Burn Classification


Note: The list below shows 4 burn degrees. While most of the public does not recognize the 4th degree, it is the correct term. The table below, with 3 degrees, is also correct. Both are acceptable.

Determining burn depth is important. Things to consider are temperature, mechanism, duration of contact, blood flow to skin, and anatomic location. Epidermal depth varies with body surface, which can offer varying degrees of thermal protection. Older adults and young children also have thinner skin

First degree:

  • Includes only the outer layer of skin, the epidermis
  • Skin is usually red and very painful
  • Equivalent to superficial sunburn without blisters
  • Dry in appearance
  • Healing occurs in 3-5 days, injured epithelium peels away from the healthy skin
  • Hospitalization is for pain control and maybe fluid imbalance


Second degree: Can be classified as partial or full thickness.

  • Partial thickness
    • Blisters can be present
    • Involve the entire epidermis and upper layers of the dermis
    • Wound will be pink, red in color, painful and wet appearing
    • Wound will blanch when pressure is applied
    • Should heal in several weeks (10-21 days) without grafting, scarring is usually minimal
  • Full thickness
    • Can be red or white in appearance, but will appear dry.
    • Involves the destruction of the entire epidermis and most of the dermis
    • Sensation can be present, but diminished
    • Blanching is sluggish or absent
    • Full thickness will most likely need excision & skin grafting to heal


Third degree:

  • All layers of the skin is destroyed
  • Extend into the subcutaneous tissues
  • Areas can appear, black or white and will be dry
  • Can appear leathery in texture
  • Will not blanch when pressure is applied
  • No pain


Fouth degree: Full thickness that extends into muscle and bone.



  First Second
(Superficial or Deep)
Third (Full Thickness)
Depth (how
deep the burn is)
Epithelium Epithelium and top aspects of the dermis Epithelium and dermis
How the wound looks No blisters; dry pink Moist, oozing blisters; Moist, white, pink, to red Leathery, dry, no elasticity; charred appearance
Causes Sunburn, scald, flash flame Scalds, flash burns, chemicals Contact with flame, hot surface, hot liquids, chemical, electric
Level of Pain (sensation) Painful, tender, and sore Very painful Very little pain, or no pain
Healing Time Two to five days; peeling Superficial: five to 21 days. Deep: 21-35 days Small areas may take months to heal; large areas need grafting.
Scarring No scarring; may have discoloration Minimal to no scarring; may have discoloration Scarring present

 

Burn injury is the destruction of the layers of the skin and associated structures.
1st Degree Burn 2nd Degree Burn 3rd Degree Burn