November 5th, 2018
In addition to the creative, performance and technical career roles, the pro industry has another side to it – para-medical skin camouflague – and the British Association of Skin Camouflague (BASC) has for many years been at the forefront of training and education. Elizabeth Allen, Chair of the BASC Education Team, lifts the lid on the background and benefits.
At base principle, there would appear to be little or no difference between corrective makeup and para-medical skin camouflage: both are designed to achieve the same result. You will be familiar with cosmetic house brands and used them to camouflage an inappropriate tattoo or a skin condition that was not a character requirement. You may be less aware that four brands with a combined choice of over 350 colours may be obtained on NHS prescription, in line with local agreements, for para-medical reasons to offer a simple solution that helps people overcome their complex dermatology-psychological problems. (1)
Any product licenced for NHS prescription has undergone scrutiny by the Medicines and Healthcare Products Regulatory Agency (MHRA) and the National Institute for Health and Clinical Excellent (NICE). Camouflage should be removed daily to allow the person to inspect their skin condition and to apply medications, emollients or sunblock. Usage must be discontinued and medical opinion sought should any skin condition or a mole change, or an allergic reaction occur.
Camouflage crèmes do not alter the form or function of the skin, neither are they medicines or curative preparations, but the immediate visual effect may help people regain self-esteem and confidence, which in turn can do much to improve their general well-being and assist a return to normal social-sporting activities, education and employment.
“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” World Health Organisation Mental Health Fact sheet NO.220 Sept 2010
Historically there has always been a social distinction between those who wore makeup and those who did not. Those who did predictably were rulers, as such their visual difference displayed their status. The exceptions were those of a dubious reputation and those involved with performing arts (and these professions could be considered synonymous) with makeup used to create a false impression or pretence. The forces for social change began in 1789 with the French Revolution when aristocrats, for survival, abandoned their visual difference; by 1837 it was generally considered by Queen Victoria’s court that it was impolite to wear makeup. Opinion slowly changed with events during the 20th Century. The early film stars instigated celebrity worship and their screen glamour was something we all wanted to emulate during the bleak years of Financial Depression, WWI and WWII.
“Each military conflict generates its own conditions and situations which lead to new (medical) advances.” Mr Baljit Dheansa, Clinical Director of Burns & Trauma, Queen Victoria Hospital, West Sussex – Daily Express 13.11.2012: how warfare has led to healthcare developments
Two surgeons considered to be the founding fathers of modern plastic-reconstructive surgery were Major, Sir Harold Gillies and his younger cousin Sir Archibald McIndoe. Gillies performed the first skin graft in 1917 and was hailed as the “saviour of the Somme”. McIndoe’s involvement was during WWII. His RAF patients formed the first support group run by patients for patients and because a lot of the procedures were experimental, they called themselves The Guinea Pig Club.
Gillies and McIndoe knew that skin taken from the patient’s torso and grafted to their face would be always be a different colour as it did not have identical years of UV exposure. McIndoe was aware that the Max Factor laboratories had perfected waterproof makeup for the film industry and also combat camouflage for the US Marines, but he needed a product suitable for delicate scar tissue and in colours that replicated the patient’s unaffected skin colour – when correctly applied it should not attract any attention. Research led to McIndoe’s colleague, chemist Thomas Blake, creating Veil Camouflage Cream in 1952 in three colours: light, medium and dark.
The final person to enter this historical circle was Joyce Allsworth; as a WAAF plotter during WWII stationed at North Weald airfield in Essex she was very much aware of McIndoe’s work and, being a makeup artist, she suggested additional colours to Blake. She worked alongside other pioneering plastic surgeons but when Dermatology departments sought skin camouflage clinics too, she approached the British Red Cross and instigated their service in 1974. Following requests for the para-medical service to be in private practice as well as the NHS, Joyce eventually founded the British Association of Skin Camouflage (BASC) in 1985. And the rest, as they say, is history! BASC continues to advise manufacturers on colours and there are now over 350 colours within the 4 brands currently available on NHS prescription.
Although camouflage came from Hollywood, please do not call these products makeup, cosmetics or slap. Performers lovingly refer to their theatrical makeup as slap.(2) Medical professionals often refer to a cosmetic result, which is a generic phrase for any non-invasive treatment. However, most people will recognise “cosmetic” as makeup. Unlike cosmetics and makeup – words which may suggest female use only – the non-exclusive expression ‘skin camouflage’ does not create psychosomatic barriers and removes any possibility of trivialising the products as beauty aids. In order to engage with the patient and provide information professionals need to be cautious how they introduce camouflage. This is especially relevant to youths, as they will be unlikely to consider attending when told to “go to the local beauty salon for some special make-up”.
But their attention might be captured if advised to “to talk to the skin camouflage consultant at the clinic.” Other language used when working with someone who has a visible difference is equally important. BASC thoroughly endorse the comment made by Professor Nichola Rumsay OBE that ‘Language is so powerful that we need to look at how it is used when talking about disfigurement. Here at the centre we talk of ‘visible difference’, which is a neutral term I would like to see used by everyone. (3)
88% of people surveyed (4) said they would never describe anyone who has a skin condition or scarring as being “disfigured” and 65.61% preferred to use the words “visible difference”. It is important that all language engages (and does not alienate) especially when someone already has a psychological issue concerning their image and self confidence; inappropriate labels may lead to additional stress related behaviours.
It is generally accepted that skin camouflage can be a vital tool during the early stages of a person’s rehabilitation and adjustment to their skin condition; for others, skin camouflage may need to be considered as long-term. In an ideal world, there would be no need for skin camouflage, but until that day arrives, BASC considers it to be a coping mechanism which can be used by anyone, irrespective of age, gender, ethnicity or religion and cultural belief.
Additional Information – About BASC
BASC is an independent charity which is run by dedicated professionals who volunteer their expertise. It is not linked to any industry, company, organisation or authority, and this allows them to promote skin camouflage independently and free from restrictions. BASC-trained consultants work independently – BASC does not employ any staff.
Further information on the history of skin camouflage is available on www.skin-camouflague.net
About the author
Elizabeth Allen (trained by Joyce Allsworth) joined the BASC General Committee in 1992 and became the Product Information Officer (1994). In 1996 she was appointed principal tutor and chair of the education team; since then she has trained almost 1,000 camouflage practitioners for BASC. Over the years Elizabeth has written many articles (examples, BMJ, International Therapist, Vitality Magazine, The Consulting Room, Dermatology in Practice, MIMS Dermatology) and is the author of Cover, the principles and art of para-medical skin camouflage (first published 2010) ISBN 978 1 4520 6603 5.
 Emotional benefit of cosmetic camouflage in the treatment of facial skin conditions: personal experience and review. LL Levy & JJ Emer, Clinical, Cosmetic & Investigational Dermatology (2012)
Cosmetic camouflage. C Antonious & C Stefanaki, Journal of Cosmetic Dermatology. (2006)
Psychology, Health & Medicine, A Clarke 4(2) 129-14 (1999)
Stigma : Notes on the Management of Spoiled Identity, E Goffman, Penguin Books, Harmondsworth (1963)
Visibly Different: coping with disfigurement.R Lansdown, et al,Butterworth Heinemann, London (1997)
Psychological Approaches to Dermatology, L Papadopoulos and R Bor, The British Psychological Society Books, (1997)
 A bit of Slap : Joan Smith considers women’s relationships with cosmetics. The Guardian 13.6.2000
Origin, c.1860 to describe the action of putting (slapping) on thick grease makeup
Oxford English Dictionary (slap) informal makeup
 If my face upsets you, it’s your problem, not mine. The Daily Telegraph 15.12.14
Body image and disfigurement: issues and interventions .
Nichola Rumsey, Diana Harcourt Body Image 1 83-97 (2004)
 Evaluation the effectiveness of psychosocial intervents,
Alyson Bessell, Timothy P Moss, Body Image 4 227-238 (2007)