How to Recognize and Treat a Second-Degree Burn

Second-degree burns occur when heat, chemicals, light, or electricity damage the first two layers of your skin. The appearance of a second-degree burn sets them apart from a less severe first-degree burn. You'll see skin discoloration, blisters, redness and swelling, and shiny, moist skin.

Whether you treat a 2nd-degree burn at home or need medical care depends on its size, location, and whether it heals properly or an infection develops.

What Is a Second-Degree Burn?

A second-degree burn is usually a mild to moderate injury. However, its severity depends on how large it is, whether it's on a sensitive part of the body, and the size of the affected body area.

The degree of a burn is based on how deep the damage goes. First-degree burns only damage the top layer of skin (the epidermis). Second-degree burns damage the epidermis and the second layer of skin (the dermis). Third-degree burns damage the epidermis, dermis, and the skin's third layer, the hypodermis (subcutaneous layer).

What Do Second-Degree Burns Look Like?

You can recognize a second-degree burn by the following symptoms:

• Skin discoloration (white, deep red, or dark brown)
• Blisters
• Shiny, moist skin
• Redness around the wound
• Seeping wound
• Pain, discomfort, and skin sensitivity
• Swelling

While second-degree burns share similar symptoms, their overall appearance varies depending on their cause. The pictures below will show you some of the different causes of second-degree burns and what they look like.

Scalding

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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 seldom cause full-thickness (third-degree) burns, but they do blister quickly.

Open Flame Burn

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An unloaded potato gun (potato launcher) gave this person a second-degree burn. The device used hairspray as an explosive agent to shoot a potato into the air. In this case, the flaming hairspray damaged the skin.

Heat Pack Burn

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A reusable 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. In this case, the destruction of the outer layer caused areas of whiteness and discoloration common with many second-degree burns.

Heat Pack Burn (Five Weeks Later)

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After a burn from a 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

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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

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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

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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.

Sunburn

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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, requiring medical attention. 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.

A second-degree sunburn takes longer to heal than a first-degree sunburn. Your skin may still be discolored after you've healed and your scars may be permanent.

Friction Burn

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A friction burn is a type of abrasion or scrape. These injuries often cause second-degree burns. The most common types of friction burn are road rash and rug burns.

Sloughing

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Once a second-degree blister pops or tears, or several days after the burn starts to heal, 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.

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.

A Word From Verywell

Because the dermis is affected in a second-degree burn, these types of skin injuries have the potential to blister and scar. Once the burn has healed, take care to protect it from the sun, as the damaged skin is more sun-sensitive, and UV radiation can contribute to the burn, leaving a persistent, dark area on the skin.

— BRENDAN CAMP, MD, MEDICAL EXPERT BOARD

Treatment

You can treat most second-degree burns at home. Follow these six steps:

1. Cool the Burn

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

• Running cool water over it
• Putting the burned area in a container of cool water (don't use ice water)
• Applying a cool compress (don't apply ice or a frozen cold pack)

Continue cooling the burn until your pain improves. This may may take as long as 30 minutes.

2. Clean the Wound

Wash your hands first to prevent dirt or bacteria from getting in the wound. Gently clean the area using mild soap and cool water. Then, pat it dry with a clean cloth, being careful not to break the blisters.

Wash the burn every day until it heals, unless you consult a healthcare provider and they give you different instructions.

3. Apply Ointment

Applying petroleum jelly or an antibiotic cream keeps the burn moist and promotes healing. You don’t need to place the ointment on the burn. Instead, put it on a nonstick dressing and then put the dressing over the burn.

Antibiotic creams should be limited to one week. Using them longer may cause a rash. If your burn is still healing at the end of a week, switch to petroleum jelly.

4. Cover the Burn

Prevent an infection and promote healing by keeping the burn covered. Apply a nonstick bandage, gauze, or burn bandage. Keep it loose instead of wrapping it tightly around the wound.

Change the bandage daily after washing the wound or if the bandage gets wet or dirty. If the bandage sticks to the burn, soaking in warm water helps loosen it.

5. Treat the Pain

Ease your pain with over-the-counter medications like acetaminophen (Tylenol) or ibuprofen (Advil and Motrin). If you need to relieve swelling, choose ibuprofen. You can also reduce swelling in a burn on a leg or arm by elevating the limb.

Do not take aspirin because it can increase bleeding in the damaged tissues.

6. Moisturize After Healing

After the burn heals, apply a moisture cream to prevent drying, cracking, and itching. Choose moisturizers that are free of perfume and dyes.

Healing Stages

Burns heal in three stages. Your second-degree burn will look different during each of the three healing stages.

• Inflammatory (reactive): During the first stage of healing, your immune system sends white blood cells to the injury. This helps prevent infection, remove dead tissue, and activate damage repair. During this stage, you will experience swelling and discoloration at the burn site.
• Proliferative (reparative): During the second stage of healing, new tissues and blood vessels grow and the wound begins to close. The damaged skin may flake or peel as your body gets rid of it. The proliferative stage overlaps with the inflammatory stage.
• Maturation (remodeling): During the third stage of healing, the new collagen produced in the second stage is strengthened and restructured. Tissue remodeling determines what the healed area will look like and how much visible scar tissue will be present. The maturation stage overlaps with the proliferative stage.

You will know your burn is healing if it progresses through these stages and there are no signs of infection.

How Can I Tell if It's Infected?

Signs of an infected second-degree burn include:

• Significant swelling (or swelling that gets worse instead of improving)
• Severe pain (or pain that's worsening instead of improving)
• Pus seeping from the burn
• Redness around the wound
• Red streaks coming from the wound
• Fever

Infections prevent healing and, without treatment, can spread throughout your body.

How Long Will It Take To Heal?

Healing time varies depending on the depth of the wound. Second-degree burns typically heal in one to three weeks, but could take six weeks or longer.

Your overall health and nutritional well-being also influence healing time. Your burn will take longer to heal if you have a weakened immune system or a deficiency in the nutrients essential for healing, such as protein, zinc, and vitamins A and C.

Will I Have a Scar?

Second-degree burns can cause scarring, but not always. Even if you don't have a scar, you may notice that your skin becomes lighter or darker in the area where the burn occurred. This type of discoloration may fade a little over time but tends to be permanent.

When to See a Healthcare Provider

Get medical attention for a second-degree burn if:

• The burn is more than 2-3 inches wide.
• Second-degree burns cover more than 10% of your body.
• 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 increases.
• The burn is on the hands, feet, face, genitals, buttocks, or over a major joint.
  

Prevention

Second-degree burns and all other types of burns can be prevented with simple precautions. For example:

• Don't touch surfaces that are hot or may be hot.
• Keep your hot water heater turned down.
• Wear sunscreen if you're going to spend time outdoors.
• Wear gloves and protective gear when working around fire or chemicals.
• Don't get close to open flames, especially when wearing loose clothing.
• Don't let children near hot objects such as pots and pans and make sure their food has cooled to a safe temperature before giving it to them.
  

Summary

Second-degree burns damage the skin's top and second layers, the epidermis and dermis. If you have a second-degree burn, you can expect to have pain and see redness, blistering, skin discoloration, and swelling. You may have some scarring, and your skin may be a different color after the burn heals.

You may be able to treat second-degree burns at home. However, medical care is essential if the burn is larger than 3 inches, burns cover more than 10% of your body, or you have severe pain, swelling, or an infection.