What do we mean by long-term effects?
Post-hospitalization (approximately three to five months after the attack and after)
Impact on the body


Upon contact with the acid, nerves can be permanently damaged. As a result, specific body parts may face restricted movement. If the nerves of the mouth are affected, eating and speaking may be difficult.


Treatments

Source: Shimizu, R., & Kishi, K. (2012). Skin graft. Plastic surgery international, 2012, 563493. doi:10.1155/2012/563493
Contracture releases are done when the skin becomes so tight that one is not able to bend or straighten the limbs. Initially, contracture scars are highly vascularized, meaning that they have a lot of blood vessels transporting the necessary nutrients to the area to heal quicker. If surgery were done at this point, there would be more complications since the scar would bleed more. However, after approximately one year, contracture scars start to mature and become softer. At this point, surgery can be done. However, there are exception to this rule. Surgery can be done immediately if the contracture is located in the following areas: eyelids (if the individual cannot close their eyes), neck (if the individual cannot move their head properly), knees (if the individual cannot be stand properly and has to be on all fours), and hands (if the individual loses the ability to flex the hand).
Sources: Goel, A., & Shrivastava, P. (2010). Post-burn scars and scar contractures. Indian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India, 43(Suppl), S63–S71. doi:10.4103/0970-0358.70724 & Hayashida, K., & Akita, S. (2017). Surgical treatment algorithms for post-burn contractures. Burns & trauma, 5, 9. doi:10.1186/s41038-017-0074-z
Sources: Goel, A., & Shrivastava, P. (2010). Post-burn scars and scar contractures. Indian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India, 43(Suppl), S63–S71. doi:10.4103/0970-0358.70724 & Hayashida, K., & Akita, S. (2017). Surgical treatment algorithms for post-burn contractures. Burns & trauma, 5, 9. doi:10.1186/s41038-017-0074-z

Source: https://www.allaboutvision.com/conditions/cornea-transplant.htm


Acid attack survivors may encounter physical limitations, such as limited joint movement, due to scarring. Physical therapy will work towards keeping all the affected joints moving. It involves different exercises such as splinting (securing a broken limb with splints) and strengthening. It can also aid in scar management through use of pressure garments and massage. The treatment time can vary. However, the average amount of time that an acid attack survivor will undergo physical therapy is about one to two years.
Source: OSullivan, Susan B., et al. Physical Rehabilitation. 6th ed., F.A. Davis Company, 2014, https://hsrc.himmelfarb.gwu.edu/books/85
Source: OSullivan, Susan B., et al. Physical Rehabilitation. 6th ed., F.A. Davis Company, 2014, https://hsrc.himmelfarb.gwu.edu/books/85
Although there is no experimental evidence that shows that massage therapy can help against keloid and hypertrophic scars, it has been shown that it can help with scar pain, itching, and minimizing contracture scar formation. It also helps with range of movement and can have a positive effect on the individual's mental health. Massage therapy can help soften and flatten the scar region.
Source: OSullivan, Susan B., et al. Physical Rehabilitation. 6th ed., F.A. Davis Company, 2014, https://hsrc.himmelfarb.gwu.edu/books/85
Source: OSullivan, Susan B., et al. Physical Rehabilitation. 6th ed., F.A. Davis Company, 2014, https://hsrc.himmelfarb.gwu.edu/books/85
Corticosteroid injections can be injected into a keloid or hypertrophic scar to reduce inflammation. The corticosteroid injections break the bonds between collagen fibers, which reduces the amount of scar tissue beneath the skin.

Medical tattooing helps improve the appearance of scars from an acid attack. It involves coloring in the scarred areas to make the skin look all the same color. The tattoos are darker than the skin for four to six weeks after the procedure. Eventually, the darker pigment from the tattoo fades to blend in with the natural skin color.
Source: Batstone, M. D., Fox, C. M., Dingley, M. E., & Cornelius, C. P. (2012). Cosmetic Tattooing of Free Flaps following Head and Neck Reconstruction. Craniomaxillofacial trauma & reconstruction, 6(1), 61–64. doi:10.1055/s-0032-1330840
Source: Batstone, M. D., Fox, C. M., Dingley, M. E., & Cornelius, C. P. (2012). Cosmetic Tattooing of Free Flaps following Head and Neck Reconstruction. Craniomaxillofacial trauma & reconstruction, 6(1), 61–64. doi:10.1055/s-0032-1330840

Keloid scars are difficult to treat and have high rates of recurrence after treatment. One way in which surgeons treat these scars is surgical removal of them.
Source: Wilson A. M. (2013). Eradication of keloids: Surgical excision followed by a single injection of intralesional 5-fluorouracil and botulinum toxin. The Canadian journal of plastic surgery = Journal canadien de chirurgie plastique, 21(2), 87–91. doi:10.1177/229255031302100208
Source: Wilson A. M. (2013). Eradication of keloids: Surgical excision followed by a single injection of intralesional 5-fluorouracil and botulinum toxin. The Canadian journal of plastic surgery = Journal canadien de chirurgie plastique, 21(2), 87–91. doi:10.1177/229255031302100208