Visible difference

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A visible difference refers to a physical characteristic, such as a scar, mark, disfigurement, or condition on the face or body that distinguishes an individual from what is conventionally considered to be the societal norm. [1] These visible differences can arise due to a multitude of factors including but not limited to congenital conditions, accidents, diseases, or surgical procedures. Such differences often carry significant psychological, social, and sometimes physical implications for the affected individual. [2]

Contents

Terminology

While the terms visible difference and disfigurement are sometimes used interchangeably, they are not synonymous and possess distinct connotations both in medical and social contexts. [3]

The term visible difference is a more neutral, encompassing descriptor for any physical characteristic that sets an individual apart from what is generally considered the societal norm. [4] This could be due to congenital conditions, acquired conditions, diseases, or even personal choices like tattoos or piercings. The critical element is that the difference is visible, but the term does not inherently imply any impairment, disadvantage, or negative valuation. [5]

Disfigurement is a term that has traditionally been used in both legal and medical contexts to refer to physical alterations that are often perceived as impairing the appearance of an individual in a significant way. [6] Disfigurement generally carries a more negative connotation and often implies a level of severity or permanence to the condition that may result in social, emotional, or functional difficulties for the affected individual.

Background and history

Early perceptions

The concept of visible differences has existed throughout human history, although the terminology and social attitudes have evolved. In many ancient cultures, visible differences were often attributed to supernatural causes or seen as a sign of divine intervention. [7] For example, birthmarks were sometimes viewed as omens or indicators of future events, both positive and negative. [8]

Modern medicine

With the advent of modern medicine, understanding the causes behind various types of visible differences has become more scientific. In the 19th and early 20th centuries, significant strides were made in dermatology and plastic surgery, which allowed for a more nuanced comprehension and treatment of these conditions. [9] The latter half of the 20th century saw further research into the psychological and emotional impact of visible differences, paralleling the rise of psychology as a distinct scientific discipline. [10]

Activism and milestones

The latter part of the 20th century also saw the rise of activism aimed at destigmatizing visible differences and advocating for legal protections. [11] Landmark legislation, such as the Americans with Disabilities Act (ADA) in the United States and the Equality Act in the United Kingdom, have created legal protections for people with visible differences. [12] [13]

Changing Faces is a UK-based organization that advocates for people living with visible differences.

Types of visible differences

Visible differences can be categorized based on origin, location, and impact.

Congenital conditions

These are visible differences present from birth and are often the result of genetic factors or prenatal influences. [14]

Acquired conditions

These visible differences arise due to external factors, such as accidents or medical treatments. [15]

Diseases

Certain diseases can cause visible differences either directly or as a side effect of treatment.

Psychological impact

The presence of a visible difference can have profound psychological implications for an individual, affecting their self-esteem, mental health, and overall well-being. [19] Importantly, research has indicated that there is not a strong correlation between the visibility or severity of the physical characteristic and the level of psychological distress an individual might experience. This counterintuitive finding emphasizes the complexity of the emotional and psychological dimensions involved.

Self-esteem and body image

People with a visible difference often face self-esteem and body image challenges. [20] Concerns about appearance can dominate their self-perception, which may lead to feelings of inadequacy or unattractiveness. This can be particularly challenging during adolescence when physical appearance is often highly emphasized.

Anxiety and depression

Studies have shown that individuals with visible differences are at a higher risk of developing anxiety disorders and depression. The constant awareness of being different and the fear of being judged or rejected can increase anxiety levels. Similarly, chronic feelings of isolation or stigmatization can lead to depressive symptoms.

Social isolation

The social implications of having a visible difference can sometimes lead to withdrawal or isolation. [19] Avoidance behavior, such as skipping social events or avoiding public places, can exacerbate feelings of loneliness and perpetuate a cycle of emotional distress. [20]

Body dysmorphic disorder

In some cases, individuals with a visible difference may develop body dysmorphic disorder, a mental health condition characterized by obsessive focus on perceived flaws in physical appearance. Importantly, these perceived flaws may be minor and not very noticeable to others. [21]

Coping mechanisms

Individuals may employ various coping mechanisms, both adaptive and maladaptive, to deal with the psychological impact. While some may resort to avoidance or denial, others may seek social support or engage in constructive problem-solving. [22]

Visibility and distress

Contrary to common assumptions, the psychological distress associated with having a visible difference does not necessarily correlate with the visibility or severity of the condition. Factors such as personal resilience, availability of social support, and pre-existing mental health conditions often play a more significant role in determining the level of psychological impact. [2]

See also

Related Research Articles

<span class="mw-page-title-main">Face</span> Part of the body that is at the front of the head

The face is the front of an animal's head that features the eyes, nose and mouth, and through which animals express many of their emotions. The face is crucial for human identity, and damage such as scarring or developmental deformities may affect the psyche adversely.

<span class="mw-page-title-main">Acne</span> Skin condition characterized by pimples

Acne, also known as acne vulgaris, is a long-term skin condition that occurs when dead skin cells and oil from the skin clog hair follicles. Typical features of the condition include blackheads or whiteheads, pimples, oily skin, and possible scarring. It primarily affects skin with a relatively high number of oil glands, including the face, upper part of the chest, and back. The resulting appearance can lead to lack of confidence, anxiety, reduced self-esteem, and, in extreme cases, depression or thoughts of suicide.

<span class="mw-page-title-main">Scar</span> Area of fibrous tissue that replaces normal skin after an injury

A scar is an area of fibrous tissue that replaces normal skin after an injury. Scars result from the biological process of wound repair in the skin, as well as in other organs, and tissues of the body. Thus, scarring is a natural part of the healing process. With the exception of very minor lesions, every wound results in some degree of scarring. An exception to this are animals with complete regeneration, which regrow tissue without scar formation.

<span class="mw-page-title-main">Alopecia areata</span> Medical condition

Alopecia areata, also known as spot baldness, is a condition in which hair is lost from some or all areas of the body. It often results in a few bald spots on the scalp, each about the size of a coin. Psychological stress and illness are possible factors in bringing on alopecia areata in individuals at risk, but in most cases there is no obvious trigger. People are generally otherwise healthy. In a few cases, all the hair on the scalp is lost, or all body hair is lost. Hair loss can be permanent, or temporary.

<span class="mw-page-title-main">Birthmark</span> Medical condition

A birthmark is a congenital, benign irregularity on the skin which is present at birth or appears shortly after birth—usually in the first month. Birthmarks can occur anywhere on the skin. They are caused by overgrowth of blood vessels, melanocytes, smooth muscle, fat, fibroblasts, or keratinocytes.

<span class="mw-page-title-main">Disfigurement</span> State of having ones appearance injured or changed

Disfigurement is the state of having one's appearance deeply and persistently harmed medically, such as from a disease, birth defect, or wound. General societal attitudes towards disfigurement have varied greatly across cultures and over time, with cultures possessing strong social stigma against it often causing psychological distress to disfigured individuals. Alternatively, many societies have regarded some forms of disfigurement in a medical, scientific context where someone having ill will against the disfigured is viewed as anathema. In various religious and spiritual contexts, disfigurement has been variously described as being a punishment from the divine for sin, as being caused by supernatural forces of hate and evil against the good and just, which will be later atoned for, or as being without explanation per se with people just having to endure.

<span class="mw-page-title-main">Sebaceous gland</span> Gland to lubricate the hair and skin

A sebaceous gland or oil gland is a microscopic exocrine gland in the skin that opens into a hair follicle to secrete an oily or waxy matter, called sebum, which lubricates the hair and skin of mammals. In humans, sebaceous glands occur in the greatest number on the face and scalp, but also on all parts of the skin except the palms of the hands and soles of the feet. In the eyelids, meibomian glands, also called tarsal glands, are a type of sebaceous gland that secrete a special type of sebum into tears. Surrounding the female nipple, areolar glands are specialized sebaceous glands for lubricating the nipple. Fordyce spots are benign, visible, sebaceous glands found usually on the lips, gums and inner cheeks, and genitals.

<span class="mw-page-title-main">Hidradenitis suppurativa</span> Human disease

Hidradenitis suppurativa (HS), sometimes known as acne inversa or Verneuil's disease, is a long-term dermatological condition characterized by the occurrence of inflamed and swollen lumps. These are typically painful and break open, releasing fluid or pus. The areas most commonly affected are the underarms, under the breasts, perineum, buttocks, and the groin. Scar tissue remains after healing. HS may significantly limit many everyday activities, for instance, walking, hugging, moving, and sitting down. Sitting disability may occur in patients with lesions in sacral, gluteal, perineal, femoral, groin or genital regions; and prolonged periods of sitting down can also worsen the condition of the skin of these patients.

<span class="mw-page-title-main">Calcinosis cutis</span> Medical condition in which calcium deposits form in the skin

Calcinosis cutis is an uncommon condition marked by calcium buildup in the skin and subcutaneous tissues. Calcinosis cutis can range in intensity from little nodules in one area of the body to huge, crippling lesions affecting a vast portion of the body. Five kinds of the condition are typically distinguished: calciphylaxis, idiopathic calcification, iatrogenic calcification, dystrophic calcification, and metastatic calcification.

<span class="mw-page-title-main">Hyperpigmentation</span> Skin condition

Hyperpigmentation is the darkening of an area of skin or nails caused by increased melanin.

<span class="mw-page-title-main">Pseudofolliculitis barbae</span> Medical condition

Pseudofolliculitis barbae (PFB) is a type of irritant folliculitis that commonly affects people who have curly or coarse facial hair. It occurs when hair curls back into the skin after shaving, causing inflammation, redness, and bumps. This can lead to ingrown hairs, scarring, and skin discoloration. PFB can be treated with various methods, including changing shaving habits, using topical creams or ointments, and undergoing laser hair removal. Prevention measures include proper shaving techniques, using sharp razors, and avoiding too close a shave.

<span class="mw-page-title-main">Comedo</span> Medical condition

A comedo is a clogged hair follicle (pore) in the skin. Keratin combines with oil to block the follicle. A comedo can be open (blackhead) or closed by skin (whitehead) and occur with or without acne. The word "comedo" comes from the Latin comedere, meaning "to eat up", and was historically used to describe parasitic worms; in modern medical terminology, it is used to suggest the worm-like appearance of the expressed material.

<span class="mw-page-title-main">Excoriation disorder</span> Medical condition

Excoriation disorder, more commonly known as dermatillomania, is a mental disorder on the obsessive–compulsive spectrum that is characterized by the repeated urge or impulse to pick at one's own skin, to the extent that either psychological or physical damage is caused.

Cosmetic camouflage is the application of make-up creams and/or powders to conceal colour or contour irregularities or abnormalities of the face or body. It offers an answer to solve all related skin problems such as Congenital origin, Traumatic origin and Dermatological origin. Furthermore, cosmetic camouflage solves the psychological problems that a skin imperfection is sometimes able to provoke, it allows to rediscover its own beauty and to return with serenity to its own social life. Cosmetic camouflage creams were first developed by plastic surgeons during World War II to cover the massive burns received by fighter pilots. Nowadays, men, women and children can use cosmetic camouflage.

<span class="mw-page-title-main">Cutis verticis gyrata</span> Medical condition

Cutis verticis gyrata is a medical condition usually associated with thickening of the scalp. The condition is identified by excessive thickening of the soft tissues of the scalp and characterized by ridges and furrows, which give the scalp a cerebriform appearance. Clinically, the ridges are hard and cannot be flattened on applying pressure. Patients show visible folds, ridges or creases on the surface of the top of the scalp. The number of folds can vary from two to roughly ten and they are typically soft and spongy. The condition typically affects the central and rear regions of the scalp, but sometimes can involve the entire scalp.

Pressure alopecia, also known as postoperative alopecia, and pressure-induced alopecia, occurs in adults after prolonged pressure on the scalp during general anesthesia, with the head fixed in one position, and may also occur in chronically ill persons after prolonged bed rest in one position that causes persistent pressure on one part of the scalp, all likely due to pressure-induced ischemia.

Red lunulae is characterized by a dusky erythema confined to the lunulae, as has been reported in association with alopecia areata. It is most commonly seen on the thumbnail.

<span class="mw-page-title-main">Osteoma cutis</span> Medical condition

Osteoma cutis is a cutaneous condition characterized by the presence of bone within the skin in the absence of a preexisting or associated lesion. Osteoma cutis often manifests as solid, varying-sized, skin-colored subcutaneous nodules.

Infantile acne is a form of acne that begins in very young children. Typical symptoms include inflammatory and noninflammatory lesions, papules and pustules most commonly present on the face. No cause of infantile acne has been established but it may be caused by increased sebaceous gland secretions due to elevated androgens, genetics and the fetal adrenal gland causing increased sebum production. Infantile acne can resolve by itself by age 1 or 2. However, treatment options include topical benzyl peroxide, topical retinoids and topical antibiotics in most cases.

Congenital erosive and vesicular dermatosis is a cutaneous condition characterized by generalized erosions, vesicles, crusting and ‘scalded skin-like’ erythematous areas affecting up to 75% of the body surface area.

References

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