Physical appearance contributes strongly to a persons sense of self, esteem and personality.

Body
image has always existed encompassing body shape, facial features, body size and any disfiguring
anomalies (Van Loey & Van Son, 2003). Disfigurements from birth or developed throughout life and
plays a vital role in defining somebody. We can acknowledge the role physical appearance plays in
our lives as a majority of the general population have in some form another strived to manipulate
their appearance in the best light possible. Physical disfigurement can arise as a result of injury,
disease, burns or trauma and is often pronged with personal, social and psychological challenges
(Thomson & Kent, 2001). Variation in physical appearances and disfiguring conditions is strongly
correlated with problems including depression, anxiety, shame and interpersonal difficulties. Thus
these physical conditions put psychological health at serious risk. Research also indicates that
physical disfigurement is likely to elicit awkward social behaviour in others and avoidance. Physical
disfigurement can arise as a consequence to breast cancer where breasts have been removed in
order to remove tumours i.e. mastectomy, as well as a result of serious burns and genetic
malformations including impacts of nuclear radiation and disfiguring diseases. These physical
differences can lead to many issues faced concerning body image and self perception. The most
frequently reported difficulties include negative self image, difficulties with social interaction and
potentially social anxiety and negative behaviour patterns such as excessive social avoidance
(Watson & Johnson, 1958). 10-70% of patients based on a variety of disfigurement factors
experienced depression and anxiety (Fauerbach et al., 2002). Patients, particularly with visible
disfigurement experience a feeling of inferiority and a stigma associated with their physical
difference. These are often coupled with a set of psychosocial problems including unemployment,
lower levels of education and poor social support (Fauerbach et al., 2002).
A charity in the UK estimated that 400 000 people in the UK alone have some kind of visible facial
disfigurement. Congenital disfigurements, that is where the individual has no recollection of life with
the physical disfigurement, affects one in 800 births (Fauerbach et al., 2002).
Recently the psychosocial impact of burn victims has become a topic of interest with an array of
distressing factors surrounding the psychology of burn patients. With burns victims, the dermal
scarring can lead to depression and post traumatic stress disorder (PTSTD) in 13-23% of cases
(Van lory & Van Son, 2003).
The psychological responses arise not simply always from the burn but also witnessing the
experience of what happened which is a large risk factor in the severity of the psychological
problems associated with burn victims. Treatment for burn victims psychologically includes
reintegration into society and social support (Patterson, 1993). Initially the patients are assessed to
gauge an understanding of their current state of mind and mental health. Sadly less than 20% of
acute care burn patients receive counselling or therapy in the US (Van lory & Van Son, 2003). More
emphasis and importance is initially placed on their physical recovery as opposed to their mental
health or overall wellbeing. Another indication of inadequate psychological support provided to burn
patients is evident in the high number of follow up visits reported (Van lory & Van Son, 2003).
There are many centres that offer psychological support and interventions for the patients that have
experienced disfiguring burns. It is most commonly public hospital burns units, ambulatory clinics
and repatriation hospitals that offer this extensive support (Thomson & Kent, 2001). The purpose of

these centres are to provide support in regaining confidence and mental stability as well as
rehabilitation back into ones daily life and activities. There are many publicly funded health and
rehabilitation centres that are available for public access and some which are subsidised to ease
financial pressure in receiving support too (Thomson & Kent, 2001). This sort of support system is
beneficial in ensuring an overall recovery in the patients health and not merely a physical
improvement.
There are an array of health professionals involved with helping the recovery of burn patients
ranging from physiotherapists, to surgeons, dermatologists and counsellors. They all play a vital
role in the health condition of burn patients. Surgeons and dermatologists have a medical impact
on patients and look after their physical health and stability. Physiotherapists help them obtain
movement back into areas which may have lost mobility from skin grafts or burn damage so they
can return to their activities of daily living as much as possible. Counsellors on the other hand
provide psychological support and mental strength through their rehabilitation contributing towards
an overall wellbeing (Patterson, 1993). These professions all require a higher degree of learning at
University and practise in the field.
The current services provided in terms of the burn unit clinics do reflect the research findings in the
necessity for mental support and support in reintegration into daily life and community. However
there is not as much significance and prominence placed on these services as ideally as research
suggests (Thomson & Kent, 2001).
Overall it evident the importance of psychological impacts in patients that have been physically
disfigured and just how important it is to address these issues as well as physical health in order to
contribute to an overall sense of wellbeing.
References
Thompson, A., & Kent, G. (2001). Adjusting to disfigurement:
Processes involved in dealing with being visibly different.
Clinical Psychology Review, 21(5), 663682.
Van Loey, N. E., & Van Son, M. M. (2003). Psychopathology and Psychological Problems in
Patients with Burn Scars: Epidemiology and Management. American Journal Of Clinical
Dermatology, 4(4), 245-272.
Watson, E., & Johnson, A. M. (1958). The emotional significance of acquired physical
disfigurement in children. American Journal Of Orthopsychiatry, 28(1), 85-97. doi:10.1111/j.19390025.1958.tb03726.x
Fauerbach, J. A., Heinberg, L. J., Lawrence, J. W., Bryant, A. G., Richter, L., & Spence, R. J.
(2002). Coping with body image changes following a disfiguring burn injury. Health Psychology,
21(2), 115-121. doi:10.1037/0278-6133.21.2.115

Patterson, D. R., Everett, J. J., Bombardier, C. H., Questad, K. A., Lee, V. K., & Marvin, J. A.
(1993). Psychological effects of severe burn injuries. Psychological Bulletin, 113(2), 362-378.
doi:10.1037/0033-2909.113.2.362