Burn injuries are caused by a variety of agents—hot liquids, flame, flash (i.e., explosions), chemicals, electricity and contact with hot objects. The most important classification of burn wounds refers to the extent and depth of the injury. In most cases, the extent and depth of the burn wound are the most significant factors contributing to the seriousness of injury of the burn victim.


The extent of a burn wound is defined as the percentage of total body surface damaged and may be determined by the Rule of Nines. This divides the body into areas of 9% or multiples of nine (figure I) and is modified for estimating the extent of burn injury in children (figure II).

Total Body Surface Area illustration of the Rule of Nine, adult and child diagrams


The depth of a burn injury refers to the amount of skin, and on some occasions other tissue, damaged or destroyed. Skin has two layers, the superficial epidermis and the deeper dermis that overlies subcutaneous tissue. Burn injuries are defined as Superficial (1st Degree), Partial Thickness (2nd Degree) and Full Thickness (3rd Degree).


  • minor damage of the epidermis
  • red, tender, dry, no blisters
  • i.e., sunburn, heals in three to six days


  • impacts epidermis and dermis
  • blisters are thick walled and sometimes ruptured
  • color is mixed red and white
  • painful, especially if pressure is applied
  • heals in three to six weeks, potential scarring, may require hospital admission, surgery


  • destruction of epidermis and dermis
  • high risk of infection, loss of temperature control
  • skin appears white, black, gray, leathery and charred, dry
  • requires hospital admission, surgery
  • months, years to heal

All burns should be treated with concern. It is important to keep in mind the golden rule of burn management: If someone has a burn on their body exceeding the size of the palm of their own hand, where blisters are present, burns to the genitalia, face or to any flexion point, this person should seek medical attention. All electrical burns require medical attention.




A burn is tissue damage that results from scalding, overexposure to the sun or other radiation, contact with flames, chemicals or electricity, or smoke inhalation.

Is it a major or minor burn?

Call 911 or seek immediate care for major burns, which:

  • Are deep
  • Cause the skin to be dry and leathery
  • May appear charred or have patches of white, brown or black
  • Are larger than 3 inches (about 8 centimeters) in diameter or cover the hands, feet, face, groin, buttocks or a major joint

A minor burn that doesn't require emergency care may involve:

  • Superficial redness similar to a sunburn
  • Pain
  • Blisters
  • An area no larger than 3 inches (about 8 centimeters) in diameter

Treating major burns

Until emergency help arrives:

  • Protect the burned person from further harm. If you can do so safely, make sure the person you're helping is not in contact with the source of the burn. For electrical burns, make sure the power source is off before you approach the burned person.
  • Make certain that the person burned is breathing. If needed, begin rescue breathing if you know how.
  • Remove jewelry, belts and other restrictive items, especially from around burned areas and the neck. Burned areas swell rapidly.
  • Cover the area of the burn. Use a cool, moist bandage or a clean cloth.
  • Don't immerse large severe burns in water. Doing so could cause a serious loss of body heat (hypothermia).
  • Elevate the burned area. Raise the wound above heart level, if possible.
  • Watch for signs of shock. Signs and symptoms include fainting, pale complexion or breathing in a notably shallow fashion.

Treating minor burns

For minor burns:

  • Cool the burn. Hold the burned area under cool (not cold) running water or apply a cool, wet compress until the pain eases.
  • Remove rings or other tight items from the burned area. Try to do this quickly and gently, before the area swells.
  • Don't break blisters. Fluid-filled blisters protect against infection. If a blister breaks, clean the area with water (mild soap is optional). Apply an antibiotic ointment. But if a rash appears, stop using the ointment.
  • Apply lotion. Once a burn is completely cooled, apply a lotion, such as one that contains aloe vera or a moisturizer. This helps prevent drying and provides relief.
  • Bandage the burn. Cover the burn with a sterile gauze bandage (not fluffy cotton). Wrap it loosely to avoid putting pressure on burned skin. Bandaging keeps air off the area, reduces pain and protects blistered skin.
  • If needed, take an over-the-counter pain reliever, such as ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) or acetaminophen (Tylenol, others).



(Courtesy of Water-Jel Technologies)