3rd degree burn: causes, treatment and aftercare

What is a third degree burn?

It is the most severe type of burn, also called a full-thickness burn. It destroys both the outer and inner layers of the skin — the epidermis and dermis — and may even damage underlying tissue such as fat, muscle or bone.

The burned area often looks white, brown or black and may appear dry or leathery. Because the nerve endings are destroyed, the affected area itself may not hurt, even though the surrounding skin can be very painful.

In contrast, a 2nd degree burn only affects the top two layers of the skin. It usually causes redness, swelling and blisters but still allows the skin to heal naturally with proper care. A 3rd degree burn, however, requires medical treatment and leaves permanent scars once healed.

Symptoms and appearance

The appearance of a third-degree burn is very different from a superficial injury. The skin may look white, brown or black, and the texture often feels dry, hard or leathery.

Pain can be reduced because of nerve damage, although not all patients are pain-free.

Because the symptoms are not always easy to recognise, only a medical professional can determine the exact degree of a burn.

In the UK, you can find more guidance on recognising and responding to burns on the NHS website.

Causes of severe burns

These burns often result from severe accidents, such as:

• Open flames and house fires: direct exposure to fire can burn through all skin layers.
• Hot liquids or steam: boiling water or steam can cause deep scalds, especially in children.
• Chemicals (acids, alkalis): strong substances that continue to damage the skin after contact.
• Electricity: high voltage can burn skin and underlying tissue along its path.
• Radiation or extreme sun exposure: rare, but possible after intense radiation or prolonged sun damage.

3rd degree burn treatment

Third-degree burns require urgent hospital care. Treatment may include:

• Wound cleaning and removal of dead tissue
• Antibiotics to prevent infection
• Intravenous fluids to support circulation
• Skin grafting to close deep wounds and restore flexibility

Even smaller third-degree burns should be assessed by a doctor. While large burns are life-threatening, smaller deep burns can also cause long-term problems if not treated properly.

For detailed advice on emergency care and treatment, see the NHS burns and scalds page.

Never use a cream on open burn wounds!

The NHS advises not to use creams on open burn wounds. ALHYDRAN follows this guidance: it is not suitable for open wounds, but is developed specifically for the delicate aftercare phase once the skin has closed.

The origins of ALHYDRAN lie in a hospital setting, where doctors began using a fresh Aloe Vera formulation to care for fragile post-burn skin. They were positively surprised by the results: improved skin condition, reduced tightness, and better scar outcomes. This led to the development of the medically proven formula used today and trusted by burn centres worldwide.

Proper aftercare with a hydrating medical cream is essential to support burn scar healing and reduce long-term complaints.

3rd degree burn recovery phases

The healing process after a third-degree burn looks very different from a more superficial burn. Because the skin is fully destroyed, natural healing is not possible, and medical treatment is always required. Recovery usually involves several stages:

• Emergency care: immediate hospital treatment focuses on stabilising the patient, cleaning the wound and preventing infection.
• Surgical treatment: removal of dead tissue and skin grafts are often needed to close the wound and support healing.
• Early recovery: once the wound is closed, the focus shifts to protecting the new skin, reducing infection risk and managing pain or itching.
• Scar maturation and rehabilitation: long-term aftercare is essential. This may include compression therapy, intensive hydration of the skin, physiotherapy to maintain movement, and psychological support.

Healing times vary depending on the size and location of the burn, and whether skin grafts are required. For many patients, aftercare continues for months or even years to achieve the best functional and cosmetic outcome.

Burn scar care and long-term recovery

Healing does not end once the wound is closed. Recovery involves a long aftercare process:

• Hydration: burn scars lack natural oil glands and therefore often feel tight, dry and itchy. Long-term hydration is essential to keep the skin supple and reduce discomfort.
• Compression therapy: pressure garments help reduce thick, raised scars.
• Itch management: up to 29% of patients still experience itching one year after a burn. Hydration and scar care products are often preferred over oral medication.
• Physiotherapy and occupational therapy: to maintain mobility and function, especially if joints are involved.
• Psychological support: scars can affect confidence and daily life.

Medical creams such as ALHYDRAN are specially developed for this type of aftercare. They combine hydration with a protective barrier effect, helping to relieve itching and improve skin flexibility. Case studies have shown that consistent scar care, combining hydration and compression, can improve skin flexibility and appearance, while reducing itching.

The results of ALHYDRAN in burn aftercare have been documented in multiple clinical studies and case reports, including third-degree burns. You can find an overview on our burn scar case studies page.

Preventing severe burns

Not all burns can be prevented, but simple safety measures can reduce the risk. Children, older adults and people with conditions such as diabetes are especially vulnerable. Staying cautious with hot liquids, open flames, chemicals and electricity helps lower the chance of serious injury.
For more extensive prevention advice, visit the NHS guidance on burns and scalds.