When corrosive substances make contact with the skin, the resulting injury is known as a chemical burn. Acids immediately react with and destroy the biological components of the skin, causing the affected tissue to rapidly denature its proteins. The severity of the damage is directly related to factors such as the acid’s concentration, its pH level, and the total duration it remains in contact with the tissue. Because the destructive process begins instantly, the speed of the initial response is the single most important factor in limiting the depth and extent of the resulting injury.
Immediate Emergency Response
The primary action in an acid splash incident is to immediately and continuously flush the affected area with copious amounts of cool, running water. The goal is to dilute the chemical and wash it away from the skin as rapidly as possible to halt the burning process. The area should be rinsed under a gentle stream of water for a minimum of 15 to 20 minutes, or until emergency medical services arrive and take over the decontamination process. For more severe exposures, flushing for 30 minutes or even longer may be necessary to ensure the acid is completely removed and the burning sensation has significantly subsided.
While the flushing process is underway, all contaminated clothing and jewelry must be quickly and carefully removed. Items like rings, watches, or clothing can trap the chemical against the skin, allowing the destructive reaction to continue and deepen the burn. Removing these items while the water is still running prevents further exposure to the body or to the rescuer.
When removing clothing, attempt to cut or tear it away rather than pulling it over the head to avoid spreading the acid to the face or eyes. The person providing aid should take precautions, such as wearing chemical-resistant gloves if available, to protect themselves from secondary contact with the acid. It is also important to ensure the runoff water carrying the diluted acid does not flow onto unaffected parts of the body or contaminate the surrounding environment.
Do not attempt to neutralize the acid with an alkali substance like baking soda or a base. Introducing a second chemical can cause an exothermic reaction, which generates heat and risks causing a secondary thermal burn, worsening the overall injury. Therefore, the only accepted immediate first aid is the application of vast amounts of water to dilute and remove the corrosive agent.
Recognizing the Severity of the Burn
After the initial decontamination with water, an assessment of the burn depth is necessary to determine the urgency of professional medical intervention. Superficial chemical burns, similar to a first-degree thermal burn, present with redness, minor swelling, and pain confined to the outermost layer of the skin. These injuries may be managed with continued cleaning and medical follow-up, but they heal without significant scarring.
Deeper burns show more severe signs, indicating that the acid has penetrated the layers beneath the surface. A partial-thickness burn may involve blistering, pain, and a mottled red and white appearance. A full-thickness burn, where all layers of skin are destroyed, often appears white, waxy, or leathery, and in the case of acid coagulation, may be dark or black due to the formation of a protein-based eschar.
Loss of sensation or numbness in the center of the burned area indicates deep tissue damage that requires immediate hospital care. Any burn covering a large area, or one that involves sensitive regions like the face, hands, feet, genitals, or major joints, constitutes a medical emergency. If the acid has splashed into the eyes or if the person has inhaled chemical fumes, which can cause respiratory distress, emergency services must be contacted without delay.
A significant exception to standard acid treatment is exposure to hydrofluoric acid, which is found in certain industrial cleaners and rust removers. While the hydrogen ion causes a corrosive burn, the fluoride ion penetrates the skin deeply and rapidly, leaching calcium from underlying tissue and the bloodstream. This systemic toxicity can lead to severe hypocalcemia, cardiac arrhythmias, and even death, sometimes with minimal external burn signs, making immediate specialized medical attention mandatory regardless of the apparent size of the burn.
Post-Incident Medical Treatment and Recovery
Once a person arrives at a medical facility, the professional response focuses on ensuring complete decontamination, pain management, and preventing infection. Medical personnel will often continue the irrigation process to remove any residual chemical lodged in the tissue. For deep burns, treatment may involve surgical or chemical debridement, which is the removal of nonviable, damaged tissue to promote healing and reduce the risk of infection.
Specialized chemical burns require a targeted antidote, which is typically a calcium gluconate gel massaged into the wound or injected beneath the skin. This calcium compound works to bind the fluoride ions, preventing them from causing further tissue destruction. For all other acid burns, doctors will apply specialized antimicrobial dressings, such as those impregnated with silver sulfadiazine, to manage the wound and protect it from bacterial invasion.
Healing is a prolonged process, and even after the initial wound closes, the burn victim may face the challenge of scarring and contractures. Deep burns often require skin grafting, where healthy skin is transplanted from another area of the body to cover the deficit. This procedure is necessary to restore the protective barrier of the skin and facilitate movement.
Long-term recovery involves physical therapy to stretch the skin and prevent contractures that can limit joint mobility. This rehabilitation aims to maximize functional recovery and minimize permanent disfigurement. Regular follow-up appointments with burn specialists are required to monitor the healing process, manage scar tissue development, and address any long-term physical or emotional effects of the injury.