Orange County, CA 4th Degree Burn Treatment

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What Is A Fourth Degree Burn?

4th-degree burns are the most severe type of burn. Not only do they destroy all three levels of skin, they burn the underlying tissue, including muscle, tendon, and bone. Some medical resources identify fourth-degree burns as those that cause damage to subcutaneous tissue, while fifth-degree burns damage muscle, and sixth-degree burns damage bone. However, most modern medical practice classifies all of these as fourth-degree burns. 4th degree burn treatment is almost always necessary as these can be highly damaging. Call us today for a free assessment and get scheduled fast!

Common Symptoms of Fourth Degree Burns

Fourth-degree burns involve complete destruction of the skin at the burn site. Thus the individual doesn’t feel any pain, as the nerves have been destroyed. The burn site may appear charred, ash white, grey, or black, with exposed muscle and/or bone. A key characteristic is eschar formation; the body produces a substance to aid in the shedding of dead tissue. The cauterized tissue may be skin, muscle, connective tissue or soft tissue.

What Causes Fourth Degree Burns?

Fourth-degree burns are not common. They require exposure to excessively high temperatures, such as in a building fire or forest fire, or an explosion. Certain highly acidic chemicals can cause the skin to dissolve rapidly and produce a fourth-degree burn, as can extreme amounts of radiation. Typically, to be burned this badly, the victim would have to experience a serious accident involving flammable materials, or become trapped inside a burning building or vehicle. They can also happen in warfare. 

Risk Factors

Risk factors for fourth-degree burns include:

  • Certain Hazardous Occupations (Firefighter, Soldier, Manufacturing, Power line worker, etc.)
  • Sex (Male)

As fourth-degree burns are less common, not much information exists on categories of risk. Incidents arise most often with respect to a lapse in safety protocols.


Fourth-degree burns are life-threatening, and have a number of potential complications that can arise immediately if not addressed before emergency personnel arrive. Always get the burn victim to a safe, quiet location and dial 911. Try to keep the burn site covered, and the patient hydrated and warm. Make sure they continue to breathe and avoid going into shock.


Fourth-degree burns destroy the skin completely, exposing soft tissues which are not designed to resist infection. Sepsis (infection of the blood) and other infections are a threat, even in areas away from the burn site. 


In a fourth-degree burn scenario, the body will send water to the areas that have been destroyed to help them recover. Water evaporates from the burn site as well. The resulting moisture loss is significant, and it must be replaced.


A severe burn can cause the body to go into shock. Shock occurs when the body needs more oxygen, yet is not getting it. Children are at greater risk of experiencing shock when they sustain a fourth-degree burn. If you are tending to a burn victim who is having trouble breathing or losing consciousness, try to get them to lie down in a safe place and breathe. Apply CPR (if you have training), and try to help them stay awake.

4th degree burn treatment


Fourth-degree burns require surgery to treat, and skin grafts are not always enough. Scars may last for a lifetime. Debridement (the cutting away of dead tissue) may be necessary to facilitate new tissue growth. But this technique is no guarantee of a complete recovery.

Heat Exhaustion/Heat Stroke

A fourth-degree burn will cause the body to absorb a tremendous amount of heat, putting the victim at risk of heat stroke. If a burn victim’s internal temperature rises too high above normal (98.6°F) for too long, they may begin to experience heat exhaustion. The following is a list of symptoms of heat exhaustion, which can give rise to heat stroke: 


  • Extreme tiredness/low energy
  • Dizziness/fainting
  • Nausea
  • Rapid Pulse
  • Muscle Pain
  • Irritability
  • Headache/Dizziness


Heat stroke can be fatal. Always dial 911 immediately when someone suffers a fourth-degree burn, and try to find a way to get them to cool down if they are overheated. Be careful as you do however, as hypothermia is also a threat to a person who has lost a significant amount of skin. 

Psychological Effects

Fourth-degree burns often result in the permanent loss of functionality of limbs, fingers, joints, and even organs. Children are especially vulnerable to trauma-related conditions such as PTSD, anxiety, or depression. If the patient suffers from one of these debilitating conditions, seek help from a qualified mental health provider. When trauma is not treated, it can result in more harm than the burn itself, especially if the burn is a result of abuse. Grief counseling is very helpful, as are traditional talk therapies.

Other Problems

Sepsis, hypovolemia, blood loss, hypothermia, long-term mobility issues, and lung damage from smoke inhalation are all risks when treating someone who has suffered a fourth-degree burn. Given their severity, dialing 911 is always the best option, as the attending physicians will have the skills and resources to treat whichever of these complications arise. 

How To Prevent Fourth Degree Burns

first degree burn on hand

Preventing severe burns begins with fire safety. Whether at home or at work, make sure that you and those closest to you are adhering to fire safety guidelines. If you have safety training classes for use of equipment or materials, take the training and pay attention. Purchase fire extinguishers and smoke and/or carbon monoxide detectors in your home, and plan an escape route that has a swift, efficient way out of the building.

When working with extremely hot or dangerous materials, there is simply no replacement for using common sense and caution. Fourth-degree burns are not common at home. But they are possible when one is careless with flammable or explosive materials. Don’t play games with your life or the lives of others. It’s simply not worth the trouble.

How To Diagnose A Fourth Degree Burn

Fourth-degree burns are so severe that they burn through the skin and into the muscle or other soft tissues. Inner tissue will be charcoal grey or black in appearance. People with this level of burn are at risk of going into shock, or dying. Don’t worry about diagnosing the patient; just get them to the ER, and they will know what to do.

Treatment (Pain and healing)

If you have suffered a fourth-degree burn and are conscious, congratulations on being alive. Get to a safe location and dial 911 immediately. Focus on controlling your breathing and staying calm. If a friend or loved one suffers a fourth-degree burn, get them to a safe location and help them continue to breathe. Dial 911 immediately and help them get to an emergency room.


While awaiting emergency personnel, keep the burn site elevated above the heart. Cover the burn site with a loose cloth or towel. If the patient gets cold, cover them with a blanket. If the burn was caused by a chemical exposure, flush the burn site with tepid water. Help the patient stay hydrated.


At the ER, the attending physician will work to clean the affected area. Antibiotics are fed intravenously to shield the victim from infection, as the risk is much greater with severe burns. Electrolytes are also added to IV fluids, and pain or anti-inflammatory medications may be as well. The doctor may give the patient a tetanus shot. Dead tissue is cut away to enable new tissue to grow. Skin grafts of living and/or synthetic skin are used to cover the burn site and help to avoid skin contracture (a condition in which the remaining skin is insufficient to cover the burn site, causing it to become stretched).


After being released, a physician will often refer the patient to a wound care clinic that specializes in burn care and will have the resources and skilled professionals to treat the patient throughout what will likely be a long road back to full health.

Other Types Of Burns

Call Wound Care OC For Burn Treatment

Wound Care OC is the premier location for burn treatment in Orange County. If you or a loved one has a fourth-degree burn, reach out to our office after you are released from the emergency room. Our professionals have extensive experience and expertise in handling severe burns. They will have access to materials and medications to help you achieve the best possible prognosis, even though it might take some time.


We’re here to be your advocate, and encourage you when you are struggling with a lack of faith. We have helped countless people like you get back to the life they were missing, and we can help you too. Give our office in Santa Ana, CA a call today, and let’s get started on your journey.

Wound care specialist Dr. Faried Banimahd

Working Hours

1533 E 4th St,

Santa Ana, CA 92701

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