Burns: Which Ones Need a Doctor
Last updated September 10, 2026.
Most minor burns heal at home with cool water and basic first aid. You need medical care for second-degree burns larger than three inches across, any third-degree burn, or burns on the face, hands, feet, genitals, or major joints. Chemical burns, electrical burns, and burns covering more than 10% of your body are always emergencies.
First-degree burns
First-degree burns damage only the outer layer of skin. The skin turns red, hurts, and may swell slightly. Most sunburns and brief contact with hot surfaces fall into this category.
These burns heal at home in three to six days. Run cool water over the area for 10 to 15 minutes, apply aloe vera or plain moisturizer, and take over-the-counter pain relievers if needed. Do not use ice, butter, or oil.
See a doctor if a first-degree burn covers a large area (more than both palms of your hands combined) or if pain does not improve after 48 hours. Children under one year and adults over 65 should be seen for any burn larger than one palm.
Second-degree burns
Second-degree burns damage deeper layers of skin and cause blisters, severe pain, swelling, and red or splotchy skin. Common causes include scalding liquids, longer contact with hot objects, and severe sunburn.
Small second-degree burns (smaller than three inches across) can be treated at home if they are not on the face, hands, feet, genitals, or a major joint. Cool the burn with running water for 15 minutes, cover it loosely with clean gauze, and do not pop blisters. Watch for signs of infection: increasing pain, red streaks, pus, or fever.
Get medical care the same day for second-degree burns larger than three inches, burns that fully circle an arm or leg, or burns on sensitive areas. Urgent care or a primary care visit works for these unless pain is severe or the burn covers a very large area.
Go to the ER for second-degree burns that cover more than 10% of the body (roughly the area of one entire leg or your whole back), burns in very young children or older adults, or burns that cause trouble breathing or swallowing.
Third-degree burns
Third-degree burns destroy all layers of skin and may damage tissue underneath. The skin may look white, black, brown, or leathery. These burns often cause less pain than second-degree burns because nerve endings are destroyed.
All third-degree burns require immediate emergency care. Call 911 or go to the ER. Do not remove clothing stuck to the burn, do not apply ointments, and do not immerse large burns in water. Cover the area loosely with a clean cloth and keep the person warm while waiting for help.
Third-degree burns always need specialized treatment, often including surgery and skin grafts. Burn centers handle severe cases. The ER will assess the burn and arrange transfer or admission if needed.
Burns that are always emergencies
Chemical burns require immediate ER care. Brush off dry chemicals first, then flush the area with running water for at least 20 minutes while heading to the hospital. Bring the chemical container or name if possible.
Electrical burns need an ER visit even if the skin damage looks minor. Electricity can cause serious internal injuries and heart rhythm problems that are not visible on the surface.
Burns from explosions, burns that cause difficulty breathing, burns with signs of shock (pale skin, rapid pulse, confusion), and burns in people with diabetes or weakened immune systems are also emergencies. Call 911 or go directly to the ER.
Location and size rules
Burns on the face, hands, feet, genitals, or over major joints need medical evaluation regardless of degree, because scarring in these areas can cause serious functional problems. A second-degree burn on your palm requires a doctor visit even if it is small.
Size is measured in total body surface area. One palm (your own palm and fingers together) equals roughly 1% of your body. Burns covering more than 10% in adults or 5% in children require ER care. Burns covering more than 20% are critical emergencies.
Burns that wrap all the way around an arm, leg, finger, or the chest can cut off circulation or breathing as swelling develops. These need immediate medical attention even if they appear to be only second-degree.
Where to go and what it costs
Minor second-degree burns can be seen at urgent care, which typically costs $150 to $250 without insurance. Primary care visits run $100 to $200 and work well if you can get an appointment the same day. Federally Qualified Health Centers offer care on a sliding fee scale and can be found at findahealthcenter.hrsa.gov.
ER visits for serious burns cost $1,000 to $3,000 or more before treatment, but they are necessary for third-degree burns, large burns, chemical or electrical burns, and burns causing breathing trouble. Do not delay emergency care due to cost. Hospitals have financial assistance programs, and you can negotiate bills after treatment.
If you are unsure whether a burn needs immediate care, you can text a free AI doctor consult at Pymander Health as a starting step, though serious burns should go directly to the ER without delay.
Common questions
When should I go to the ER for a burn?
Go to the ER for third-degree burns (white, black, or leathery skin), second-degree burns covering more than 10% of your body (about one leg or your back), chemical or electrical burns, burns causing trouble breathing, or burns that circle an arm or leg. Also go for burns on very young children, older adults, or anyone showing signs of shock.
Can I treat a second-degree burn at home?
You can treat small second-degree burns at home if they are smaller than three inches across and not on the face, hands, feet, genitals, or major joints. Cool with running water for 15 minutes, cover loosely with clean gauze, do not pop blisters, and watch for infection. See a doctor if the burn is larger or in a sensitive area.
How do I know if a burn is first, second, or third degree?
First-degree burns are red, painful, and have no blisters. Second-degree burns cause blisters, severe pain, and red or splotchy skin. Third-degree burns look white, black, brown, or leathery and may hurt less because nerves are destroyed. When in doubt, get medical evaluation, especially if blisters form or skin looks damaged beyond redness.
Do all burns on the face or hands need a doctor?
Yes. Burns on the face, hands, feet, genitals, or major joints should be evaluated by a doctor regardless of size or degree because scarring in these areas can cause serious functional or cosmetic problems. See a doctor the same day, either at urgent care or your primary care provider if available quickly.
What should I do immediately after getting burned?
Run cool (not cold) water over the burn for 10 to 15 minutes. Do not use ice, butter, or oil. Remove jewelry or tight clothing before swelling starts, but do not remove anything stuck to the skin. Cover the burn loosely with clean gauze or a cloth. For serious burns, call 911 or go to the ER immediately after cooling.
How much does burn treatment cost without insurance?
Urgent care visits for minor burns run $150 to $250. Primary care visits cost $100 to $200. ER visits start at $1,000 to $3,000 before treatment. Community health centers offer sliding scale fees and can be found at findahealthcenter.hrsa.gov. Do not avoid emergency care for serious burns due to cost, hospitals have financial assistance available after treatment.
Sources
Pymander is not a replacement for a physician and does not provide medical advice, diagnosis, or treatment.