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Medical Author:

John P. Cunha, DO, FACOEP

John P. Cunha, DO, FACOEP

John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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All thermal burns (from fire or flame) cause an injury to the different layers of the skin. The type of burn and the severity of the burn depends on the number of layers of skin affected.

Traditionally burns were described using the word degrees (first, second, and third). Now most doctors describe burns as to their thickness (superficial, partial, and full).

The skin is made up of three important layers:

1. the epidermis (or the outer layer),
2. the dermis, and
3. the subcutaneous tissues.

Each corresponds roughly to the types of burns. (It is important to note that many burn injuries may include all three types of burns at the same time.)

• Superficial burn or first degree burn: This burn involves only the epidermis, the outermost layer of the skin. Most people are familiar with this burn in the form of sunburn.
  
  
  • Symptoms and signs - Painful, red, area turns white when touched, no blisters, moist
  
  
• Partial thickness burn or second degree burn: This burn involves the epidermis and some portion of the dermis, the second layer of the skin. This type of burn may be further categorized as superficial or deep, depending on how much of the dermis is involved.
  
  
  • Superficial symptoms and signs - Painful, red, area turns white to touch, mottling, blisters, moist, hairs still present
    
    
  • Deep symptoms and signs - May or may not be painful (it may be so deep that nerve endings may be destroyed), may be moist or dry (so deep that sweat glands are destroyed), may or may not turn white when area is touched, hair is usually gone
  
  
• Full thickness burn or third degree burn: This is the most severe burn. The burn involves all of the epidermis and dermis—the first two layers of the skin. Nerve endings, tiny blood vessels, hair follicles, and tiny sweat glands are all destroyed. If very severe, the burn may involve bone and muscle.
  
  
  • Symptoms and signs - Painless, no sensation to touch, pearly white or charred, dry, may appear leathery

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