25 Years Later: Remembering September 11 Through the Lens of Dermatologic and Burn Care

Twenty-five years ago, on September 11, 2001, the terrorist attacks on the World Trade Center changed New York City and the nation forever. Nearly 3000 people were killed, thousands more were injured, and the health consequences of that morning would continue to emerge for decades.

For the medical community, September 11 also created an unprecedented emergency. Within minutes of the attacks, injured survivors began arriving at hospitals across New York City. Burns, lacerations, inhalation injuries, and ocular injuries were among the acute consequences physicians encountered as fire, debris, and the collapse of the Twin Towers transformed lower Manhattan.¹

For dermatology and the closely connected disciplines of wound and burn care, the events of September 11 offer another perspective from which to remember the lives affected by the attacks: through the treatment of devastating injuries to the skin and the long-term health consequences experienced by those who survived and responded.

An Unprecedented Burn Emergency

The William Randolph Hearst Burn Center at NewYork-Presbyterian/Weill Cornell Medical Center became one of the central sites caring for patients with severe burns following the attacks.

In a retrospective account published by NewYork-Presbyterian for the 20th anniversary of September 11, clinicians described preparing for an influx of casualties as the scale of the disaster became clear. Over the following 5 months, the multidisciplinary burn team treated 18 severely injured patients from the attacks, 11 of whom survived.²

The intensity of the injuries demanded an extraordinary clinical response.

Palmer “Joe” Bessey, MD, a surgeon at the burn center, recalled performing 4 abdominal decompression procedures for severely burned patients on September 12 alone—a procedure that, prior to the attacks, the center typically performed less than once per year. For approximately 2 months afterward, the team required 2 operating rooms 5 days each week to treat survivors, more than doubling its typical surgical volume at the time.²

Many patients underwent repeated operations during their recovery, with some requiring as many as 10 procedures.²

Burn care extended far beyond the operating room. Physicians and nurses worked alongside physical and occupational therapists, respiratory therapists, nutritionists, social workers, psychiatrists, and other clinicians as survivors began what would become lengthy physical and psychological recoveries.

Understanding the Injuries of September 11

An assessment conducted by the New York City Department of Health and the CDC offers a broader picture of the injuries sustained by survivors.

Investigators reviewed emergency department and inpatient records from 5 hospitals, including the 4 hospitals closest to the World Trade Center and a burn referral center. Among 790 injured survivors treated during the first 48 hours following the attacks, approximately half received medical care within the first 7 hours. Eighteen percent required hospitalization.¹

Although inhalation and ocular injuries were among the most frequently treated conditions, burns represented another important component of the trauma. Rescue workers were less likely than other survivors to present with burns, with burns documented in approximately 2% of rescue workers compared with 6% of nonrescue survivors evaluated in the analysis.¹

The numbers, however, capture only part of the clinical burden. Patients arriving at specialized burn centers included individuals with extensive injuries requiring months of surgeries, wound management, rehabilitation, and multidisciplinary care.

When Survival Became Recovery

For patients who survived severe burns on September 11, leaving the hospital did not mark the end of treatment.

Burn injuries can fundamentally alter skin function, mobility, sensation, appearance, and quality of life. Wound closure may be followed by scar management, reconstructive procedures, rehabilitation, and prolonged physical and psychological recovery.

Twenty-five years later, researchers are still learning from the experiences of patients who sustained burns during the attacks.

A 2026 study examined long-term patient experiences and outcomes among survivors of the September 11 attacks who were treated for burn injuries at a New York City burn center. Researchers evaluated 4 survivors more than 2 decades after their initial injuries, providing a rare look at the lasting effects of severe burns sustained during the disaster.³

The participants had experienced widely varying degrees of injury, with burns involving between 3% and 80% of total body surface area and an average involvement of 33.1%. Researchers assessed long-term physical and psychological outcomes, including quality of life, posttraumatic stress, depression, and patients' perceptions of their recovery.³

Despite the severity of their initial injuries, the survivors demonstrated substantial long-term recovery. However, the findings also highlighted the psychological burden that can accompany major burn trauma and mass-casualty events. The study underscored that recovery from catastrophic burn injury extends beyond physical wound healing and that long-term care must consider psychological and social well-being alongside functional outcomes.³

The study is particularly significant as the nation marks the 25th anniversary of the attacks. The patients who entered New York burn centers in September 2001 can now provide more than 2 decades of insight into what it means to live after a catastrophic burn injury.

For dermatology, wound care, and burn specialists, their experiences reinforce the importance of viewing recovery as a continuum. Acute wound management, grafting, scar formation, rehabilitation, mental health, and quality of life are interconnected components of care that can remain relevant years—or even decades—after the initial injury.

A Dermatologic Legacy Beyond Burns

The dermatologic consequences associated with September 11 also extend beyond injuries sustained that morning.

The collapse of the World Trade Center produced an enormous cloud of dust and debris to which survivors, firefighters, police officers, construction workers, cleanup crews, and other responders were exposed.

Research involving World Trade Center survivors subsequently identified associations between dust-cloud exposure and numerous health complaints. One surveillance study found that individuals caught in the dust and debris cloud were more likely to report skin rash or irritation, along with respiratory symptoms and other health problems.⁴

A review examining the attacks specifically through a dermatologic lens described both the acute skin trauma of September 11—including burns and lacerations—and chronic conditions subsequently reported among survivors and responders. These included skin irritation and poorly characterized skin lesions as well as sarcoidosis, autoimmune conditions, nonmelanoma skin cancer, and melanoma.⁵

The authors also emphasized the role of first responders and health care professionals who cared for the injured while acknowledging that many responders themselves subsequently experienced lasting health consequences.⁵

Importantly, the presence of these conditions among World Trade Center–exposed populations does not necessarily establish that the attacks caused every individual diagnosis. Rather, the findings have contributed to decades of surveillance and research aimed at understanding the long-term consequences of an unusually complex environmental exposure.

The Role of Long-Term Dermatologic Care

The experiences of September 11 survivors also demonstrate why care for serious skin injuries cannot end when wounds close.

Severe burns can leave hypertrophic scars, contractures, pigmentary changes, pruritus, chronic pain, altered sensation, and functional limitations. Depending on the location and severity of the injury, patients may require reconstructive procedures and long-term scar management in addition to rehabilitation.

The visible nature of many burn scars can also contribute to the psychological consequences of injury. The findings of the 2026 survivor study reinforce the importance of considering these physical and psychological outcomes together when evaluating long-term recovery.³

Advances in burn and wound management during the past 25 years have continued to change how clinicians approach acute survival and long-term recovery. Yet the experiences of those injured on September 11 demonstrate that successful treatment cannot be defined solely by survival or wound closure.

25 Years of Healing

The medical story of September 11 is ultimately one of both extraordinary injury and extraordinary care.

At the William Randolph Hearst Burn Center, clinicians who treated survivors have recalled not only the severity of the burns they encountered but also the relationships that developed over months of treatment and rehabilitation. Nurses, surgeons, therapists, and other members of the care team worked through repeated operations, dressing changes, rehabilitation sessions, and the emotional consequences of a disaster unfolding outside the hospital walls.²

Their experiences also illustrate something dermatology professionals understand particularly well: Damage to the skin can carry consequences far beyond the wound itself.

Skin protects, regulates, senses, and forms the boundary through which individuals physically encounter the world. When that barrier is profoundly injured, healing can require years, and scars can remain for a lifetime.

A quarter-century after September 11, remembrance appropriately centers on the nearly 3000 people who lost their lives, their families, the survivors, and the first responders who entered unimaginable circumstances to help others.

For the dermatology and burn care communities, September 11 also remains a reminder of the clinicians who helped survivors heal when survival was only the beginning.

Twenty-five years later, their work—and the patients whose scars carry the history of that day—remain part of September 11's enduring medical legacy.

References

1. Centers for Disease Control and Prevention. Rapid assessment of injuries among survivors of the terrorist attack on the World Trade Center—New York City, September 2001. MMWR Morb Mortal Wkly Rep. 2002;51(1):1-5. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5101a1.htm
2. NewYork-Presbyterian. Tragedy & healing: Inside the William Randolph Hearst Burn Center on 9/11. Health Matters. Published September 10, 2021. https://www.nyp.org/healthmatters/inside-the-william-randolph-hearst-burn-center-on-sept-11
3. Two decades on: evaluating patient experiences and long-term outcomes in 9/11 survivors treated at a New York burn center. Burns. Published online 2026. https://pubmed.ncbi.nlm.nih.gov/41206643/
4. Brackbill RM, Thorpe LE, DiGrande L, et al. Surveillance for World Trade Center disaster health effects among survivors of collapsed and damaged buildings. MMWR Surveill Summ. 2006;55(2):1-18. https://pubmed.ncbi.nlm.nih.gov/16601667/
5. Zaidi AJ, Mahmoud A, Hassan S, Mohammed TO, Hoenig LJ. The September 11, 2001, terrorist attacks from a dermatology perspective: a remembrance. Clin Dermatol. 2021;39(6):985-989. doi:10.1016/j.clindermatol.2020.09.001 https://pubmed.ncbi.nlm.nih.gov/34920835/