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CHANGING FACES

Facing life - facial disfigurements can cause stress and suffering

Having a facial blemish or disfigurement can be a painful psychological problem for those affected.

Today's society is extremely image conscious, and there's pressure for everyone to look glamorous and blemish-free.

We all know that looks are purely superficial, but we often judge people by their appearance, especially when we first meet them.

One in 150 people in Britain has a facial disfigurement. For those affected, it can turn a simple shopping or social trip into an ordeal.

Curious stares, strange looks, hurtful remarks and even put-downs can all be part of everyday life.

Inside Out gets under the skin of the problem, and examines how looking different can affect people with facial disfigurements.

"I just want to live my life, go out, go to work, like everybody else. There's a person behind this face." Michelle Willis.

First appearances

Imagine having a facial disfigurement and meeting someone for the very first time.

Because we all make judgements about people on the basis of how they look, social situations can be difficult for people with facial disfigurements.

Face values - Judy Hemsley knows how cruel kids can be

For those with a facial disfigurement, feelings of anxiety, anger, fear and embarrassment are likely to come to the fore.

After all, the face is the first part of the body that we normally see when we meet a person.

As well as the stares and strange looks, there are often odd comments, teasing, and even taunting and bullying, especially for children.

Living with a face that looks different can be a challenge both for children and adults.

It's natural for other adults to be curious, but people staring and asking questions can make those with disfigurements uneasy.

A brave face

Judy Hemsley has neurofibromatosis, a genetic condition that has altered her eye, and the appearance of her skin.

A short shopping trip with Judy is all it takes to get an idea of what it can be like to have facial disfigurement.

People on the street are constantly staring at her.

Michelle Willis knows exactly what it's like to feel the directness of their stares..

She's had many similar experiences, every day of her life, and it has lead to embarrassment, annoyance and anger.

Michelle was born with a tumour where her right eye should have been, and now has a false eye.

"People forget there's a person behind this disfigurement.

"I've got feelings, I'm a person, and it does hurt when people treat you differently and can be cruel," she says.

Thinking positive

Judy Hemsley knows only too well how cruel people can be if you have a facial disfigurement.

When she was 19-years-old she was asked out on a date by a good looking guy, and was so thrilled that she went out and bought a new outfit.

But when she met her date, he had another girl on his arm and cruelly taunted Judy about her face.

She remembers him saying dismissively, "Do you really believe that someone like me would want to be seen with someone like you?".

As he walked away laughing, he quipped, "Look at your face. I can't be seen with you. You'll always be on your own."

At the time Judy was crushed, "I felt ashamed of being me and having a face like I've got. Now I'm a lot more positive about it. It's made me quite a positive person."

Facing facts

But does it end with simply looking at people curiously or being cruel? Inside Out devised an experiment to see if we also give disfigured people a wide berth.

Inside Out presenter Julia Hankin was made up with tattoo ink by a make up artist - to give the appearance of a prominent port wine stain.

She then takes her seat on a busy bus route. It takes 65 minutes for someone to sit next to her.

Under the skin - Julia Hankin is made up with a facial blemish

But, on the same journey with the make up off, it was a very different story - someone takes the seat next to Julia after about 30 seconds.

The result does not surprise Professor Nichola Rumsey, from the Centre for Appearance Research at the University of West England.

"That sounds very much like the kind of research that we did a while back in London, on the tube and on buses as well, and found that people chose not to sit next to someone when they had a disfigurement on their face.

"And yet they'd come and sit next to them very happily and very quickly if that person was there without.

"Someone with a disfigurement can sit there for an awfully long time and feel that people are actually choosing to take any seat but the one next to them - and that's not a great feeling".

A question of appearances

As well as the purely physical, there's also more serious questions about discrimination and appearance.

Both Michelle Willis and Judy Hemsley have had difficulties at work. Michelle explains what happened when she started her nursing training, "When I went for my interview to become a nurse, they said I would have to get a medical.

"When I went along for the appointment I felt as if I was being mentally assessed, they were asking me questions about how I was going to cope if somebody asks about my face.

Discrimination at work can be a problem

"I felt as if she was mentally assessing me, as if I wasn't intelligent enough to be a staff nurse."

Judy came up against prejudice when she applied for a receptionist job at a local hotel.

"When I went along and had the interview, one of the panel pulled me aside and said I'm sorry the advertisement that went out in the paper was incorrect.

"The job you applied for is actually for a chambermaid and we need somebody to clean the toilets."

When her father rang up to check he was told his daughter "didn't have receptionist type face material. You couldn't have anybody come into the hotel and have me standing at the reception desk".

So what's the solution? Judy favours the direct approach, "to be honest I would prefer people to say what's wrong and see me for what I am, ask me exactly what's wrong, look past that and then look at me".

Michelle would like to be left in peace. "Just to blend in with the crowd. And have a day out shopping and have nothing at all, no staring, no comments.

"It would be absolutely lovely just to be able to go out in a public place and have no reaction at all and just be treated normally".

Face value

So what are the most common causes of facial disfigurement - they include:

• birth related disfigurements including a cleft lip, birthmark or cranio-facial condition;
• physical injury such as burns, accidents, car crash injuries, scarring or dog bites;
• health condition including eczema, acne, or vitiligo.

For children a facial disfigurement can be especially stressful and embarrassing.

It can even result in bullying at school as well as low self esteem, guilt, anger and acute embarrassment.

Support groups such as Changing Faces now produce guidance and advice for both parents and teachers on how to best deal with awkward situations.

Facing the future

Skin disfigurement and facial blemishes are a major problem for may adults and children.

Medical treatment is available for many conditions, including cosmetic surgery.

Make-up can reduce facial disfigurement and highlight other facial features, and can be applied by the person or a specialist.

Skin or cosmetic camouflage can be applied to good effect to conceal features such as blemishes, birthmarks and scarring.

Medical and cosmetic treatment can help enormously, but for some adults the problem is one that they have to learn to live with.

However, until we understand that a person's intelligence, looks and personality is more than skin deep, women like Judy and Michelle will continue to suffer from discrimination and damaging glances.