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Degrees of burns
Last reviewed: 06.07.2025
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First degree burns are red, easily and noticeably pale when lightly pressed, painful and sensitive. Blisters do not form with first degree burns.
In superficial burns with partial damage to the dermis, the skin also turns pale when pressed, is painful and sensitive. Burn blisters develop within 24 hours. The bottom of the blisters is pink, and fibrinous exudate forms over time.
Deep burns with partial damage to the dermis may be white, red, or have a mottled white-red appearance. The burn surface does not turn white when pressed, and is less painful and sensitive than with a superficial burn. A pinprick is often interpreted as normal pressure on the skin surface. Blistering may occur, but these burns are usually dry.
Burns with complete dermal damage may be white and soft, black and charred, brown and hard, or bright red due to hemoglobin fixed in the subcutaneous areas. Pale burns with complete dermal damage may simulate normal skin, except for the absence of blanching of the areas when pressing. The burnt areas are painless and insensitive. Hair is easily extracted from the follicles. Blisters usually do not develop. Sometimes several days pass before the formation of signs that allow differentiating burns with complete dermal damage from deep burns with partial damage.
Burns are classified according to the depth of skin damage.
A first degree burn is limited to the epidermis.
A second-degree burn (not the entire thickness) affects part of the dermis and is divided into superficial and deep.
A superficial second-degree burn affects the upper half of the dermis. These burns heal within 2-3 weeks. Healing occurs due to epidermal cells covering the ducts of sweat glands and hair. These cells grow to the surface, then migrate along it, connecting with cells of neighboring glands and follicles. Burns that heal within 2-3 weeks rarely leave scars, except in cases of infection.
Deep second-degree burns involve the entire dermis and take more than 3 weeks to heal; healing occurs only from the hair follicles. Scarring is typical.
Third-degree burns damage the entire thickness of the skin, including the underlying subcutaneous tissue. Healing occurs only from the periphery. These burns, with the exception of small lesions, require skin grafting.
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