What type of burn did I have?

October 7, 2019 2:26 PM

I had a pretty nasty burn a few weeks ago from a brush with my motorcycle's tailpipe. It's healed now, but what degree was it?

I'm mostly just curious at this point, but I'm confused because it seemed to straddle the indicators for second- and third-degree burns, to wit:

• The top layer of skin peeled off immediately, as if it were a recovered sunburn.
• The skin underneath was very white for a few hours, if not close to the first whole day, but it wasn't charred and other than being very pale was visibly intact, with no exposure of lower layers.
• No blisters formed, it was more like road rash except it took around two weeks to get to the point where real skin had grown back and I could stop bandaging it.
• I definitely felt pain in the area right after the event and for a while afterward until it healed.

The lack of blisters seems like the biggest indication to me that it was maybe worse than a second-degree burn, while the other indications are more ambiguous. I realize that we're talking about a discrete typology imposed on a phenomenon that's actually a spectrum of severity, but I'm curious how it might have been diagnosed. For what it's worth, daily cleaning, reapplication of a second skin wet bandage, and antibiotic salve made it heal pretty cleanly, although the skin there is pink-purple.

posted by invitapriore to Health & Fitness (5 answers total)

Best answer: From similar experiences I place these sort of burns in the weird category of skin damage like what you would get from say holding dry ice, or getting hit by a drop of a strong acid or base. The outer layer of skin was toast in an instant before the thing that causes damage was removed. More like a third degree burn, but a flash burn. The moisture in that outer layer of skin was evaporating and giving you a bit of protection from the actual heat. Leidenfrost effect. So just that bit that was in direct contact for that moment is just dead skin now. But there was not enough time for the heat to actually do damage much deeper or over a wider area.

The same sort of thing happens when you freeze a little bit of skin, or drop a bit of some chemical that just rips the water out of your skin (and you wash it off really fast). Or *cough* you drop a molten glob of aluminum on the back of your hand or turn around and brush the side of your face through a MAPP gas torch going full burn.

It hurts a bit, but doesn't char. Doesn't blister. Sometimes the top layer just peels off exposing the next layer. Sometimes it's just like a carpet burn or some other abrasion that scabs over a bit and flakes off.

I'm not even sure it really qualifies as a burn, but maybe there's some other word for quick localized dermal destruction.
posted by zengargoyle at 5:00 PM on October 7, 2019

Best answer: I took a wound care class recently, and the classification system we used was based on the depth of the tissue damaged. Keep in mind that any burn can have areas that have been damaged more or less deeply, so your burn can definitely be of more than one type, and the depth of damage is a spectrum so you may fall somewhere in the middle.
- Superficial: damage to epidermis, redness and mild discomfort, peels in 5-10 days
- Superficial partial thickness: injury to upper third of dermis, will have blisters, bright red to pink, wet/weeping, very painful, most hair follicles intact, sensitive to temperature, heals in 7-14 days
- Deep partial thickness: injury into the dermis, pale pink to white mottled appearance, minimal drainage/weeping, most hair follicles damaged, heals by re-epithelization and contracture over months, can be relatively painless if nerve endings damaged
- Full thickness: all the way through epidermis and dermis through to fascia, muscle, and bone, white, waxy, dry appearance, no hair follicles, will feel tight and firm from swelling, requires grafting or heals very slowly by contracture and re-epithelialization

Based on your description, this was probably somewhere between a superficial and deep partial thickness burn (which I believe does line up with a second degree burn), where as a full thickness burn would be a third degree one.
posted by autolykos at 6:42 PM on October 7, 2019 [1 favorite]

No blisters, not into underlying tissues, and [if you] still have nerve sensation to the area (can feel pain or touch)... then this is only a 1st degree burn. RN with accreditation in advanced wound care here...
posted by itsflyable at 9:11 PM on October 7, 2019 [3 favorites]

Best answer: Just looking at autolykos' response, and I'd agree with the assessment... although it may be more of a radiant heat damage to underlying tissues, which can be quite painful (you may want to look up toasted skin syndrome). That being said, some burns can overlap 1st/2nd degree, and not have had blistering. I like the newer descriptors used in that wound care class, as they are easier to visualize, and less of a definitive classification - because it's the real world, and we all know that not everything can be perfectly compartmentalized. The main thing is that you have done well in your treatment. The scarring will likely stay that colour for at least a year before it may lighten, and possibly become lighter than surrounding tissues.
posted by itsflyable at 9:27 PM on October 7, 2019 [1 favorite]

Response by poster: Thanks for the answers! Marking a lot of best answers because they all seem to agree with each other from their varying perspectives. I definitely want to reiterate for anyone reading this who might have just burned themselves this way how smoothly healing went with washing, wet bandages, antiseptic, and wrap being reapplied daily -- it wasn't the most fun thing in the world, but using a protective layer that doesn't stick to the wound and acted as pain relief besides was a godsend, and in spite of my being out and about during the healing period there wasn't ever even a slight indication of infection. That's not to say one shouldn't see a medical professional in such a situation, but this at least seems to be a maximally effective regimen to stick to until you do.
posted by invitapriore at 1:31 PM on October 9, 2019