There is no doubt that people suffering from skin diseases and conditions that cause visible difference still face, and fear, stigmatization, which can lead to social anxiety and depression.  Research, due to be presented at the British Association of Dermatologist’s Annual Meeting this week, looked at whether this stigma is a hangover from Elizabethan England, preserved by the enduring popularity of Shakespeare.

Researchers from Nottingham, Leicester and Derby, analysed Shakespeare’s language and found that it reflected the Elizabethan obsession with perfect, unmarked, pale skin. They speculate that the playwright’s status as the most well-known English language writer of all time, may be helping to fuel ongoing stigma around skin disease. Many of his most memorable insults are derived from skin imperfections:

“Thou art a boil, a plague sore, an embossed carbuncle” (King Lear).

“Thou art a perpetual triumph, an everlasting bonfire night. Thou has saved me a thousand marks in links and torches” (Henry IV part 1).

“A pox upon him” (All’s Well That Ends Well)

“I scorn you, scurvy companion” (Henry IV part 2).

Dr Catriona Wootton, Dermatologist at Queen’s Medical Centre in Nottingham and one of the study’s authors, said: “Rat-infested and with open sewers, overcrowding and sexual promiscuity, Elizabethan London was a melting pot for diseases such as plague, syphilis and smallpox. Many of the diseases of the time involved lesions or sores on the skin, so skin imperfections were seen as a warning sign for contagious disease.  This was not limited to signs of infection, but to any blemishes or moles, which were considered ugly and signs of witchcraft or devilry. Shakespeare uses these negative undertones to his advantage, employing physical idiosyncrasies in his characters to signify foibles in their behaviour.”

Shakespeare was not at the root of this stigmatisation, and indeed in Hamlet, he highlights the innocence of affected individuals: “that for some vicious mole of nature in them, as in their birth – wherein they are not guilty, since nature cannot choose his origin – their virtues else, be they as pure as grace, as infinite as man may undergo, shall in general censure take corruption from that particular fault”.  However, many far less tolerant examplesabound and it is argued that his success has led to the perpetuation of this stereotype.

Nina Goad of the British Association of Dermatologists said:

“It is interesting to note that much of the Elizabethan stigma over disfiguring skin disease still persists today.  Over the last few decades dermatologists have tried to address the effect this can have on patients.  However, even now, many examples exist in films and literature where visible disfigurements are used to represent villainy or malice. This is particularly concerning when such films are aimed at children, who learn that beautiful, flawless people are kind and trustworthy, and scarred or blemished people are to be feared. Nobody is suggesting that we edit Shakespeare but maybe we should ensure that new films and books don’t reinforce this stereotype. Many skin patients require psychological support to deal with the visual aspect of their disease. Whilst this support remains patchy, the British Association of Dermatologists is working on a Department of Health funded project to provide online support, which is a good first step.”

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For more information please contact:  Nina Goad, Head of Communications, 0207 391 6094 or mobile 07825567717 during conference week, or email: nina@bad.org.uk, Website: www.bad.org.uk