Putting appearance on the agenda: Supporting paediatric patients with disfigurement-related psychosocial issues

Miss Caroline Gee1, Dr  Jessica  Maskell2, Dr  Heidi  Williamson3, Professor  Roy  Kimble1,4, Associate Professor Peter  Newcombe5

1Centre for Children’s Burns and Trauma Research, Centre for Children’s Health Research, Level 7, 62 Graham Street, South Brisbane, QLD, 4101, c.gee@uq.edu.au   2Gold Coast University Hospital, Social Work Department, 1 Hospital Boulevard, Southport, QLD 4217, Jessica.Maskell@health.qld.gov.au  3Centre for Appearance Research, University of the West of England, Frenchay Campus, Bristol, UK, BS16 1QY, Heidi3.Williamson@uwe.ac.uk  4Pegg Leditschke Children’s Burns Centre, Lady Cilento Children’s Hospital, Level 5, 501 Stanley Street, South Brisbane, QLD, 4101, royk@uq.edu.au 5Institute for Teaching and Learning Innovation, LIB Building (17), Level 3, The University of Queensland, St Lucia, QLD, 4072, newc@psy.uq.edu.au


Approximately one third of children who live with disfiguring conditions are at risk of developing psychosocial difficulties. Common challenges include body dissatisfaction, social anxiety, poor self-esteem, fear of rejection and stigmatisation. However, children and adolescents are offered little to no support to cope with the psychosocial consequences of their altered appearance.

This research explored the psychosocial impact as well as current support and care needs of paediatric patients living with permanent aesthetic differences. Fifty two interviews with health professionals who work across a range of specialities were conducted, as well as with adolescents and children who live with an altered appearance. Studies within the overall project have specifically explored factors that influence a child’s psychosocial adjustment, gaps and barriers in appearance-related care, perceptions of and preferences for support and treatment.

Overall, findings highlight how psychosocial issues related to disfigurement are often ignored or avoided and health professionals as well as families struggle discussing and treating appearance-related subject matter with young people. Children and adolescents living with a range of appearance-altering conditions have also shared common difficulties, frustrations and suggestions on how they can be more sensitively and effectively supported.

This paper will present a summary of the findings and provide strategies for working with paediatric patients who have an appearance ‘categorised’ as different. It is hoped that the findings will benefit health professionals who work, not only in allied health but also, in medical roles in their future clinical practices.


Caroline is completing her PhD with the Centre for Children’s Burns and Trauma Research, Brisbane, Australia. Her PhD is a large qualitative project exploring appearance-related psychosocial care for children and adolescents living with disfiguring conditions.

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