What are third-degree burns?

Third-degree burns, the most serious, involve all layers of skin.

Third-degree burns are so deep that only the edges will heal. Scars will eventually cover the rest of the burned area if skin grafting is not done.

What causes third-degree burns?

Third-degree burns are usually caused by:

• clothing on fire

• immersion in hot water

• contact with flames, hot objects, or electricity

• corrosive chemicals.

What are the symptoms of third-degree burns?

The skin may be white, or it may be black and leathery. There may be little pain in the burned area, but the areas surrounding the burn may be quite painful.

What is the treatment?

All third-degree burns require medical treatment. Call 911 for emergency rescue if available or transport the person to an emergency room. Assist a burned person as follows:

• If the person's clothes are burning, do not let him run. Running can fan the flames so that they rise to the person's face. Smother the flames with a blanket, rug, or jacket while rolling him on the ground.

• Remove jewelry and tight clothing from the burned area.

• DO NOT remove clothing that is stuck to the burn.

• DO NOT apply ice water, lotions, ointments, sprays, or home remedies.

• Immerse the burned area in cold water or apply cold compresses BRIEFLY to bring body temperature back to normal. Leaving the burned area in cold water too long can lead to cooling down the body too much.

• In extensive burns, check for these signs of shock:
  • decreased level of consciousness

  • rapid, shallow breathing

  • faint, rapid pulse

  • nausea, sometimes followed by vomiting.

  If the person is in shock, be sure you have called for medical help. Do not move the person unless you have to. He should be lying down. Unless he has breathing difficulties or pain, raise his feet. Cover him with a blanket to conserve body heat. Keep him as calm as possible.

• Wrap the person loosely in a clean sheet if the burned area is extensive. Otherwise, apply dry, nonfluffy loose bandages, such as a pillowcase or disposable diaper.

• Raise a burned arm or leg higher than the person's heart. However, keep the head and shoulders raised slightly if the person is burned on the neck or face or is having trouble breathing.

• If the person is conscious and not vomiting and if medical help is more than 2 hours away, give him small sips of water or clear juice. If he is in shock, however, and asks for water, moisten his lips but do not allow him to drink.

• DO NOT give the person alcohol.

For chemical burns:

• Flush liquid chemicals from the skin thoroughly with running water for 15 to 30 minutes.

• Remove any clothing and jewelry on which the chemical has spilled.

• Brush dry chemicals off the skin if large amounts of water are not available. Small amounts of water will activate some chemicals. Be sure to keep the chemicals away from your eyes.

• Cover the burn with a dry, loose bandage.

For electrical burns:

• All electrical burns must be examined by a doctor. An electrical burn may appear to cause minor damage, but it can extend deep to the tissues beneath the skin.

• Cover the area of the burn with a dry, nonfluffy, loose bandage. Do not apply any ointments or other substances to the burned area.

How long will it take a third-degree burn to heal?

Third-degree burns may require hospitalization for a few days or for many weeks. Scars may require several operations by a plastic surgeon, depending on the severity of the burns. Extensive burns are usually treated at a burn center.