Stigma

As a consequence, people with chronic skin diseases such as acne, eczema or psoriasis may suffer ridicule and rejection. Even if this response is anticipated rather than real, an individual may choose to avoid social interactions or avoid certain activities to ensure that they do not have to face unpleasantness from others (Hong et al., 2008). Individuals may describe themselves as being stigmatised by their condition, where stigma can be described as a ‘connotation of disgrace associated with certain thing’(Allen, 2000). As this definition highlights, people with skin disease often associate it to issues of morality, in other words, there is some level of (perceived) disgrace associated with it. This may in part be due to religious teachings emphasising the impor tance of cleanliness and because of skin diseases’ association with dirt it becomes associated with Godlessness.

A study looking at feelings of stigmatisation in patients with psoriasis noted six different dimensions of stigma experience, many of which echo what has already been stated (Ginsburg & Link, 1989). Those dimensions were:

• anticipation of rejection
• feeling of being flawed
• sensitivity to others’ attitudes
• guilt and shame
• secretiveness
• positive attitudes

In this study, different people had these experiences to different levels; however, the single factor that was most likely to predict for feelings of stigma and despair was bleeding skin. Whilst stigma may be thought of as a social construct, feelings of stigmatisation can have significant impact on psychological well-being. It was shown that a group of psoriasis patients who had felt stigmatised by people deliberately avoiding touching them, had significantly higher depression scores than a group with similar level of disease who did not feel stigmatised (Gupta et al., 1998).