How Do You Decide If A Burn Needs Professional Medical Aid?

In 1992, Mrs. Stella Liebeck took McDonalds to court over a cup of coffee! She had spilled their coffee on her thighs, which resulted in 3rd degree burns, for which she had to get skin grafts. She finally won the case and the jury awarded her 2 days’ worth of revenue from coffee sales. However, she finally received a confidential settlement from the company.

Burns can be a nasty business and can be a source of excruciating pain. Based on their intensity, rather than their cause, they are classified into various degrees. This classification can be helpful for a layman to determine the kind of help and first aid a burn victim might require.

Skin layers

Before we get into the degree of burns, let’s first take a look at the skin, which is the primary organ affected in any burn.

The skin consists of 2 basic parts – the epidermis and dermis.

The epidermis is the outer part of the skin, and is thinner than the dermis, which is the inner layer. The epidermis has no blood vessels. The epithelial cells receive their nourishment via diffusion from the dermis. New cells that are formed, slowly move to the top of the epidermis and change their shape and composition as they become isolated from the blood source.  These cells eventually die and are sloughed off. The epidermis is further divided into 5 layers – stratum corneum, stratum lucidum, stratum granulosum, stratum spinosum, and stratum germinativum or stratum basale.

layer of skin

Photo Credit : Wikimedia Commons

The dermis lies below the epidermis and is the thicker of the two. The two are connected by a basement membrane. The dermis has connective tissue and nerve endings. It also has hair follicles, sweat glands, blood vessels, lymphatic vessels, etc. It can also be divided into 2 parts – the papillary region and reticular region.

Below the dermis is the subcutaneous tissue. This is technically not part of the skin. Also called the hypodermis, the main function of this layer is to attach the skin to the underlying bone and muscles, etc.

1st degree burn

This is the least harmful type of burn and is also called a superficial burn. It only affects the epidermis, and rarely requires any medical attention. Sunburns fall under this category. These burns usually present as redness and swelling of the skin. 1st degree burns do not leave any scars. The burn heals with a week as the top layer of cells is sloughed off.

The most common first aid for 1st degree burns is dipping or exposing the affected portion into cold water. Painkillers can also be taken in case the pain is too much for a person to handle. There is rarely any long-term damage, but if there is, it is in the form of darkening or lightening of the skin.

first degree burn

Redness caused due to a first degree burn (Photo Credit : Wikimedia Commons)

2nd degree burn

These burns are more painful and harmful than a 1st degree burn. In this type of burn, the damage extends down into the dermis. These burns take longer – about two three weeks – to heal completely. They may or may not leave a scar. Depending on the size and intensity of the burnt area, a skin graft may or may not be required.

These burns usually develop blisters that can burst immediately. This gives the burnt area a wet-looking appearance. Conversely, the blisters can also persist until the later stages of healing. 2nd degree burns often cause pigmentation in the skin after healing. During the healing process, a soft, thick scab may form, which eventually reveals the new and healed skin beneath it.

With these burns, it is also advisable to expose the affected area to cold water, as a form of first aid.

3rd degree burn

These are the most severe types of burns and take the longest to heal. In 3rd degree burns, both the epidermis and dermis are completely burnt. This includes all the hair follicles, sweat glands, etc. There may also be damage to the underlying tissue. There is a common misconception that 3rd degree burns are the most painful. Conversely, in these burns, the damage is so severe that even the nerve endings in the affected area are burnt, thus making the area numb. Depending on the cause, the affected area may appear waxy white, dark brown, etc. It may also develop blisters.

There is no fixed time for the healing of this class of burns. They usually always leave a scar, and always require medical attention. Most of the time, skin grafts may be required due to the extensive damage to the skin.

type of burn

Affected skin in a first, second and third degree burn (Photo Credit : Wikimedia Commons)

When the damage of a 3rd degree burn extends down to the underlying bones, muscles and tendons, it is referred to as 4th degree burn.

Burns can be extremely painful and can also prove fatal. While first-degree burns can be taken care of at home without trained medical assistance, it is unadvisable to do the same for 2nd degree burns. Even if the afflicted area is small, it is always better to get professional help. 3rd degree burns are impossible to treat at home, and can lead to permanent damage if not treated properly. However, any burn on the face, genitalia, or a major joint should receive an professional opinion, regardless of severity.


  1. National Institute Of General Medical Sciences
  2. Search Results Johns Hopkins Medicine, Based In Baltimore, Maryland
  3. Medical Information And Health Advice You Can Trust.


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About the Author:

Mahak Jalan has a BSc degree in Zoology from Mumbai University in India. She loves animals, books and biology. She has a general assumption that everyone shares her enthusiasm about the human body! An introvert by nature, she finds solace in music and writing.

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