches hot wax near a burning wick, the wax can explode. The type of candle or wax can make a big difference in how severe the injury is.

Paraffin wax melts at around 120 degrees F. Votive candles melt 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. That’s a common temperature for body waxing.

Steam Iron Burn

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

It’s easy to 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. That’s hot enough to cause a severe burn in less than a second.

If the jet of hot steam hits your eye, your cornea can be severely damaged. Burns like this can cause:

• Scarring
• Holes in the eye tissue
• Blindness

Hot Oil Burn

Hot oil burns are common in the kitchen, especially among children. Deep fryers are often the culprits. When water spills or splashes into a deep fryer, there’s a huge splatter. Fat splattering from a hot frying pan can also cause burns. In this case, hot oil from a campfire frying pan damaged someone’s knee.

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. You can be injured if you try to change the oil too soon after a car engine has stopped running. Even worse is molten sugar used for making candy. It can easily exceed 340 F.

Sloughing

Once a second-degree blister pops or tears, the epidermis will begin to fall away in sheets. This normal process is called sloughing. This photo shows sloughing after someone spilled hot water from a pot of pasta onto her foot.

Sloughing may start several days after the injury. When skin sloughs after a severe burn, the exposed tissue may not have begun to heal. In such cases, oral antibiotics may be needed to reduce the risk of infection.

Sunburns

Sunburns usually cause redness, stinging, and peeling. However, if you stay out long enough or fall asleep in 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 can cause terrible pain.

Because such large areas are involved, you may also experience:

• Rapid dehydration
• Fever
• Chills
• Weakness
• Higher likelihood of infection

In rare cases, people with sunburn can go into shock.

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

Friction Burn

A friction burn is a type of abrasion or scrape. It causes the loss of the epidermis and damages the dermis below. Friction burns don’t involve heat, but they are still considered second-degree burns.

They’re treated in the same way as a thermal (heat) burn. The most common types of friction burn are road rash and rug burns.

Topical antibiotic ointments and twice-daily dressing changes can usually 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 second-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. It may take as long as 30 minutes.

No Ice!

Don’t use ice or ice water to cool your skin after a burn. Temperatures that are too low can further damage the tissues.

Treatments for a second-degree burn may include:

• Antibiotic cream, over-the-counter 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 second-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

Summary

Second-degree burns damage the top layer of skin (epidermis) and sometimes also involve the dermis. Fire, chemical heat packs, and hot liquids can cause burns like these. So can friction and sunburn.

If you’ve had a second-degree burn, you can expect to have pain, redness, blistering, and sloughing of the top layers of skin as you heal. You may have some scarring and your skin may be a different color after the burn heals.

You may be able to treat a second-degree burn with cool water, antibiotic creams, pain relievers, and clean bandages. If your burn is more severe, you should seek medical care right away.

Frequently Asked Questions

What is the fluid in a burn blister?

The fluid inside a burn blister is ultrafiltration of plasma. It is rich in immunoglobulins, cytokines, prostaglandins, and interleukins. This may help the burn to heal faster.

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 right away.

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

A second-degree sunburn should be fully healed within one to three weeks if it’s treated properly and infection doesn’t develop. Your skin may still be discolored and scars may be permanent, but the discomfort should be fully resolved.

13 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Burns.
2. Vloemans AF, Hermans MH, van der Wal MB, Liebregts J, Middelkoop E. Optimal treatment of partial thickness burns in children: a systematic review. Burns. 2014;40(2):177-90. doi:10.1016/j.burns.2013.09.016
3. Centers for Disease Control and Prevention. National Hospital Ambulatory Medical Care survey: 2015 emergency department summary tables.
4. Bittner EA, Shank E, Woodson L, Martyn JA. Acute and perioperative care of the burn-injured patient. Anesthesiology. 2015;122(2):448-464. doi:10.1097/ALN.0000000000000559
5. University of California San Diego School of Medicine: UC San Diego Health. About burns.
6. Grosu-Bularda A, Andrei MC, Mladin AD, et al. Periorbital lesions in severely burned patients. Rom J Ophthalmol. 2019;63(1):38-55.
7. Bachier M, Hammond SE, Williams R, Jancelewicz T, Feliz A. Pediatric scalds: Do cooking-related burns have a higher injury burden?J Surg Res. 2015;199(1):230-236. doi:10.1016/j.jss.2015.05.016
8. Norman G, Christie J, Liu Z, et al. Antiseptics for burns. Cochrane Database Syst Rev. 2017;7(7):CD011821. doi:10.1002/14651858.CD011821.pub2
9. Sánchez-Pérez JF, Vicente-Agullo D, Barberá M, Castro-Rodríguez E, Cánovas M. Relationship between ultraviolet index (UVI) and first-, second- and third-degree sunburn using the Probit methodology. Sci Rep. 2019;9(1):733. doi:10.1038/s41598-018-36850-x
10. University of Michigan Medical School: Michigan Medicine. Home treatment for second-degree burns.
11. Cleveland Clinic. Burns.
12. Gupta S, Chittoria RK, Chavan V, et al. Role of Burn Blister Fluid in Wound Healing. J Cutan Aesthet Surg. 2021;14(3):370-373. doi:10.4103/JCAS.JCAS_90_19
13. Józsa G, Tóth E, Juhász Zs. New dressing combination for the treatment of partial thickness burn injuries in children. Ann Burns Fire Disasters. 2017;30(1):43-46.

By Rod Brouhard, EMT-P
Rod Brouhard is an emergency medical technician paramedic (EMT-P), journalist, educator, and advocate for emergency medical service providers and patients.

Second-degree burn: Everything you need to know

Second-degree burns, or partial thickness burns, are more severe than first-degree burns. They affect the outer layer of skin, called the epidermis, and part of the second layer of skin, called the dermis.

Second-degree burns can be very painful and often take several weeks to heal. Burns that affect large areas of skin can cause serious complications and may be prone to infection.

In this article, learn more about second-degree burns, including the symptoms and when to see a doctor.

Doctors categorize burns according to the amount of damage they cause to the skin and surrounding tissue.

• First-degree burns are generally minor and affect only the outer layer of skin. They are the most common type of burn. Most sunburns fall into this category. Learn more about first-degree burns here.
• Second-degree burns are more serious burns that affect the outer layer of skin and the next layer, the dermis. They take longer to heal.
• Third-degree burns are the most serious types of burn. They affect both layers of skin and may also affect other tissue, such as sweat glands. Third-degree burns usually need a skin graft.

Second-degree burns can be relatively minor, such as when a burn from a stove or iron burns deeper into the skin. They can also be very serious and even life-threatening.

Second-degree burns are more dangerous when:

• They affect large areas of the body.
• They affect the joints, face, or hands.
• They affect the genitals or buttocks.
• They occur in someone with a weakened immune system, such as someone who is undergoing chemotherapy for cancer.

Second-degree burns can cause serious infections, especially if they cover large areas of the body or if a person does not receive the right treatment.

Physical sources of heat, such as the sun and stoves, can cause second-degree burns. Certain chemicals, including bleach and other cleaning products, can also cause burns.

Some common causes of second-degree burns include:

• severe sunburn, such as when a person with very fair skin sits in the sun for an extended period
• accidents with ovens and stoves
• exposure to fire
• contact with boiling water

Accidental injuries are a common reason for second-degree burns. For example, a child might place their hand on a hot burner.

Intentional abuse, such as during acid attacks, can also cause second-degree burns.

Any serious burn, especially on exposed areas of the skin or on large sections of the body, warrants a trip to the doctor.

Some common symptoms of second-degree burns include:

• a wet-looking or seeping wound
• blisters
• a burn with an irregular pattern
• intense pain or skin sensitivity
• skin that looks white, very deep red, or very dark brown

A person who develops a fever or feels ill after sustaining a burn may have an infection.

A doctor or other healthcare professional can diagnose the severity of a burn by looking at it. They will ask questions about what caused the burn, as well as whether the person has any other medical conditions.

In some cases, a doctor will also estimate the percentage of the body the burn covers, as this can help with assessing the risk of infection and serious complications.

People who think they have sustained second-degree burns should seek medical care. Receiving the right first aid can prevent serious complications.

While a person is waiting to be examined, performing the following steps may help:

• Remove any clothing, pieces of jewelry, or other objects that cover the burn. They may be hot, continuing to burn the skin and intensifying the severity of the burn. If it is not possible to remove clothing without damaging the skin, leave it on.
• Cool the burn by running it under cool, but not cold, water. Do not apply ice to the burn.
• Drink plenty of water or electrolyte fluids to prevent dehydration.
• Cover the burn with gauze or a loose dressing. Do not wrap the cover tightly, as this can cut off circulation.
• Do not break open blisters.
• Avoid applying butter or other home remedies, especially immediately after sustaining the burn.

Medical treatment depends on the severity and location of the burn. A doctor may clean the burn or apply an antibiotic cream.

If the burn is very severe or covers much of the body, a person may need to stay in the hospital for monitoring.

A doctor may also prescribe antibiotics, especially if a person has an infection or is at high risk of developing one. Severe infections might require treatment with intravenous antibiotics.

Very serious second-degree burns may need a skin graft. During a skin graft, a surgeon will transplant skin from one area of the body to another to replace the damaged skin.

Recovering from second-degree burns can take anywhere from a few days to several weeks. If a person develops complications, recovery might take longer.

Home management varies depending on the severity of the burn and the overall health of the person who sustained it. It is vital to ask for clear burn management guidelines from the doctor who treated it.

To speed up recovery and help reduce pain, a person can try the following strategies:

• Take over-the-counter (OTC) pain relievers, such as ibuprofen or acetaminophen.
• Keep the burn clean and covered.
• Regularly moisturize the burn once the wound closes and stops draining. This can speed healing and may reduce or prevent scarring.
• Apply an OTC antibiotic ointment to the wound to keep it clean and prevent infection.
• Avoid rubbing, scratching, or picking at the burn, as this can reopen the wound, increasing the risk of infection.

If a person develops a fever, notices red streaks around the burn, or believes that their symptoms have suddenly worsened, they may have an infection. In this case, they should see a doctor.

Many common accidents can cause second-degree burns, including spilling something hot on the skin or touching a hot appliance.

Receiving prompt treatment can help prevent scarring, infections, and other serious complications, so it is best to see a doctor as soon as possible. If the burn is large or intensely painful, go to the emergency room.

Last medically reviewed on May 16, 2019

• Dermatology
• Emergency Medicine

How we reviewed this article:

Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

• Burns. (2018).
  https://www.nigms.nih.gov/education/pages/Factsheet_Burns.aspx
• Burns. (2018).
  https://www.who.int/news-room/fact-sheets/detail/burns
• Initial first aid treatment for minor burns. (n.d.).
  http://ameriburn.org/wp-content/uploads/2017/05/burnfirstaid.pdf
• Lloyd, E. C. O, et al. (2012). Outpatient burns: Prevention and care.
  https://www.aafp.org/afp/2012/0101/p25.html
• Sepsis and burns. (2017).
  https://www.sepsis.org/sepsis-and/sepsis-and-burns/
• Wound care after burn injury. (2017).
  https://msktc.org/burn/factsheets/Wound-Care