In the midst of a global pandemic, awareness of anything other than our own mental wellbeing and the health of those we know, and love has understandably not been the same priority that it was pre-covid. However, today I wanted to just remind people about the causes for facial visible difference in preparation for life resuming (hopefully) this year when those who may be seeing lockdown as protection against unwelcome stares or reactions will be re-joining an ever-superficial society.


There are two main reasons why someone may look different in appearance. While its less important to know the different causes in detail, it’s really important to understand that a person’s appearance is no reflection of their character and in many cases, the struggles or adversity that create us can create more compassionate and considerate individuals. We should all bare this in mind when we are interacting with others. I for one, have met some very ‘beautiful’ yet awful people over the years which has taught me the value of giving people my time before making my mind up about them.

1.Congenital conditions

In some cases, people are born with facial visible differences such as a cleft lip and palate or obvious birth marks. In the case of my son Harry, he was born at the extreme end of a spectrum condition called Goldenhar syndrome. For him, this meant that he was born with no eye, eye socket, ear, nostril and has a short, underdeveloped jaw.

Harry at 2 years old

Although some craniofacial conditions are genetic in origin, the causes of this condition are unknown. The most common theory is that a random interruption of the blood supply affected the aspect of the foetus which was developing at that time.

2.Acquired conditions

In contrast to conditions that children are born with, there are a number of reasons why a person’s appearance may change through their life.


Health issues

This can be due to skin conditions such as eczema, psoriasis, acne or facial cancers which require surgeries to repair affected areas. Nerve damage or conditions can also affect facial muscles too.

Read Nathalia’s fantastic interview here on life with her birthmark.

Physical injury

Facial difference in this area can result from burns, accidents, bites or any incident which means the individuals appearance is altered after an incident.

Catrin Pugh after her accident

You can read the amazing story of burns survivor, Catrin Pugh here.

As with any condition, there are varying degrees in which people are affected but one thing is the same regardless of the cause or severity of facial difference; everyone deserves the same level of respect and consideration.

Many children report incidents of bullying because of how they look, and many adults have experienced moments of discrimination or awkward encounters where people are reluctant to interact with them.

As part of a BBC documentary ‘Inside Out’ the presenter Julia Hankin was made up with tattoo ink by a make-up artist to give the appearance of a prominent port wine stain.

Julia Hankin made up with tattoo ink to resemble a portwine stain birthmark

She then took her seat on a busy bus route.

It took 65 minutes for someone to sit next to her. But, on the same journey with the make-up off, it was a very different story – someone took the seat next to Julia after about 30 seconds.

As a society, many of us are unconsciously operating at a level of mental shortcuts developed through our life and historical or cultural beliefs, often fed into by block buster movies, that those who look different can’t be trusted or are somehow ‘bad’.

Hopefully, todays blog post will help you to understand, and hopefully share with family, friends and your own children, the reasons for facial difference and the importance of social acceptance.

Other blogs you may enjoy from More Than a Face:

Helping children to understand facial differences