Health care professionals encounter burns in their patient populations frequently, and must be able to differentiate between types of burns, as well as know how to treat burn injuries using current practice standards. The following is an overview of first and second degree burns, including pathophysiology and treatment.

First Degree Burns

First degree burns, often referred to as superficial burns, affect only the epidermis or outermost layer of skin. They are dry, red and can be very painful. When touched, skin that is burned superficially will blanch. The injured epidermis will slough off after a few days. These burns generally heal quickly and do not cause scarring.

First degree burns are not considered to be open wounds; therefore, they require no dressings. Cool compresses may provide some relief from pain. In addition, moisturizers may increase comfort. Analgesics may be required for patients who experience large first degree burns. Some patients may even require hospitalization briefly in order to control pain. Antimicrobials are not required for first degree burns. Patients may be advised to apply a moisturizer containing a sun block to the burned area(s) until the burns have healed entirely.

Second Degree Burns

Second degree burns, also referred to as partial-thickness burns, are divided into two categories:

• Superficial partial-thickness burns - these burns involve the epidermis and the dermis. The dermis is only involved superficially. Second degree burns are moist and red. There may be blister formation. These burns are very painful due to the fact that nerve endings are intact but are exposed due to loss of the epidermis. Scarring may result, but is generally minimal. Superficial partial-thickness burns normally heal in approximately two weeks.
• Deep partial thickness burns - these burns involve the epidermis and extend through most of the dermis. They are less red and are drier than superficial second degree burns. They may also be less painful. These burns may take up to a month to heal, and scarring may be extensive.

It is important to remember that burns often contain a mixture of burn depths; therefore it is possible for a patient to have areas of both first and second degree burns.