Second degree burns are more serious than first degree burns. While first degree burns involve only the epidermis (the outermost layer of skin), second degree burns involve both layers of skin (epidermis and dermis). Second degree burns are differentiated by the amount/depth of damage to the dermis. Superficial second degree burns involve the outer layers of the dermis, while deep second degree burns extend down through most of the dermis. Sometimes the terms ‘partial-thickness second degree burn’ and ‘full-thickness second degree burn’ are used.
How do superficial second degree burns appear?These burns are red and moist. Blisters may form. Pain can be severe with this type of burn because the nerve endings remain intact and are exposed when the epidermis is destroyed. Scarring may occur but can be minimal. Barring complications, such as infection, these burns often heal in as little as two weeks.
How do deep superficial burns appear?
These burns are drier and appear less reddened than their superficial counterparts. They may actually cause less pain if the nerve endings are destroyed. These burns take longer to heal (up to a month or more), always cause scarring which can be severe, and may require skin grafting.
Is it possible to have both types of burns at the same time?Yes, it is possible to have both superficial and deep second degree burns at the same time. In fact, this is probably the rule rather than the exception. Burns will quite often have a mixture of burn depths, as skin rarely burns completely evenly.
Are both types of burns treated the same?Deep second degree burns sometimes require skin grafting. Skin grafting may be done to replace damaged skin or to temporarily cover a burn while it heals. Skin grafting is done by a surgeon. It is often difficult to determine whether a burn is a deep second or a third degree burn; a surgeon’s opinion as to whether a burn will heal without grafting may be sought.
What should be done about blisters?Second degree burns often cause large blisters to form. There are two schools of thought as to what should be done with blisters. Some experts advocate breaking any blisters that form, as they believe that the burn will heal more quickly and will be less likely to become infected if the blisters are artificially ruptured and drained. Others believe that blisters should be left alone, as the fluid within them is sterile; in other words, they believe leaving the blisters intact will help to prevent infection. Regardless, all blisters will break sooner or later, leaving behind damaged skin that may need to be debrided (trimmed or removed).
How should second degree burns be treated initially?All burns should be cooled by placing the affected area under cold running water or applying a towel or cloth soaked in cold water. This will halt the burning process and will help to relieve pain. Unless very small, most second degree burns should be seen by a physician.