Second-Degree Burn in Children

What is a second-degree burn in children?

A burn is damage to tissues of the body caused by contact with things such as heat, radiation, electricity, or chemicals. A second-degree burn affects the outer layer of skin (epidermis) and part of the inner layer of skin (dermis).

What causes a second-degree burn in a child?

In most cases, second-degree burns are caused by:

• Very hot water
• Flames
• Skin that briefly comes in contact with a hot object
• Sunburn
• Chemicals
• Electricity

What are the symptoms of a second-degree burn in a child?

Symptoms can occur a bit differently in each child. Symptoms can include skin that is:

• Blistered
• Deep red
• Swollen
• Wet and shiny
• Painful to the touch
• White or discolored in an irregular pattern in the burn area

These symptoms can be caused by other health conditions. Make sure your child sees their healthcare provider for a diagnosis and to assess how bad the burn is.

How is a second-degree burn diagnosed in a child?

The healthcare provider will ask about your child’s symptoms and health history. They will give your child a physical exam. The diagnosis of a second-degree burn is based on the signs and symptoms, and recent exposure to something that can cause a burn. This may be the sun, something hot, electricity, or a chemical.

How is a second-degree burn treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

A second-degree burn usually heals in 2 to 3 weeks, as long as the wound is kept clean and protected. Deep second-degree burns may take longer to heal.

Treatment may include:

• A wet cloth soaked with cold water (cold compress) held to the skin, to ease pain
• Antibacterial cream, to help prevent infection
• Antibiotics to take by mouth
• Other creams, to lessen pain and swelling
• Nonstick dressing or bandage that’s changed every day
• Over-the-counter medicine, such as acetaminophen or ibuprofen, for pain and swelling
• Keeping the area elevated (for instance, an arm or leg) to lessen pain and swelling
• Giving a tetanus vaccine

Don't break blisters. Let your child's healthcare provider manage blisters as needed.

What are possible complications of a second-degree burn in a child?

Possible complications can include:

• Infection of the burned area
• The skin in the burned area will be more sensitive to sunlight while healing
• The skin in the burned area may stay darker or lighter than other skin

What can I do to prevent a second-degree burn in my child?

These are some of ways to prevent burns in children:

• Make sure your hot water heater is set below 120°F (48.8°C).
• Be careful with hot drinks.
• Make sure pot and pan handles are turned toward the back of the stove.
• Be careful using car seats, strollers, and seat belts that are left in hot cars. The material and metal may get very hot.
• Keep your children away from fireplaces and grills.
• Keep your child out of the sun. Use sunscreen when your child is old enough, usually at 6 months.
• Keep cleaning products and other chemicals in a safe place. If they are under a sink, use a lock on the cabinet door.
• Put covers on electrical outlets.
• Keep hot appliances in safe places. This includes toasters, irons, and hair-styling tools.
• Teach children never to play with matches and lighters and keep these items away from young children.
• When bathing children, face them away from the faucets so they can't accidentally turn on the hot water.
• Before placing your child in the bath, check the water temperature with the inside of your wrist. The water should feel warm, not hot.
• Don't use tablecloths around small children. They can pull the cloth and cause hot food to spill on them.

How can I help my child live with a second-degree burn?

Your child may need to see their healthcare provider often to check and treat the burn. As the burn heals, the area will be itchy. Apply cream as instructed by your child's healthcare provider. Make sure your child's nails are cut short. Protect the area from sunlight. Your child should stay out of the sun and use sunscreen.

When should I call my child's healthcare provider?

Call your child's healthcare provider if:

• Your child has a fever
• There is fluid leaking from the burn area
• There is increased swelling or redness of the burn area

Key points about a second-degree burn in children

• Second-degree burns involve the outer layer of the skin and part of the inner layer of skin.
• They may be caused by very hot water, open flames, hot objects, sun, chemicals, or electricity.
• They are treated by applying cold at first. Creams or lotions and nonstick dressings are used.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
• Ask if your child’s condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your child’s healthcare provider after office hours, and on weekends and holidays. This is important if your child becomes ill and you have questions or need advice.