A second degree burn, also called a partial thickness burn, is a burn that affects the dermis without penetrating deep enough to affect the hypodermis. Most second degree burns come from the same sources as first degree burns but are the result of prolonged exposure to the burn source. Chemical and electrical burns are also a common source of second degree burns.
Second degree burns can be further broken down into two sub-classifications, superficial and deep. The distinction between superficial and deep burns is how far into the dermis the burn penetrates.
Superficial second degree burns penetrates only to the s tratum papillare—the upper layer of the dermis. This is the layer of the dermis comprised primarily of connective tissues that connects the dermis to the epidermis. While the term “superficial” may make these burns seem harmless, they can still be extremely painful and may require medical attention.
Deep second degree burns penetrate through the upper dermis and into the stratum reticulare—the lower layer of the dermis. This layer contains a majority of the bodies sensory receptors which makes deep second degree burns the most painful burns that someone can experience. This layer also contains hair roots, sweat glands, and blood vessels. Deep second degree burns can permanently affect hair growth and oil production in the affected areas and lead to long term scarring. Burns this deep also take about twice as long to heal as superficial second degree burns.
Pain: The five senses help the body understand what is going on in the world around it. Pain fills a similar role within the body and is an important tool for survival. It’s the body’s way of informing the brain that something is wrong. Pain causes us to recoil from surfaces that are hot and tells us to avoid putting weight on a broken foot. Without pain, we could cause serious damage to our bodies without realizing it.
The nervous system is the way in which pain is transmitted to the brain. The dermis contains nerves that are sensitive to the body’s functions. If some function is not acting properly, nerves relay this information to the spine through an electronic signal. Because nerves are so sensitive, one of the epidermises functions is to protect the nerves from receiving stimuli that would cause false pain signals.
Second degree burns destroy the epidermis’s ability to perform this function. The nerves become exposed or damaged and begin sending an increased number of signals to the brain. The brain receives these signals and interprets them as severe pain. Because of the severity of the pain, over-the-counter medication may not be sufficient to control the pain.
Blisters: The most indicative sign of a second degree burn is the formation of blisters. Blisters are a natural reaction to severe irritation and inflammation within the skin. The body sends fluid to the surface of the skin to act as a protective shield against further damage. Some of that moisture collects into rapidly constructed flaps of thin skin that form blisters.
Weeping: Moisture which isn’t captured in blisters makes its way to the surface of the skin. The epidermis is too damaged to retain the moisture, so the moisture seeps out making the burn appear wet.
Coloration: Second degree burns appear deep red but turn white when pressure is applied. The red color comes from the body’s release of histamines which dilates the capillaries causing excess blood to come to the surface of the skin, exactly the same as a first degree burn. When pressure is applied, blood is forced out of the capillaries. This process is called blanching. Under normal conditions, blood flow should return to the skin as soon as the pressure is alleviated. Second degree burns damage the blood capillaries and cause inflammation making it more difficult for blood to return to the surface. This gives the skin a white appearance until blood returns to the area.
Peeling: Peeling occurs when a burn damages living cells in the dermis. The body is forced to discard these dead cells resulting in peeling. Because there are more living cells in the dermis than in the epidermis, second degree burns tend to peel more extensively than first degree burns.