Second- Vs. Third-Degree Burns

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Second- Vs. Third-Degree Burns—and Why the Worst One May Not Hurt

"The Survival Doctor's Guide to Burns"

“The Survival Doctor’s Guide to Burns,” on sale today!

by James Hubbard, M.D., M.P.H.

Today is the day! The Survival Doctor’s Guide first ever e-books are officially on sale!

Until midnight tonight, you can get them for only $2.99 each. That’s 25 percent off the regular price. Don’t get trampled by the rush to the electronic bookstore. But if you do get a gash, at least you’ll know what to do now.

Today, I’m featuring another sneak peek inside one of the books: The Survival Doctor’s Guide to Burns.

Did you know the worst burns may not even hurt because the nerve endings are killed? Kinda deceptive when you’re trying to tell how bad a burn is. But not if you know the other signs to look for.

A first-degree burn, the least serious, turns red. Second- and third-degree show different signs, as I describe in the following excerpt.

Excerpt from The Survival Doctor’s Guide to Burns. (Text in blue indicates words in this interactive book that link to other sections. WARNING: The information in this excerpt is NOT complete; please see the book for full instructions and disclaimers.)

In-Depth About Burn Depths
What to Do When You Have to Treat a Bad Burn Yourself

Second-Degree Burn: Blistered

Blistering is the second-degree burn’s calling card. The blisters may pop up immediately or after several hours. Infection is the worry.

These burns usually heal in two or three weeks with minimal scarring, but you need to keep them clean and protected.

Don’t yield to temptation and start popping all the blisters. As long as they’re intact, they act as sterile bandages. Okay, maybe puncture the ones greater than an inch in diameter since they’re probably going to leak anyway.

But, remember, once you puncture a blister or it starts leaking on its own, it becomes an open wound prone to infections, so then you need to do the following:

  1. Debride the blister.
  2. Wash the wound with soap and water. Towel dry around it.
  3. Apply antibiotic ointment or honey (not for babies).
  4. Apply a gauze-and-tape dressing.
  5. Change the dressing daily or if it gets wet or dirty: Clean off any dirt or crust buildup, then reapply the ointment and bandage.

If the redness starts moving into the healthy skin, you need an oral antibiotic.

Third-Degree Burn: Blanched or Speckled

A third-degree burn damages all the skin layers—down to the fat or muscle. If it goes into those non-skin layers some people call that a fourth-degree. For our purposes you’ll treat them the same.

The skin is initially blanched or speckled white, or gone altogether. Since nerve fibers have been killed, a third-degree burn may not hurt as bad as other burns. Your skin may even be numb.

If you can’t get to a doctor, initial treatment is the same as for a second-degree burn: Deal with blisters and open sores, and debride the loose, dead skin.

Long-Term Treatment for Third-Degree Burns

Depending on the amount of surface area, third-degree burns will take months to heal. Some that don’t go quite as deep can take less time. Scarring is inevitable. It’s important to keep affected joints as mobile as possible to prevent restrictive scars.

Unless you’re going to get help within a day or two, the only chance for new healing is to debride the black, leathery, dead tissue that will form, called an eschar.* …

Have you checked out the survival books yet? I’d love to know what you think.

*WARNING: Debriding a wound by yourself can be dangerous and life-threatening. DO NOT ATTEMPT without reading the book. This is only an excerpt meant to give you an idea of what you will find in The Survival Doctor’s Guide to Burns. Important instructions and warnings are not included.

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  • Kryzdy

    I was making tea and my pitcher broke, spilling the boiling water down my legs. It sent my body into shock, and I couldnt walk for a few minutes afterwards. Blisters immediately started popping up. A friend helped me to a chair and after I was able to process what had happened, I remembered I had an aloe vera plant on my patio. I hobbled out to it, and took off a leaf. I only used the gel contents, but applied it on a regular basis. The blisters were gone after only an hour and the aloe helped hydrate my shocked skin. The burn went all the way from my upper thigh, to my calves and back behind my knee. The skin behind my knee was where I was worried about infection. After a week or so, the skin behind my knee started to slide off and was bright red. I went to the doctor and explained that I had used aloe (and even sliced cucumbers) to keep moisture in the skin, and to clean it on a regular basis. The doctor was amazed at everything and told me that there was nothing any doctor could have done that would have been close to the aloe vera. That was the best thing I could have used.
    I am so grateful that I had an Aloe plant. Everyone should have one just in case.

    Thank you for this information on when to use aloe and for which burns. I am glad that I only had 2nd degree.. because I would have still used the aloe on the 3rd.

    Hopefully someone can learn from my own experience!

    • James Hubbard, M.D., M.P.H.

      Kryzdy, thanks for sharing. Great story.

  • James Hubbard, M.D., M.P.H.

    Thanks so much, millenniumfly.

  • millenniumfly

    If you haven’t bought the Survival Doc’s Books yet, I highly recommend you do so even at the regular price. They’re well worth the read. In fact, here’s my review of the books here.