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Assessing the extent of the burn

Burns are assessed by how seriously the skin is damaged, which layers of skin are affected and also the size of the burn. There are three main types of burns, superficial, partial thickness and full thickness, which tend to look different and have different symptoms.

Skin has three layers. The:

  • Outer layer of skin (epidermis)
  • Layer of tissue just beneath which contains blood capillaries, nerve endings, sweat glands and hair follicles (dermis)
  • Deeper layer of fat and tissue (subcutaneous fat or subcutis)

Superficial burns

Superficial burns only affect the outer layer of skin causing redness, tenderness and inflammation.

Partial thickness burns

Partial thickness burns affect both the outer layer of skin and the layer of tissue just below. This type of burn can be extremely painful, with the outer layer of skin being burnt and broken causing blistering, swelling, pain and rawness.

Blisters are caused by tissue fluid leaking into the burnt area just below the skin’s surface and protect the underlying skin while it is healing.

Full thickness burns

Full thickness burns affect all three layers of skin causing the skin to look pale, charred and waxy with fatty deposits. There may also be damage to the nerves which can often mask the severity of the burn due to the pain receptors being damaged.

When assessing a burn you should look to see how deep the burn has caused damage and also estimate the size of the burn. One quick way to estimate the surface area that has been burned is to compare it to the size of the palm of the casualty’s hand, which is roughly equal to 1% of the body’s total surface area.

You must send them to hospital:

  • If the burns affect the hands, feet, face or genital areas
  • For all full thickness burns
  • If a burn extends around a limb
  • For all partial thickness burns larger than 1% of the body’s surface
  • For all superficial burns that represent 5% of the body’s surface
  • For burns with a mixed pattern of depth

Children under ten years of age should always seek medical attention after a burn or scald.

If you are in any doubt you should seek medical advice.

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