Understanding the Healing Stages of a Burn Wound

Written by Phoenix Society for Burn Survivors on September 13, 2022

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Surviving a burn, no matter the level, is a journey. Burn wounds are complex injuries that take time to heal, depending on the depth of the damage. Burn injuries can be caused by electricity, contact with fire, hot liquids, steam, or chemicals, among other things. A burn injury typically requires medical attention when it penetrates the second layer of skin. As the burn starts to heal, a blister may form over the injured area as white blood cells attack bacteria and prevent infection as a new layer of skin grows to replace the destroyed skin. 

In addition to physical impact, the trauma of an inciting incident can also affect mental health during the healing process. You are not alone in the burn wound healing process; we at Phoenix Society for Burn Survivors are here with you to empower and support you. 

What types of burns are there? 

Burn care will vary depending on the severity or depth of the burn as well as how large the burn is. Doctors measure burns by the percent of total body surface area (% TBSA). Minor burns are less than 15% in adults and less than 10% in children. Major burns are up to 35% in adults and 30% in children. Critical or life-threatening burns make up the remaining percentage. A burn survivor may have different types or degrees of burns depending on the size of the burn and the number of locations. 

There are four degrees of burn injury

  • First-Degree Burns (Superficial)

    • This type of burn affects the top layer of skin, or epidermis, and causes minor damage to the skin. The skin can be red or tender. Common first-degree burns include mild peeling sunburns or a short contact cooking injury. These burns can usually be treated at home. Healing usually takes a few days and doesn’t typically show scarring.

  • Superficial Second-Degree Burns (Partial Thickness) 

    • This burn type penetrates the skin's second layer, the dermis. This type of burn often forms blisters, and can generally heal in 10 to 14 days with mild to moderate scarring. 

  • Deep Second-Degree Burns (Partial Thickness) 

    • This type of burn is a deep, partial thickness burn that goes further into the skin and involves both the epidermal and deeper dermal layers of the skin. Scarring for this type of wound can be severe, and these types of wounds can need skin grafting. A skin graft is a surgery that removes injured skin and replaces it with healthy skin from another body location. These deep burns can leave raised scars. 

  • Third-Degree Burns (Full Thickness) 

    • Third-degree and more severe burns, sometimes referred to as full-thickness burns, damage both layers of skin and can go into the underlying tissue. Burned skin may feel dry and leathery and turn white, black, or gray. You may not have initial pain as nerve endings under the skin can be destroyed, which affects the body’s ability to feel pain. As the nerves regrow, your sense of touch may be affected. These burns have a high risk of infection and often require additional treatment. The care team will involve a surgeon using skin grafts to help heal the area.  

  • Fourth-Degree Burns 

    • This is the most severe and potentially life-threatening type of burn. Fourth-degree burns are the highest degree, and affect all layers of skin, muscles, tendons, and bones. 

What types of burns are there?

Types of Burn Injuries 

There are a variety of ways that a burn injury accident can occur. The mechanism in which a burn injury happens may also affect healing and/or the severity of the burn. Here are the causes for burn injuries: 

  • Chemical 

  • Electrical 

  • Flame/Flash 

  • Hot Object Contact 

  • Scald 

  • Steam 

  • Sunlight or other sources of UV light such as tanning beds 

  • Other injuries to the skin or disease processes involving the skin (ex. Stevens Johnson syndrome)

Burn Wound Healing Stages 

Burn injury healing time will vary depending on injury, degree, and treatment used to treat the wounds. While minor burns may begin to close within a week, many mild to moderate burns may take weeks or several months. Severe burns (grafted or ungrafted) can take months or years to recover, requiring a lot of patience and strength.  

The type of burn – physical, chemical, or other – will require different treatments that vary from other traumatic wounds and various types of burns. Burn wounds are a medical super-specialty because they usually affect all body systems beyond the skin. There are multiple burn wound healing stages. 

The first stage of healing is helping the skin heal and fill in, whether bandages or more complex skin grafts assist that process. Once the skin is closed, moisturize the skin to decrease the chance of blisters or tears. This can decrease itching.  

Healing with a burn is not one size fits all; every injury will be different. The location of a burn will impact what to expect out of recovery. For example, if the burn is over a skin joint like the shoulder, the burn skin healing process and related scarring can limit shoulder movement. Though it may permanently impact the area’s range of motion, therapy can often help restore significant motion as part of the burn wound healing process. 

When to Seek Medical Attention for a Burn Injury 

It can be difficult to know when to seek medical attention for a burn injury, but it is always important to consult a medical professional if you have concerns about the appearance and/or pain you are experiencing as a result of a burn.   

Here are some common signs that you may need to seek medical attention: 

  • Burn has caused skin to appear leathery or have charred patches of black, brown, or white 

  • Large, fluid-filled blisters have formed underneath the skin 

  • The burn begins to present signs of infection, such as oozing, increased pain, redness, or swelling 

  • You begin to see signs of deep scarring from an injury 

  • The burn appears to have affected all layers of the skin or even deeper tissues 

  • Burn occurs as a result of chemicals, grease, or electricity 

  • The burn is more than 10% TBSAof your body 

  • The burn appears to be second degree or greater 

  • You are considered an at-risk patient (diabetics, infants, toddlers, elderly, or chronic medical conditions) that may experience prolonged healing 

  • The burn injury is on the face, hands, feet, or groin  

When in doubt, it is best to call a doctor or 911 in the event of an emergency. In some cases, your local hospital may not be able to fully care for your injury, and therefore, you may need to be transferred to a specialized burn center. 

Burn Injury Healing of All Kinds 

In addition to the physical stages of a burn injury, it is important that survivors seek out mental and emotional support after a burn injury. Your journey as, or supporting, a burn survivor will take time as you go through all stages of recovery. Phoenix Society is an all-inclusive community that welcomes all. 

There are resources available to aid you as you heal.

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