Partial Thickness 
(1st degree)

• superficial burns are limited in depth to the first 2 or 3 of the 5 layers of the epidermis 
• characterized by erythema, hyperemia, tenderness and pain
• no vesicles or blisters
• due to the shallow depth, regeneration of skin will occur within several days

Moderate Partial Thickness 
(2nd degree)

• burns involve entire epidermis (blue zone) and upper third of dermis (mauve zone)
• skin will usually appear red
• injury to microvessels that perfuse the skin results in wet wounds with bullae and blisters
• very painful; pain increases when exposed to air currents
• will heal within 1 - 6 weeks with minimal scarring

Deep Partial Thickness 
(2nd degree)

• burn includes the entire epidermis and deep into the dermis
• impairment of blood supply often limits fluid leakage; blisters are not usually present and only a modest amount of plasma leakage appears on the wound
• wound usually red with white appearance in center; blanches following assessment for capillary refill
• dermal necrosis and surface protein turns gives burn surface a yellow appearance
• will heal spontaneously by slow granulation, often leaving unstable epithelium, scarring and contractures
• grafting is the desired treatment as it improves the quality of the healing (better cosmetic and functional healing) and reduces the opportunity for infection
• can progress to full thickness injuries if infection develops

Full Thickness Burn
(3rd degree)

• results in destruction of skin through all layers of epidermis and dermis, extending into subcutaneous fat and underlying tissue
• subcutaneous layer contains hair follicles and sweat glands and is poorly vascularized; this is below the stratum germinativum layer (dark blue area) which is responsible for the generation of new skin cells
• burn appears white, red or brown and is often charred and leathery in appearance 
• skin is usually dry and insensitive to pin or palpation
• if skin is broken, subcutaneous fat may be visible
• associated with extensive fluid and electrolyte imbalances, altered thermoregulation, metabolic disturbances and infection
• although small wounds will contract and eventually heal, larger wounds require grafting 

 

Epidermis: 
blue area

Stratum Germinativum: 
dark blue area

Dermis: 
mauve area

Subcutaneous Fat: 
yellow area

Burn Depths:
partial thickness (1)
moderate partial thickness (2)
deep partial thickness (3)
full thickness (4)

Diagram 1