Third-Degree Burn

What is a third-degree burn?

Third-degree burns are a serious type of burn that requires immediate medical attention. A burn is damage to your skin or underlying tissue due to extreme temperatures, a chemical or a light source.

A third-degree burn damages the top layer of your skin (epidermis), the middle layer of your skin (dermis) and the layer of fat underneath your skin (hypodermis). A third-degree burn can also damage your sweat glands, hair follicles and nerve endings.

You won’t feel immediate pain if you have a third-degree burn because the burn destroyed your nerves. This can make you believe that your burn isn’t serious, but it is, and you should see a healthcare provider for treatment.

What does a third-degree burn look like?

Features of a third-degree burn include:

• Leathery skin.
• Dry skin.
• Skin discoloration that’s white, black or bright red.
• Swelling.

A third-degree burn won’t blanch or turn white temporarily when you press on your affected skin. Blanching is common for first- and second-degree burns.

A third-degree burn will likely have features of a second-degree burn around it, including:

• Blisters.
• Shiny, moist skin.
• Skin discoloration from a deep red to dark brown.

Where are common locations for third-degree burns?

You can get a third-degree burn anywhere on your body depending on what caused the burn. Common locations for a third-degree burn include your:

• Hands.
• Face.
• Feet.
• Arms and legs.

How does a third-degree burn compare to other types of burns?

The number of each degree of burn identifies how many layers of damage your body has, including:

• First-degree burn: Damage to the top layer of skin.
• Second-degree burn: Damage to the top and middle layers of skin.
• Third-degree burn: Damage to the top and middle layers of skin and the fatty layer (hypodermis).

While less common, extremely serious burns can extend past three degrees and could include:

• Fourth-degree burn: Damage past your hypodermis into subcutaneous fat, nerves and tendons.
• Fifth-degree burn: Damage to your muscle.
• Sixth-degree burn: Damage to your bone.

If you have a first- or second-degree burn that’s less than 3 inches in diameter or a burn that’s not on your face, you can treat your burn at home. Serious burns or large burns include third-degree burns and up. See a healthcare provider if you have a serious burn.

What are the most common causes of a third-degree burn?

The same things that can cause a first- and second-degree burn can cause a third-degree burn. The difference is how long your body met a heat, chemical or light source that caused damage, or the intensity of the source of the burn. The more intense the damage source and/or the longer your body interacts with a cause of a burn, the more damage you’ll have.

Common causes of a third-degree burn include:

• Flames from a fire.
• Touching a hot object.
• Ultraviolet radiation and sunburn.
• Boiling water or steam.
• Chemicals (like acids and bases).
• Radiation.
• Electricity.
• Dry ice, liquid nitrogen or other sources of intense cold (such as aerosol sprays).

How do I treat a third-degree burn?

If you have a third-degree burn, visit an emergency department for treatment. While you may not feel pain, the damage to your skin and tissues is severe and requires medical attention. Treatment varies for a third-degree burn based on size and location. A healthcare provider may treat a third-degree burn by:

• Cleaning your burn: Your provider will clean your skin by removing debris, dead skin and tissue from the burned area. Don’t try to remove anything from your burn before seeing a healthcare provider.
• Covering your burn: After cleaning your burn, your provider will place an antibiotic ointment on your burn and gently cover your burn with a bandage. It’s important to keep your burn covered and clean to prevent infections. You should change your bandage at least once daily. Your provider will give you instructions on how to care for and clean your burn.
• Antibiotics: You may need antibiotics to prevent or clear an infection from your body. If you have a large third-degree burn, your provider may administer these antibiotics intravenously by placing a needle into a vein in your arm to slowly give you the medicine you need. If you have a small third-degree burn, you may take antibiotics by mouth.
• Replacing fluids: You may lose blood or bodily fluids from your burn if it’s large or severe. This can lead to shock and be life-threatening if left untreated. A healthcare provider may use a needle in your vein to give you fluids that contain electrolytes to replenish what you lost.
• Pain medications: While you might not feel pain immediately after your burn, you may feel sore as your body heals. Your provider may suggest over-the-counter pain relievers or medication to help you feel more comfortable.
• Skin grafting or reconstructive surgery: For large third-degree burns, a healthcare provider may offer skin grafting to help your wound close. Skin grafting takes healthy skin from another part of your body to cover your wound. This is a surgical procedure, and there are other possible surgeries that may help repair very severe damage.

Will a third-degree burn cause a scar?

Yes, a third-degree burn will likely cause a scar on your skin. If you follow your healthcare provider’s instructions on how to take care of your burn, your scar could be smaller than expected. Scars can fade over time.

How can a third-degree burn be prevented?

Burns are usually preventable. To prevent them, or at least reduce the risk of them happening, you can:

• Wear sunscreen when you go outside.
• Avoid touching hot objects.
• Keep hot objects, surfaces, live electrical cords and outlets out of reach of children.
• Lower the temperature of the hot water in your home.
• Test the temperature of food and drinks before giving them to children.
• Stay away from open flames.
• Keep body parts and anything flammable clear of household heating sources (such as fireplaces, radiators, etc.).
• Wear protective clothing or gear when you need to handle objects at extreme temperatures.

How long does it take for a third-degree burn to heal?

It will take at least three weeks for a third-degree burn to heal if it’s small. Larger third-degree burns can take a couple of years to heal completely. Your healthcare provider can help you understand how long your healing will take based on the size and location of your burn.

When should a third-degree burn be treated by a healthcare provider?

If you have a third-degree burn, visit the emergency room. Third-degree burns should always receive treatment from a healthcare provider and you shouldn’t attempt to treat a third-degree burn at home. If you’re unsure what type of burn you have, see a healthcare provider.

A note from Cleveland Clinic

A third-degree burn is a serious injury that requires immediate medical attention. Don’t wait to visit the emergency room after a third-degree burn, as they can cause shock and be life-threatening if left untreated. You may not immediately feel pain from a third-degree burn, which can make you think it isn’t serious, but it is. If you’re unsure what type of burn you have, see a healthcare provider as a precaution.