Partial Thickness Burn

What is a partial thickness burn?

Partial thickness burns may be split into three categories: superficial burns, superficial partial-thickness burns, and deep partial thickness burns. Superficial burns usually only affect the outer layer or epidermis of the skin and last a few days (3-5). Superficial and deep partial thickness burns extend past the epidermis and into the deeper dermis layer. Deep partial-thickness burns extend past the dermis and reach the underlying “reticular” layer.

Superficial partial thickness burns may have blisters and redness returns quickly after pressing on the burnt skin. Sensation does not subside with these burns and light touch can be extremely painful. Deep partial thickness burns may appear waxy and moist and involve deeper structures that transmit pain sensations to the brain. Deep partial-thickness burns may be insensitive to light touch, but both types are sensitive to pressure. Finally, deep thickness burns often leave severe scars whereas partial thickness burns often leave skin discoloration.

Treatment will focus on controlling pain, and cleaning and bandaging the wound properly to promote healing and limit the risk of infection. More widespread or severe burns will require urgent, professional medical care.

Run the burn under cool water for up to twenty minutes. Clean the area with soap and water, then apply antibiotic ointment and cover with a bandage. You should see a physician to determine the extent of the burn, and to get any prescription antibiotics or special wound dressings.

Symptoms of partial thickness burn

Main symptoms

If you have sustained a partial thickness burn, it can likely be described by the following symptoms.

• Redness, swelling, and blisters: The most common symptoms of partial thickness burns are increased redness, blisters (e.g. yellow or clear), and swelling at the site of the burn. Except in full thickness burns, the skin is usually reddened. In superficial partial-thickness burns, the redness is usually continuous and becomes white when pressed upon. In deep full thickness burns, the redness may not be continuous, but also does not turn white when pressed upon. Swelling is common among burns, especially at the onset. However, the swelling is often not severe. Burns damage the skin’s ability to hold in fluid, so much of the fluid that would contribute to swelling leaks out of the tissue, contributing to a moist appearance. They may have a yellowish or clear fluid. If possible, do not destroy blisters — they should be left alone to heal.
• Pain: Superficial partial-thickness burns are often extremely painful. They are often accompanied by blisters, and if those blisters are destroyed, the nerve endings that transmit pain to the brain lose most of their coverage. Because of this, they can be extremely sensitive and even a strong wind can cause considerable discomfort for a burn victim. The pain will dissipate as the burn heals and can be handled with proper bandages and pain medication. Strong pain medication is often used to manage pain as it can help alleviate the associated loss of sleep and difficult healing course.

Other symptoms

Other, more severe symptoms of partial thickness burns may include the following.

• Dehydration and hypothermia: Dehydration is one of the most severe symptoms of a burn over a significant portion of the body. Since the skin is responsible for maintaining fluid levels within the body, a severe burn may significantly disrupt or limit its ability to do so. The skin may also be unable to retain water or regulate body temperature if there is a severe burn over a significant portion of the body. In cases like these, it will be immediately necessary to provide intravenous access to allow for the maintenance of fluid levels. Hypothermia is also a significant risk as the body often regulates heat by sweating. When burned, it cannot regulate the loss of fluid, so a significant amount of body heat is lost as fluid evaporates from damaged skin.
• Infection: Infections are the other potentially severe consequence of burns. In both deep and superficial partial thickness burns, the skin’s ability to keep microbes from entering the body is compromised. This significantly raises the risk of infection in the days, weeks, and months after infection. Because of this, regular bandage changes and even antibiotics may be administered depending on the severity of the burn and the amount of the body surface affected.

Causes of partial thickness burn

Thermal burn

The most common cause of partial thickness burns is heat (as opposed to electricity, friction, or chemicals). Commonly, a superficial partial thickness burn may be the product of contact with hot water commonly known as a “scalding.” Contact with a hot surface like a radiator or an oven may also cause a superficial partial thickness burn. A deep partial thickness burn usually occurs after contact with a very hot source of water, like steam or pressurized water, or contact with a thicker liquid that stays in contact with the skin for longer and is able to transfer more heat to the affected body part. Finally, flames can also lead to deep partial thickness burns. House fires are a common cause of thermal burns.

Chemical burn

Less commonly, chemicals may cause a burn wound. Chemical burns tend to be more damaging and affect deeper structures. Because of this, they are uncommon causes of partial thickness burns.

Treatment options and prevention for partial thickness burn

This section will address burns of mild severity as burns of moderate or high severity should be treated emergently by a medical professional.

Controlling pain

Most commonly, non-steroidal anti-inflammatories are the pain control medications of choice unless you are predisposed to bleeding. It may also be helpful to apply ice to the wound or to place a cold, damp towel over the wound. This is known to have a soothing effect upon the wound.

Cleaning the wound

Once pain is controlled, it is important to cleanse the burn with mild soap and water or a dilute antiseptic solution. Dilute antiseptic solutions can be bought over-the-counter or purchased and diluted yourself. If you cannot purchase or do not have an antiseptic solution, you may use soapy water.

Bandaging the wound

Use a clean bandage affixed securely — but not overly tight — to the wound to keep the moisture and keep debris from entering the burn. If the skin is broken, it may be necessary to seek evaluation if the wound is larger than 1-2 centimeters. Small wounds that are bandaged properly and washed regularly are at little risk of infection, but larger wounds may need medical supplies for proper wound care.

When to seek further consultation for partial thickness burn

You should pursue further wound care if your wound is not improving in appearance after a few days, the pain is not improving, the wound is producing pus, or if there is any loss of sensation or extreme pain present when the wound is touched.

If you have a larger wound

Any wound involving an area larger than a few centimeters may require urgent (e.g. but not emergent) medical care for proper wound care. Wounds involving the entire surface of a limb (e.g. hand, forearm, thigh) or the chest or back may require urgent medical care both to minimize the risk of infection and to minimize the risk of developing debilitating scars.