Many people with disfiguring diseases hide from society and eschew relationships for fear of rejection and criticism, writes Steve Farrar.
The extent of emotional distress endured by people with one common skin complaint, vitiligo, has emerged from a survey carried out by Gerry Kent, lecturer in clinical psychology at the University of Sheffield.
His research, to be published in the journal Psychology, Health and Medicine, suggests that attempts at avoiding potentially embarrassing situations caused much more suffering than the condition itself.
Although the study focused on vitiligo, a non-contagious condition that causes patches of skin to lose their pigment, Dr Kent believes the conclusions probably hold for diseases such as psoriasis.
He surveyed 630 people with vitiligo, which affects more than one in 100 people in the UK, asking them how it had directly affected their lives in the previous three weeks.
Many said they may have been ridiculed by others or had had to back out of a social commitment, such as going swimming with a friend, because this would involve revealing the extent of their condition.
"There were a lot of strategies people employed to make themselves more 'passable', choosing non-revealing clothes or using make-up to camouflage depigmented skin," Dr Kent said. "Some reported avoiding getting into intimate relationships where they might risk rejection and this made them very depressed and anxious."
Dr Kent said these strategies, while understandable, were more damaging than simply explaining their condition to friends and not hiding.
But he said the problem was essentially one of ignorance among the rest of the population who did not understand vitiligo.