2nd degree burn treatment and care: cooling, blisters and scar aftercare

What is a 2nd degree burn?

A second-degree burn damages the epidermis (outer skin layer) and reaches into the dermis (the layer underneath). The skin looks red, moist and is usually very painful. Blisters are common and need careful protection.

Within second-degree burns, healthcare professionals distinguish between two types:

• Superficial second-degree burn: the skin looks shiny red or pink, is moist and painful, and usually develops blisters. The healing time for this type is about 2 weeks.
• Deep second-degree burn: the skin can appear red to whitish, remains moist and very painful, and blisters are present. Healing often takes longer than 3 weeks and may leave scars.

First aid for a 2nd degree burn

Quick and correct first aid can minimise the damage to your skin and reduce the risk of complications. These first aid recommendations align with trusted healthcare sources, including the NHS. For detailed official advice, visit the NHS website.

For the best healing result, follow these steps:

Cooling with water

For the best result, cool the burn as quickly as possible:

• Act immediately
  Cool the burn for at least 10 minutes under lukewarm running water.
• Avoid very cold water
  Do not use ice-cold water or ice, as this may cause hypothermia or further skin damage.
• Let water flow gently
  Allow the water to run over the wound, not directly onto it, to avoid additional irritation.

Do not pierce blisters

Burn blisters are the body’s natural way of protecting damaged skin. The clear fluid inside keeps the wound moist and shields it against infection. Expert advice varies on how to treat blisters, but one thing is clear: never burst them yourself. Instead, follow these steps for the best healing result:

1. Leave blisters intact. Do not puncture or squeeze them yourself. An intact blister forms a natural barrier against bacteria. In some hospital settings, a doctor may choose to deroof the blister – this means removing the top layer of skin under sterile conditions. This should only be done by a medical professional.
2. Keep the area clean. Gently wash around the blister with lukewarm water and mild, fragrance-free soap. Pat the skin dry with a clean towel.
3. Cover if needed. If the blister is in an area that rubs against clothing, protect it with a sterile dressing. This reduces the risk of accidental rupture.
4. If a blister breaks do not peel it off. Carefully trim loose skin with sterile scissors and cover the area with a clean dressing. Apply gentle pressure to hold the dressing in place but avoid anything too tight.
5. Watch for signs of infection. Increasing redness, swelling, pus or bad smell around the blister are warning signs. If you notice these, contact your GP or another medical professional.

Avoid Sunlight

Burn wounds and burn scars are extremely vulnerable and highly sensitive to UV radiation. The skin in these areas is thinner, lacks full pigmentation, and doesn’t offer the same natural protection as healthy skin. Even mild sun exposure can trigger inflammation, slow down the healing process, and lead to permanent pigmentation changes such as darkening or discoloration of the scar (hyperpigmentation). Cover the area and avoid sunlight for at least two years after the burn.

Scar tissue continues to develop and remodel for up to two years. Throughout this period, the skin remains vulnerable. To support healing and minimise the risk of thickened or discoloured scars, it’s essential to protect the area from UV exposure every day, even when it’s cloudy.

Tip: Use a medical cream with sun protection, such as ALHYDRAN SPF 30, which combines powerful hydration with broad-spectrum UVA and UVB protection. Apply it daily to support scar healing and shield sensitive skin from harmful rays.

Managing pain

Pain from 2nd degree burns can be intense. Over-the-counter medication such as paracetamol or ibuprofen can help ease discomfort.

Elevating the burned area can also reduce swelling and pressure-related pain.

When to seek medical help

Small burns can often be treated at home, but you should seek medical help if:

• The burn is larger than 8 cm (about 3 inches).
• The burn is on the face, hands, feet, genitals, or over a major joint.
• Signs of infection appear (increasing pain, pus, spreading redness, fever).
• The person is a child under 5, an older adult, or has a weakened immune system.

Aftercare once the wound is closed

Once a second-degree burn has closed, aftercare becomes essential. The skin then passes through three natural healing phases.

In the first, inflammatory phase, which lasts a few days, the body reacts with redness, swelling and warmth as the immune system works to prevent infection.

During the repair phase, usually between one and three weeks, damaged tissue is cleared away while new cells and blood vessels are formed; the wound gradually closes.

This is followed by the remodelling phase, which can last for weeks to months. In this stage, collagen fibres are reorganised so that the scar becomes stronger and flatter. Good scar care during this period makes the biggest difference.

During this recovery, the skin often feels dry, itchy and tight. Without good hydration, the chance of visible scarring increases.

Want more in-depth guidance on scar care?

Request our free Scar Guide with expert tips on healing and scar prevention. With proper burn scar care, you can reduce the chance of scarring and minimise scar-related discomfort.

Using a scar cream

A good medical moisturising cream helps keep the skin hydrated, making it feel more comfortable. Studies show that hydration reduces redness and itch and helps the skin stay flexible. ALHYDRAN is developed for this purpose and supports scar healing by improving skin elasticity and soothing irritation.

When to start using a scar cream?

For a superficial second-degree burn, you can usually begin after about two weeks, once the wound has fully closed.

In the case of a deep second-degree burn, it often takes around six weeks before scar care can start. Always consult a healthcare professional before applying a cream in these situations.

Explore ALHYDRAN cream

Long-term scar care

Burn scars can continue changing for months or years. Ongoing care helps prevent raised or thickened scars. Options include:

• Hydration: applying medical creams to maintain moisture balance.
• Silicone therapy: use silicone sheets or gels alongside creams.
• Pressure therapy: wear compression garments to help flatten scars.
• Sun protection: always protect scars from UV exposure.

Daily life and recovery

Healing skin is delicate. Follow these practical tips:

• Wear loose, soft clothing to reduce friction.
• Avoid hot baths or harsh soaps, which dry out the skin.
• Keep moving gently to avoid stiffness and promote circulation.

Be alert for persistent itch or tightness. Regular hydration can help relieve these symptoms. If the complaints remain severe, consult your doctor.

2nd degree burns pictures: before & after

Summary: the key advice for burn recovery

• Cool immediately for at least 10 minutes with lukewarm water.
• Do not pierce blisters.
• Avoid sunlight for at least 2 years.
• Start scar care with a medical cream like ALHYDRAN once the wound is closed.
• Use pain relief as needed and elevate the burned area if possible.
• Seek medical help when burns are large, infected, or in vulnerable locations.

Good first aid and consistent aftercare can reduce scarring and support better healing.

References

We believe it is important that our claims are backed by evidence. The information we share is based on scientific research, clinical studies, and specialist experience worldwide.