For Patients With Birthmarks, Psychosocial Interventions Improved Wellbeing

A psychosocial intervention and public exhibition improved the overall wellbeing and self image of individuals with birthmarks.

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In a recent study,¹ researchers sought to determine the impact of a public exhibition and professional photoshoot on the wellbeing of individuals with congenital melanocytic nevi (CMN). Furthermore, they sought to evaluate the exhibition’s impact on the public perception of people with birthmarks. They cited a lack of existing studies examining the psychosocial aspects of having a birthmark, including the potential impact of therapeutic interventions.

Study authors described a patient recruitment effort led by Caring Matters Now, a United Kingdom-based charity supporting individuals with CMN, in 2016. Caring Matters Now partnered with a UK-based photographer to take patient portraits. Individuals with extensive and/or visible CMN were eligible for participation, and participation was not limited to geographic location, amassing participants from 5 continents. Prospective participants were required to meet with the photographer virtually and provide written consent.

Before and after photographing participants, researchers asked the 30 participants (or their parents, if under the age of 18) to complete a survey describing their photoshoot experience and behaviors pre and post photoshoot completion. The questionnaire asked participants whether the photoshoot made them feel:

• Better about their skin
• Beautiful despite difference
• More accepting of their looks without their clothes
• More appreciative of their uniqueness
• More comfortable in their skin

They also asked participants whether they considered what they wore in relation to their CMN, their level of confidence in crowded places, and their level of confidence about showing their CMN.

All photos were publicly displayed in London, UK, for a 10-day duration in March 2019. Members of the public who visited the exhibition were asked to complete a survey; of the more than 8000 visitors, 464 agreed to complete the survey. The survey asked visitors whether the exhibition made them feel:

• Better about their skin
• More accepting of people with visible differences
• More accepting of their looks just the way they are
• More appreciation for the different and unique characteristics of my skin
• More love for the skin they are in

More than 90% of photoshoot and exhibition participants with CMN responded positively, agreeing or strongly agreeing, with all points of the questionnaire. Furthermore, responses from participants following the photoshoot and exhibition were positive and demonstratedsignificantly increased confidence. 33% of parents representing their older children described the experience as “inspiring,” while 57% of parents representing their young children described the experience as “beautiful.”

While only 51% of exhibition visitors described hearing of CMN prior to viewing the photos, more than 85% agreed or strongly agreed with all points of the questionnaire. 74% of attendees were individuals with CMN who described the exhibition as being “very helpful” in their appreciation and self-perception of their difference.

Study limitations, as noted by study authors, included the study’s self-selective nature and a lack of collection of demographic data from exhibition visitors, aside from gender.

“In the era of social media, where the negative psychological effects of posting self-photographs are frequently reported, the positive effect of this exhibition on the views of the general public is a perhaps surprising demonstration of the power of this novel approach. In particular, the general public not only looked more positively on the participants with visible difference, but felt better regarding their own appearance,” study authors wrote. “These data supportthe impression of the UK support group Caring Matters Now Charity, that non-hiding of visible difference on the skin can have beneficial psychological effects. Further studies will be required to assess whether this approach works in the context of other forms of visible difference, and whether the effects can be replicated using the exhibition book.”

Reference

1. Zolkwer MB, Whitehouse J, Sanderson SC, Kinsler VA. Impact of public exhibition on the perception of birthmarks. Pediatr Dermatol. Published online 2023. doi:10.1111/pde.15315