Burn Care Guidelines 2nd & 3rd Degree Burns
Remember, never use ice on a burn. It decreases blood flow and prevents healing.
Second Degree Burns appear open, shiny
and moist, blistered, and pink or red. These
burns are painful and sensitive to touch.
These burns may be treated at home, in the
clinic, or in the hospital. Second degree
burns often take 1-3 weeks to heal.
Third Degree Burns appear dry or leathery,
white, brown, maroon, dark red, or black.
These burns are not sensitive to pain. Third
degree burns often take greater than 3 weeks
to heal or need skin grafting. These burns
are treated at home only if they are quite
Follow the burn care treatments below
marked with an X.
_____ Remove the dressing. Do not soak to
remove it. Dry dressing removal cleans
away dead tissue and debris.
_____ Wash burns gently once a day with
unscented, antimicrobial soap. Do not use
baby soap or soaps with lotion in it. Wash
off antibiotic cream, blisters, and loose skin.
Rinse well. A small amount of bleeding may
be expected. Facial burns should be washed
_____ Remove antimicrobial
cream/ointment from jar with gloves or
washed hands to prevent contamination of
_____ Apply a thin layer of Bacitracin or
Silvadene antimicrobial cream or ointment
to the burn two times per day (about 10-12
_____ For facial burns – apply antibiotic
ointment twice a day, and more often if face
becomes dry. No gauze is needed on the
face. Shave facial hair once a day.
_____ For ear burns – apply bacitracin
antimicrobial cream twice a day. Do not get
cream in the ear canal. It may build up and
plug the ears.
_____ Apply a non-stick gauze called
_____ Wrap all burns except the face and
ears with non-stretch roller gauze. Extra
layers of gauze may be needed if the wound
Stop Smoking. Smoking decreases blood
flow and oxygen to new and healed burns. It
slows down the healing process.
How to Prevent Swelling
Compression and elevation are very
important to preventing swelling away from
your wound and promoting healing. This
can also help relieve pain.
_____ Apply Dermafit or compression
_____ Face or head burns— elevate head
_____ Hand or arm burns—rest hand or arm
on pillows above the level of the heart as
much as you can.
_____ Foot and leg burns—keep feet and
legs up on pillows when sitting or in bed.
Keep heels off edge of pillow.
Watch for Signs and Symptoms of Infection:
ξ Redness (about 1 inch in width) and
swelling around the burn.
ξ Foul smelling drainage from the
ξ Flu-like symptoms (temperature
greater than 100.4º or 101.5 F for
children by mouth for two readings
taken 4 hours apart, chills, nausea,
vomiting, or muscle aches).
ξ Increasing burn pain. Not relieved
by prescribed pain medicine.
_____ Take prescribed pain pills 45
minutes- 1 hour before dressing changes.
_____ Between dressing changes use
Tylenol® (acetaminophen or extra strength
acetaminophen) to treat pain. You will have
less pain as the burn heals. The burn feels
stiff or like it is being pulled as it heals.
_____ Use ibuprofen only if approved by
_____ Exercise to keep joints moving and to
stretch new skin.
_____ Keep moving and walk often
_____ Use your burned extremity
_____ Drink plenty of fluids with extra
protein, 8-10 (8 oz.) glasses in 24 hours, to
_____ Eat a well balanced diet high in
protein to help the wound(s) heal.
_____ Use moisture creams to prevent
drying and cracking. Healed skin appears
_____ Apply moisture creams that are
perfume and dye-free such as Lubriderm,
Eucerin ®, or Nivea® as often as needed to
keep the skin moist and soft. Avoid creams
with alcohol or numbing agents.
For questions Monday through Friday, 8:00
am – 5 pm please call the General Surgery
and Burn Clinic at 608-263-7502.
If you have urgent questions or needs after
hours or on weekends, please call the Burn
Unit Nurses at 608-263-1490 or call
608-262-2122 and ask to have the Burn
If you have non urgent questions or needs
after hours or on weekends, please leave a
message for the General Surgery triage
nurse at 608-890-9542.
If you live out of the area, call 1-800-323-8942.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 8/2016 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4573.