A third degree burn, also called a full thickness burn, is a burn that has penetrated the epidermis and dermis and extended into the subcutaneous fat of the hypodermis. Third degree burns are usually the result of large fires (forest or house fires), certain chemicals (hydrochloric acid), or high-voltage electrical burns (down power lines).
Coloration: Third degree burns destroy the upper layers of skin, including the layers where a majority of the skin’s blood vessels are found. As a result, third degree burns do not appear red like first or second degree burns do. Instead, third degree burns turn white or brown in appearance. The lack of blood supply in the surface area also means that third degree burns will not exhibit signs of blanching.
No pain: Along with the destroying blood vessels, third degree burns destroy the nerve endings in the affected area. As a result, the nerve endings cannot transmit any signals to the brain, so there is little to no pain at the sight of the burn. In some cases, third degree burns may come in conjunction with second degree burns in the surrounding tissue. If this is the case, the victim may experience an absence of pain in localized regions but still suffer severe pain on the whole.
Dryness: The site of third degree burns will also be dry. The body’s natural defense mechanism of sending fluid to the injured area becomes impaired because of the destruction of the dermis. Additionally, glands within the skin are injured or destroyed and cannot produce natural oils.
Leathery texture: In addition to removing moisture from the burn area, third degree burns damage the collagen in the surrounding area. Collagen is the main structural component in the skin’s connective tissue. The destruction of collagen breaks down the skin’s ability to hold its shape and gives the remaining skin a leathery texture.
While all burns have the potential of causing other medical complications, third degree burns (or higher) have a heightened probability of serious medical complications. It is often the complications of third degree burns that are fatal instead of the burns themselves. Understanding these complications is an important aspect of properly treating victims of third degree burns.
Breathing: When third degree burns are the result of a fire, it is likely that the victim is exposed to smoke. Smoke inhalation is the leading cause of inhalation injuries and greatly increases the mortality rates among burn victims. Irritants may cause swelling or blockages in the airways leading to asphyxiation.
Hypovolemia: Blood vessels in the vicinity of third degree burns are typically severely damaged. If they are not cauterized by the burn, damaged blood vessels lead to loss of blood volume in the body—hypovolemia. This in turn puts the victim into a state of shock which increases heart and breathing rates. Severe hypovolemia can lead to unconsciousness or death.
Hyper/Hypothermia: The skin is the primary organ used in maintaining a consistent body temperature. The destruction of skin from third degree burns places the victim at a heightened risk of developing hyperthermia, a dangerously high body temperature, or hypothermia, a dangerously low body temperature. Either condition leads to confusion and impairs the victim’s decision making capabilities. Extreme cases are fatal.
Sepsis: The skin is also the primary organ for preventing infections from entering the body. Sepsis is a whole-body inflammation caused by severe infection. Infection can damage vital organs and induce fevers or shock.