(3) Subcutaneous tissue. The subcutaneous tissue lies beneath the
dermis and is composed primarily of fat. The fat serves as an insulator against cold
Figure 6-1. Skin layers.
b. Degrees (Depth) of Burn.
(1) First-degree burns. First-degree burns cause the skin to be red and
painful (like a sunburn), but does not produce blisters. It involves only the superficial
(2) Second-degree burns. Second-degree burns are more serious. The
burn is painful and blisters are present. There is damage to the epidermis and the
dermis. There may also be some swelling in the subcutaneous layer even though the
layer is not actually damaged.
(3) Third-degree burns. Third-degree burns involve damage to or
destruction of all three layers of skin. It usually involves damage to the fascia and may
also include damage to underlying muscles, nerves, blood vessels, and/or bone. The
skin may look leathery, dry, and discolored (charred, brown, or white). Clotted blood
vessels may be visible under the burned area and subcutaneous fat may be visible.
Third degree burns may not be painful because the nerves have been destroyed, but
the surrounding area with second and first-degree burns may be painful. Third-degree
burns involve a large loss of body fluid that can lead to shock.