Disease and Condition

A burn is an injury to the tissues of the body. Burns are classified according to the amount of tissue they affect and how deep they are. A third-degree burn is the most serious because it destroys all the layers of the skin.


Anyone can get a third-degree burn. Children and the elderly are more likely to experience complications from burns.

Causes of  Burns Third Degree

People are more likely to suffer third-degree burns from contact with corrosive chemicals, flames, electricity, or extremely hot objects; immersion of the body in extremely hot water, or clothing that catches fire.

 Symptoms of Burns Third Degree

Skin with a third-degree burn may appear white or black and leathery on the surface. Because the nerve endings in the skin are destroyed, the burned area may not be painful, but the area around the burn may be extremely painful. Pain causes the breathing rate and pulse to increase. Some areas of the burn may appear bright red, or may blister. Third-degree burns can also damage fat, muscle, and bone. Electrical burns damage the deep tissues. Often only the area of the skin where the electricity entered the body looks black and charred. Electrical shocks can make a person stop breathing and interrupt the rhythm of the heart. Third-degree burns can cause the victim to go into shock. Shock occurs when loss of fluids causes the blood pressure to become so low that not enough blood reaches the brain and other major organs. The symptoms of shock include fainting, general weakness, nausea and vomiting, rapid pulse and breathing, a blue tinge to the lips and finger nails, and pale, cold, moist skin. If the victim has been burned in a fire and has been exposed to large amounts of smoke, he or she may also have chest pain, red and burning eyes, and a cough. All third-degree burns require emergency medical treatment.

 Diagnosed of Third Degree Burns

Your doctor will examine the burned area and classify it according to the amount of tissue affected and the depth of the burn. He or she will ask how the burn occurred. The doctor will check for other conditions related to burn injuries, such as smoke inhalation, carbon monoxide poisoning, or other injuries. If the patient is a child, the doctor will ask further questions to ensure the patient is not a victim of child abuse. Doctors assess the severity of a burn by determining what percentage of the total body surface area (BSA) is affected. In patients older than nine years, they apply what’s called the “rule of nines” to determine the percentage of BSA. For example, the genital area is considered 1% of BSA. The head and neck are 9%. Burns on each arm, including the hand, is also 9% of BSA. Each leg, including the foot, is 18%. The front of the torso is 18%, as is the back of the torso, including the buttocks. In children younger than nine, the palm of the child’s hand is used as a measure of 1% of BSA. Third-degree burns that cover less than 2% of BSA are considered minor. Third-degree burns that cover 2 to 10% of BSA are considered moderate burns. Those that cover more than 10% of BSA, as well as those on the face, hands, feet, or genitals, are critical.
 Treatment of Third Degree Burns

All third-degree burns require medical treatment. Minor third-degree burns can be treated in a doctor’s office, but all others should be considered a medical emergency that requires hospital treatment,  or get the person to an emergency room as soon as possible. If the person is on fire, do not let him or her run. Smother any flames with a blanket, jacket, or water, if available, or have the victim use the “stop, drop, and roll” method. Remove any clothing or jewelry from the injured area, but DO NOT remove clothing if it is stuck to the burn. Very briefly immerse the burned area in cold water or use a clean towel or wash cloth moistened with cold water to stop the burning process. Don’t hold the burned area in cold water for too long or you will cool down the body too much. Also don’t use ice or ice water because they will further damage the tissue. Do not break open any blisters, or there will be a greater risk of infection. If the blisters are open, don’t remove any clothing that might be stuck to the burn, and don’t run water over the burn. This will increase the risk of shock. Whether the blisters are broken or not, you can place a dry, sterile gauze pad over the burn, but do not use any bandages with adhesive. If the burned area is larger, lightly drape a clean sheet over it to protect it until you get medical treatment. It is important for the bandage to be loose so the burn gets air.

Never apply butter, oils, or burn ointments. They make it more difficult for the burn to heal and can actually make the burn worse because the heat can’t escape. Arms or legs that are burned should be kept raised to reduce the amount of swelling. If the face or neck are burned, raise the person’s head slightly. This will also help if he or she is having trouble breathing. If the person appears to be going into shock, lay him or her flat on the ground, raise the feet around 12 inches (30 cm), and call for medical help. You can cover the patient with a blanket to keep him or her warm.

Do not give a person who is in shock anything to drink. Otherwise, you can provide the patient with small sips of clear liquid, such as water or juice.

Chemical burns are treated a little differently. For liquid chemicals, first remove any clothing or other items that the chemicals have spilled on. Then, thoroughly wash any chemicals off the skin under running water for 15 to 30 minutes. For dry chemicals, use large amounts of water to flush the chemicals from the skin. Never use small amounts of water because they may actually activate the chemicals. If no water is available, use a clean cloth to brush any dry chemicals off the skin. Loosely cover the burn with a dry, sterile bandage, and see a doctor for further treatment. Different chemicals have different effects, so you should always check the chemical label, if possible, for additional directions. Always see a doctor if the chemicals have gotten into the eyes or mouth. If a person has had contact with electricity, call 911 and make sure the source of the electrical current is disconnected before touching the victim. Administer emergency cardiopulmonary resuscitation (CPR) if the victim’s heart has stopped beating or he or she is having trouble breathing. Lightly cover the burned area with a dry, sterile bandage until medical help arrives.

Moderate and critical third-degree burns require hospitalization. The body loses a great deal of fluid through the burned area, so replacement fluids are given through an intravenous (IV) line, which is a tube placed into a vein. If the lungs are damaged, or breathing is difficult, a tube is inserted into the throat to help with breathing. The patient will need to take antibiotics to protect the burned area from infection, as well as a prescription pain medication. If the patient’s immunizations aren’t up to date, he or she may also need a tetanus booster. Sometime severe burns are treated by putting the patient into a special room that is filled with pure oxygen under high pressure. This is called a hyperbaric chamber, and the patient must receive this treatment within 24 hours of being burned for the treatment to be effective. The burned areas are cleaned and covered with an antibiotic cream, then covered in sterile bandages. These bandages are changed frequently and the burned area is carefully monitored for signs of infection. The dead tissue around the burn is surgically removed, called debridement.

As burned skin heals, it develops a thick, scabbed surface, called eschar, that makes it difficult for blood to flow to the injured area. Doctors often have to use a procedure called an escharotomy to cut through the eschar so the healthy tissue underneath can receive the blood flow it needs. Severe third-degree burns leave extensive scars because the burns are so deep. For this reason, the burned area may need to be covered with a skin graft, where a piece of healthy skin is taken from an unburned area of the body and transplanted permanently to the burned area. This is called an autograft. If the patient’s skin can’t be used, the plastic surgeon may use the skin of another human donor (called an allograft), or the skin of an animal, such as a pig (called a xenograft). Allografts and xenografts are temporary, but protect the skin as it heals. Critical third-degree burns may take weeks to months of hospital treatment and require physical therapy to help restore movement to the burned areas and to minimize scarring.

Prevented Mangment

Many burns occur at home and could have been prevented. You can avoid first-degree burns by handling hot liquids and objects carefully. Make sure electrical cords are in good condition, household chemicals are safely stored and labeled, and hot beverages and objects are out of reach of small children. When handling chemicals, wear protective gloves and eyewear, and follow label directions for safe handling. Never wear clothing with long, loose sleeves while cooking or around any type of open fire. Never put a child into a tub unless you have first tested the water temperature. You can guard against burns from hot water by keeping your hot water heater set lower than 120 degrees Fahrenheit (49 degrees Celsius). Children should also sleep in flame-resistant pajamas or nightgowns. Do not smoke, or make sure discarded cigarettes are completely extinguished. Teach your children fire safety and make sure they do not have access to matches or lighters. You can also protect you and your family from burns by making sure you have operating smoke detectors on every floor of your house. Also check the temperature of a child’s car seat or seat belt before buckling the child in. Even these objects can cause burns after a period of time in direct sunlight. Never allow children to handle fireworks without adult supervision. Fireworks are a leading cause of burns and other injuries. You can avoid sunburns by using a sunscreen of at least a 15 SPF rating. Apply sunscreen liberally at least 20 minutes before sun exposure and reapply after swimming or sweating. Avoid spending time in the sun from 10 a.m. to 3 p.m., when the rays are strongest. Always take shelter during severe storms to avoid being struck by lightning.