Acid attacks like the ones that targeted two British teenagers volunteering in Zanzibar are grimly effective – and difficult to treat, burn experts say.
The key to recovery is quick removal of acid-soaked clothing, immediate rinsing with copious amounts of water and fast treatment by doctors who can address issues like skin grafts, scarring and dealing with searing pain.
“It’s a terrible, terrible injury and it’s terrible to inflict it on someone else,” said Dr. Sidney F. Miller, founder and past director of the Burn Center at The Ohio State University.
Acid is cheap, widely available and invariably devastating when it is intentionally thrown with the goal of maiming, disfiguring or blinding the victims, according to the Acid Survivors Trust International, a nonprofit group that tracks acid attacks and works to help victims.
Teenagers Kirstie Trup and Katie Gee were due to arrive back in London Friday for treatment of burns suffered Wednesday, when two men riding a motorcycle poured acid on them. The 18-year-olds were in Zanzibar to volunteer as teachers on the majority Muslim island.
The young women reportedly suffered “horrendous” burns to their faces, hands, legs, backs and necks, Gee’s father, Jeremy, told the Telegraph newspaper.
But they are only the latest victims of acid violence, which occurs regularly in several countries, including India, Bangladesh, Colombia, Nepal, Cambodia and Afghanistan, the Acid Survivors group reports on its website.
About 1,500 cases are recorded every year, although that number is likely to be massively underreported, experts say. Between 75 percent to 80 percent of cases involve women, and about 30 percent of the women are younger than 18.
There aren’t many intentional cases of acid attacks in the U.S., said Dr. Tom Tallman, an emergency physician at the Cleveland Clinic. But the key here – or in other countries is to address the injury as quickly as possible.
Depending on its strength, acid can burn through the full thickness of the skin in seconds, even eating into tissue and muscle below. As the skin heals, it develops scar tissue, which creates much of the disfigurement often associated with acid burn victims.
Skin grafts and plastic surgery are often required, he added.
For the British girls, who have access to Western medical care, plastic surgery techniques can include both surgical and non-surgical options, said Dr. Howard Liu, director of cosmetic dermatology at Cedars-Sinai Medical Group in Los Angeles.
Fat grafts, bio-compatible dressings that encourage new skin growth and other innovative treatments could help them heal, even from the whole-body and splatter injuries that typically occur with acid burns, he said.
"For these two young ladies, hopefully they will get the resources they need to recover," Liu said.
But that’s not often the case for typical acid attack victims, said Miller, who is also associated with the American Burn Association. They are forced to contend with medical systems equipped only to provide basic wound care -- at best.
The burn association reaches out to doctors and hospitals in low-income countries to help train medical teams to respond quickly and effectively to the heinous intentional injuries.
“There are a lot of ways to hurt people,” Miller said. But this is one of the worst, he added.