Welcome to Science of the Scare! Every month I will dissect a Big Science Question from a horror movie and talk through it in (mostly) easy-to-digest terms.

Science and horror have a wild, entangled history and have left us with loads of questions to ponder. Deep, important questions like: just how many ways could we have a zombie pandemic? Is genetic engineering always a slippery slope to monstrosity? This month’s Big Science Question:

Could a human being survive without their skin?

This particularly nasty question comes to us from Pascal Laugier’s 2008 film Martyrs — a classic example of New French Extremity. The film follows two close friends, Anna (Morjana Alaoui ) and Lucie (Mylène Jampanoï). Lucie escaped a torture situation as a child and was left haunted by an emaciated woman. As an adult, Lucie seeks revenge against the family that she believes is responsible for her childhood abuse. Anna is called to Lucie‘s aid, but instead becomes the newest subject of a philosophical cult that believes that transcendence can be achieved through torture.

Anna starts the film with skin, the way most people have skin, and ends up very much without it by the film’s end.

You don’t need me to tell you that skin is a hugely important organ: it’s the barrier that protects our insides from outside threats — from disease-causing microbes to sun exposure to some degree of physical injury. It helps regulate your body temperature and helps your body retain moisture. It’s also chock-full of sensory receptors that help you experience touch, pressure, heat, and cold so you can make snap decisions based on the information you get from what you can touch and feel.

When it comes to skin removal, there is a long history of flaying as a form of corporal punishment, but it usually involved removing the skin shortly before a death sentence (such as by hanging) or after death had already occurred. As far as historical records go, there isn’t much information about how long a body can survive without skin in a flaying scenario. The closest comparison we can make, then, is with people who have experienced full-thickness burns on a large part of their body, or with people who have experienced open degloving injuries, where skin has torn away from underlying tissues (a phenomenon known as avulsion — think that one scene in 2017’s Gerald’s Game).

Open degloving injuries can be challenging to treat, but they can be treated with skin replantation and microsurgery to re-establish blood flow to the reapplied skin. A technique called Vacuum-Assisted Closure (VAC) might also be used to reduce pressure around the degloved area, which controls bacterial action and encourages healing. More complex body parts, like hands, pose extra challenges — a replantation procedure for an entire body’s skin would be extra prone to complications.

“[…] skin is a hugely important organ: it’s the barrier that protects our insides from outside threats […] It’s also chock-full of sensory receptors that help you experience touch, pressure, heat, and cold”

What sort of complications? The biggest one would be infection, considering your first line of defense has been stripped away. There is also always the risk that the surgery doesn’t take, and the tissue begins to become necrotic. Dehydration and desiccation of tissue can also be an issue.

If we look back toward Anna in Martyrs, her situation goes beyond simple degloving: her skin has been systematically removed from her body, leaving nothing intact except for the skin on her face (presumably so she can communicate her experience to Mademoiselle (Catherine Bégin)). Even the elastic cartilage of her outer ear is gone. It’s also immediately obvious that all of her subdermal fat has been removed, too, leaving all of her musculature exposed and unprotected.

Here’s what we can assume:

Anna‘s skin will not heal and grow back on its own, not even as scar tissue. Given that her skin has been completely removed, there is nothing acting as a scaffolding for new skin to grow.

Systematic torture may have trained Anna to mentally transcend pain, but that pain is still very real and very present — and in this case, excruciating. Moving on her own is practically impossible.

Flaying means blood loss, and we never see Anna getting a blood transfusion. There’s a high probability that she will go into shock from straight-up blood loss.

When we leave Anna, she’s laid out in a bath, presumably meant to keep her body from dehydrating. This can only ever be a short-term solution, though. It’s not like Anna is in a hermetically-sealed room — it’s only a matter of time before she gets a nasty infection from some sorts of opportunistic bacteria. If you’re feeling optimistic (if you can call this optimism!), maybe whoever takes Mademoiselle‘s place to lead the cult wants to keep Anna around. Maybe they have access to technology and a synthetic barrier that can act as a new skin for Anna, since her flayed skin probably isn’t in any shape to be replanted and revascularized. If you want my opinion about whether she’ll survive, all I have to say is “keep doubting”.

“It’s not like Anna is in a hermetically-sealed room — it’s only a matter of time before she gets a nasty infection from some sorts of opportunistic bacteria.”

Can you think of a better strategy for living without skin? Have a Big Science Question from horror that you’d like to see answered? Let us know over on Twitter, Reddit, and in the Horror Movie Fiend Club on Facebook!