Metro

Recovery for women in acid attack depends on where, how deeply they were burned

Passengers looked at information monitors as they waited for their trains at The Saint-Charles Station in Marseille last month.
BERTRAND LANGLOIS/AFP/Getty Images/File
Passengers looked at information monitors as they waited for their trains at the Saint-Charles Station in Marseille last month.

The road to recovery for the Boston College students who were sprayed with acid in France will depend on where the acid struck them and how deeply it burned, two Boston burn surgeons said.

Little is known about the nature of four students’ injuries, which occurred in an attack Sunday in the southern city of Marseille, by a woman described as “disturbed.’’ French officials said they have no evidence to suggest it was a terrorist attack.

“The degree of injury depends on the strength of the acid and how long the acid was in contact with the body,” said Dr. Stephanie L. Nitzschke, a burn surgeon at Brigham and Women’s Hospital, who had no knowledge of the students’ cases beyond media reports.

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One of the students posted on Facebook that she and another student got acid in their eyes. That can cause injuries ranging from a temporary corneal scratch to vision loss, depending on how much acid got into the eye. Still, the fact that the women were not admitted to the hospital is “a promising sign,” said Nitzschke, who will become medical director of the Brigham’s burn center on Oct. 1. It suggests the women may have had first- and second-degree burns that can be managed on an outpatient basis.

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First-degree burns are similar to a sunburn, affecting the top layer of skin. Second-degree burns go a little deeper and usually involve blistering.

Acid hurts the skin in the same way fire does, by braking down the proteins in skin cells. The initial treatment for acid burns is irrigation: washing the skin with a stream of water over the affected areas for a half-hour to two hours.

First- and second-degree burns are then treated with ointments and bandages to protect the wound from infection while the skin heals itself, said Dr. Colleen M. Ryan, staff surgeon at the Sumner Redstone Burns Center at Massachusetts General Hospital. “If it’s a small area, first- and second-degree can be managed as outpatients,” Ryan said. “It may be something that requires treatment and follow-up for years.”

Burns are more devastating when they affect a highly functional or “cosmetically sensitive” part of the body, Nitzschke said. The women were reportedly sprayed in the face, and facial burns pose a risk of injuries to the eyes or mouth, and scarring that can change appearance.

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But Ryan noted that even if the burns heal without visible scars, the women may suffer an invisible injury: the psychological aftereffects of being attacked. Among the people who were inside the Station nightclub in West Warwick, R.I., when it burst into flames in 2003, those who were burned and those who escaped physical harm suffered equal rates of post-traumatic stress disorder, she noted. “Sometimes it’s the fear associated with one of these attacks itself,” Ryan said.

Three of the students in Sunday’s attack were enrolled in BC’s Paris program and one was studying in Copenhagen. In Facebook posts, two of the women expressed sympathy for the suspected 41-year-old attacker, who was arrested.

“Mental illness is not a choice and should not be villainized,” wrote Michelle Krug.

Felice J. Freyer can be reached at felice.freyer@globe.com. Follow her on Twitter @felicejfreyer.