An acid attack, also called acid throwing, vitriol attack, or vitriolage, is a violent assault involving the act of throwing acid or a similarly corrosive substance onto the body of another "with the intention to disfigure, maim, torture, or kill". Perpetrators of these attacks throw corrosive liquids at their victims, usually at their faces, burning them and damaging skin tissue, often exposing and sometimes dissolving the bones. Acid attacks can lead to partial or complete blindness.

The most common acids used in these attacks are sulfuric acid and nitric acid. Hydrochloric acid is sometimes used but is much less damaging. Aqueous solutions of strongly alkaline materials, such as caustic soda (sodium hydroxide) or ammonia, are used as well, particularly in areas where strong acids are controlled substances.

The long-term consequences of these attacks may include eye burns, blindness, severe permanent scarring of the face and body, and far-reaching social, psychological, and economic difficulties.

Although acid attacks occur all over the world, this type of violence is most common in developing regions, It is often gender-related violence, with "a disproportionate impact on women" according to Acid Survivors Trust International (ASTI). However, in countries such as the United Kingdom, where acid attacks are associated primarily with gang violence, the majority of both perpetrators and victims are male.

Health effects The most notable effect of an acid attack is lifelong disfigurement of the face and body. According to the Acid Survivors Foundation in Bangladesh, victims of acid attacks have a high survival rate. Victims that survive face physical challenges, which require long-term surgical treatment, and psychological challenges, which require in-depth intervention from psychologists and counselors at each stage of physical recovery. These far-reaching effects on their lives impact their psychological, social, and economic viability in communities.

Medical The medical effects of acid attacks are extensive. As a majority of acid attacks are aimed at the face, several articles thoroughly reviewed the medical implications for these victims. The severity of the damage depends on the concentration of the acid and the time before the acid is thoroughly washed off with water or neutralized with a neutralizing agent. The acid can rapidly eat away skin, the layer of fat beneath the skin, and in some cases even the underlying bone. Eyelids and lips may be completely destroyed and the nose and ears severely damaged. Though not exhaustive, Acid Survivors Foundation Uganda findings included: The skull is partly destroyed or deformed and hair lost. Ear cartilage is usually partly or totally destroyed; deafness may occur. Eyelids may be burned off or deformed, leaving the eyes extremely dry and prone to blindness. Acid directly in the eye also damages sight, sometimes causing blindness in both eyes. The nose can become shrunken and deformed; the nostrils may close off completely due to destroyed cartilage. The mouth becomes shrunken and narrow, and it may lose its full range of motion. Sometimes, the lips may be partly or totally destroyed, exposing the teeth. Eating and speaking can become difficult. Scars can run down from the chin to neck area, shrinking the chin, and burn scar contracture can extremely limit range of motion in the neck. Inhalation of acid and fumes usually creates respiratory problems, exacerbated restricted airway pathways (the esophagus and nostrils) in acid patients.

In addition to these above-mentioned medical effects, acid attack victims face the possibility of sepsis, kidney failure, skin depigmentation, and even death.

Psychological After physical recovery, acid assault survivors face many mental health issues, primarily depression and anxiety. Additionally, victims reported lowered self-esteem according to the Rosenberg scale and increased self-consciousness, both in general and in the social sphere.

Social In addition to medical and psychological effects, many social implications exist for acid survivors, especially women. For example, such attacks usually leave victims disabled in some way, rendering them dependent on their spouse and/or family for everyday activities, such as eating and running errands. These dependencies are increased by the fact that many acid survivors cannot find suitable work, due to impaired vision and physical disability. This negatively impacts their economic viability, causing hardships on the spouses and families that care for them. As a result, divorce rates are high, with abandonment by husbands found in 25% of acid assault cases in Uganda (compared to only 3% of wives abandoning their disfigured husbands). Moreover, acid survivors who are single when attacked almost certainly become ostracized from society, effectively ruining marriage prospects. Some media outlets overwhelmingly avoid reporting acid attack violence, or the description of the attack is laconic or often implies that the act was inevitable or even justified.Sarah Halim and Marian Meyers (2010), News Coverage of Violence Against Muslim Women: A View From the Arabian Gulf, Communication, Culture & Critique. Volume 3, Issue 1, pages 85–104, March 2010

Treatment and consequences When acids contact the skin, response time can affect the severity of burns. If washed away with water or neutralized promptly, burns can be minimized or avoided entirely. However, areas unprotected by skin, such as the cornea of the eye or the lips, may be burned immediately on contact.

Many victims are attacked in an area without immediate access to water, or unable to see due to being blinded or forced to keep their eyes closed to prevent additional burns to the eye. Treatment for burn victims remains inadequate in many developing nations where incidence is high. Medical underfunding has resulted in very few burn centers available for victims in countries such as Uganda, Bangladesh, and Cambodia. Uganda has one specialized burn center in the entire nation, opening in 2003; Cambodia has only one burn facility for victims, and scholars estimate that only 30% of the Bangladeshi community has access to health care.

In addition to inadequate medical capabilities, many acid assault victims fail to report to the police due to a lack of trust in the force, a sense of hopelessness due to the attackers' impunity, and fear of retribution by the assailant(s).

These problems are exacerbated by a lack of knowledge of how to treat burns: some victims have applied oil to the acid, rather than rinsing thoroughly and completely with water for 30 minutes or longer to neutralize the acid. Such home remedies only serve to increase the severity of damage, as they do not counteract the acidity.

Motivation of perpetrators The intention of the attacker is often to cause shame and pain rather than to kill the victim. In Britain, such attacks, particularly those against men, are believed to be underreported, and as a result many of them do not show up in official statistics. Some of the most common motivations of perpetrators include: Personal conflict regarding intimate relationships and sexual rejection Sexual-related jealousy and lust Revenge for refusal of sexual advances, proposals of marriage, and demands for dowry Gang violence and rivalry Conflicts over land ownership, farm animals, housing, and property

Acid attacks often occur as revenge against a woman who rejects a proposal of marriage or a sexual advance. Gender inequality and women's position in the society, in relation to men, plays a significant role in these types of attacks.

Attacks against individuals based on their religious beliefs or social or political activities also occur. These attacks may be targeted against a specific individual, due to their activities, or may be perpetrated against random persons merely because they are part of a social group or community. In Europe, Konstantina Kouneva, a former member of the European Parliament, had acid thrown on her in 2008, in what was described as "the most severe assault on a trade unionist in Greece for 50 years." Female students have had acid thrown in their faces as a punishment for attending school. Acid attacks due to religious conflicts have been also reported. Both males and females have been victims of acid attacks for refusing to convert to another religion.

Conflicts regarding property issues, land disputes, and inheritance have also been reported as motivations of acid attacks. Acid attacks related to conflicts between criminal gangs occur in many places, including the UK, Greece, and Indonesia.

Epidemiology According to researchers and activists, countries typically associated with acid assault include Bangladesh, India,"Still smiling The women fighting back after acid attacks" BBC. Naomi Grimley. Nepal, Cambodia, Vietnam, Laos, United Kingdom, Kenya, South Africa, Uganda, Pakistan, and Afghanistan. Acid attacks have been reported however in countries around the world, including:

Afghanistan Australia Bangladesh Belgium Bulgaria Cambodia China Hong Kong S.A.R. Colombia France Gabon Germany India Indonesia Iran Ireland Israel Italy Jamaica Kenya Laos Mexico Myanmar Nepal Nigeria Philippines Pakistan Russia Sri Lanka Sweden South Africa Taiwan Tanzania Thailand Uganda United Kingdom United States Vietnam

Additionally, anecdotal evidence for acid attacks exists in other regions of the world such as South America, Central, and North Africa, the Middle East, and Central Asia. However, South Asian countries maintain the highest incidence of acid attacks.

Police in the United Kingdom have noted that many victims are afraid to come forward to report attacks, meaning the true scale of the problem may be unknown.

Gender An accurate estimate of the gender ratio of victims and perpetrators is difficult to establish because many acid attacks are not reported or recorded by authorities. For example, a 2010 study in The Lancet noted that there are "no reliable statistics" on the prevalence of acid attacks in Pakistan.

A 2007 literature review analyzed 24 studies in 13 countries over the past 40 years, covering 771 cases. According to the London-based charity Acid Survivors Trust International, 80% of acid attacks are on women, and acid assaults are grossly under-estimated. In some regions, assaults perpetrated on female victims by males are often driven by the mentality "If I can't have you, no one shall."Bhalla, Nita (9 July 2013) India's top court says gov't not trying to stop acid attacks . Thomson Reuters Foundation

In Bangladesh, throwing acid has been labeled as a "gender crime", as there is a dominance of female victims who are assaulted by males in the country, for the reason of refusing to marry, or refusing sexual advances.

In Jamaica, women throwing acid on other women in relation to fights over male partners is a common cause. In the UK, the majority of victims are men, and many of these attacks are related to gang violence.

In India, a female victim was attacked with a knife twice, but no criminal charges were filed against the suspect. The victim was only given police aid after being hospitalized following an acid attack, raising questions of police apathy in dealing with cases of harassment.A case of police apathy?, The Hindu, 3 February 2012

Another factor that puts victims at increased risk for an acid assault is their socioeconomic status, as those living in poverty are more likely to be attacked. , the three nations with the most noted incidence of acid attacks – Bangladesh, India, and Cambodia – were ranked 75th, 101st, and 104th, respectively, out of 136 countries on the Global Gender Gap Index, a scale that measures equality in opportunities between men and women in nations.

Prevention