Advice for DP's insecurity

[soworriedabouthim]

DP has a large port and wine coloured birthmark that covers his left arm in patches and goes onto his neck and covers the left side of his chest.

He has always been very insecure about it and 'hidden' it from everyone apart from close family. Winter isn't too bad as naturally he would wear long sleeved tops/scarfs, etc, however Summer has always been a problem as it is obviously too hot to wear these clothes although he still does.

Every Summer seems to get harder and harder for him and he has lived this way all his life, just hiding under long sleeved, high collared tops and feeling miserable for the whole of Summer because he is too hot and not wearing the clothes he would like to.

Myself and his family have always been sympatetic and reassuring when he feels down about it but he still doesn't seem to understand that noone will look at him differently or think of him differently.

I just don't know what to do anymore in terms of making him feel better about it. He has a very physically demanding job which requires him to work outside most days and he is going to work wearing a t shirt and jumper in this weather!! It's far too hot for that and i'm so worried about his health, that he could just pass out one day! I'm also getting increasingly worried about his mental state aswell as he has often had anxiety attacks in the past when it has been really hot and everything has got on top of him. He is always saying things like 'why was I unfortunate to get it' 'why can't I have normal skin like you', etc. I can't imagine how hard it is for him because i've never had to deal with anything like this, I just hate to see how sad it makes him when he see's other men walking on the beach carelessly without tops on, etc. I wish he felt comfortable in his skin and didn't care if anyone looked at him differently.

I just wondered if there was anybody here who has known of somebody in a similar situation or has any advice they could give me on how to help him deal with it?

Can I ask a really stupid question ?

why has he never had it removed ?

He has spoken to his GP before about having it removed, however the risks are quite high as his is very sensitive and it is a large area. And also there is the chance it will come back even darker later in life. Unfortunately I don't think thats an option for him :(

ok, fair enough and thanks for answering my dim (ish) question

You sound lovely, btw

Regards how much more you can do to make him feel better about it ?

I don't think you can

Hopeully, someone else will come along with some bright ideas

No problem, thankyou for replying to my post! I've never posted here before but really needed to hear other people opinions on this. I just feel so sad about it all, I hate having to watch him so sad and depressed and not be able to do anything about it :(

Good luck x

Counselling?

I have some bad keloid scarring and I have to cover up in the summer. Some of it is on my shoulder and I can't wear sleeveless tops which is a pain because every dress that I like is sleeveless. Also, I won't take my DD to a public swimming pool, my DH takes her. So I do understand where he is coming from.

2 suggestions:

1. Why won't he wear a tee-shirt? Would anyone really notice his arms that much? Do you think he is overly-sensitive?

1. I am now getting treatment here in the US where I now live. There are options here which were never offered to me in the UK. I have to say that the treatment options here are so much better for cosmetic procedures. I would check out some of the hospitals over here e.g. the Mayo Clinic. If you did find treatment, it is not as expensive as you might think and they will generally do a payment plan with you.

You both sound lovely, and my heart goes out to you.

Only he can change his own mindset. Would he be willing to work on his self-esteem? Through therapy, workshops, self-help books?

Has he been offered laser treatment?

My friends ds has a v large port wine stain, and has been having laser on it for years, but the new laser has been amazing - he has it done on the nhs. He also uses clinique city block to cover it which is v effective, and has had cbt to help him cope.

But, to me, it sounds like your dh needs some help with his anxiety first and foremost. Has he asked his gp for some counselling to talk it through, ot there are organisations like Lets Face It

My experience of the NHS was pretty rubbish so it's good to know that the laser is available CMO. Obviously, cosmetic procedures are not a priority and there tends to be a "Oh well, too bad, you have to live with it," attitude. It sounds as if your DH is totally demoralised OP, and I can really understand that. It's easy for other people to say "Be positive etc" but they don't have to live with the looks and tactless comments.
I know I felt really powerless and as soon as I got treatment my attitude changed and I feel so much better.
I do feel that in the US there is a more dynamic attitude to treatment and less of the "Mustn't grumble, why don't we make a cup of tea," philosophy.

Has he even seen a plastic surgeon, OP?

Oh God, sorry to keep posting, but this is bringing up a lot of my "ishooos".

OP, you say "no one will look at him differently." But that isn't true, is it? If he has had this from birth, he will have suffered a lot of awful comments. I can't even repeat some of the things people said to me. Over time, it becomes very traumatising. You can't positively think your way out of that.

These scars create a lot of shame in my opinion/experience. It is very isolating. If you have not been there, it is really hard to understand. You feel different, freakish and not a medical priority. Everywhere you are bombarded with images of perfect people wearing clothes you can't.

I think the best thing you can do is to explore treatment options for him. He may feel too worn down to do that and find it difficult to talk about. My DH pushed me into finding treatment and I am so glad he did.

Just to share my own story in case it helps your DP or anyone else reading this...
I have a lazy eye, it's quite noticeable. Have had it since I was a kid although it's got worse with age, as they can do. I remember being called a cross eyed bitch at school and that really hurting; it still stings now. Now my eye points outwards so often people would look over their shoulder to see who I was talking to, etc etc. It got very tedious.

When I was 25 I had surgery to correct it. I thought that my self esteem would change dramatically afterward, but of course I was just the same inside, so I behaved very similarly, gazed at my shoes, etc. I was warned that the surgery may not fix it forever, and after a year so so it may start to drift out again. Sure enough, a year later it was pretty bad again, though it was (and has remained) somewhat improved to pre-surgery.

The whole experience (and the point of posting this) taught me that:

a) People can be quite horrible and no amount of people you love bigging you up can take away from the fact that there is a lot of ignorance, prejudice and unpleasantness in certain peoples attitudes. Having straight eyes for a year made me realize that people (strangers) were treating me totally differently to when one was wonky; I felt vindicated and that it wasn't all in my head when I had previously wondered if people were behaving oddly because of it. They were - I wasn't going mad. What relief!

b) How I behave about my issue is key. People will take their cue from me, so if I am awkward and embarrassed, they will be. I always used to look away from people, or turn my head to hide the lazy eye. Basically just masking it like your DP masks his birthmark with clothing. This doesn't make ME feel any better, and it just makes it more difficult for people to know about it, react to it in whatever way they are going to (and they will) and then move on from it, stop seeing it as they get to know me beyond the outer image. I was actually shooting myself in the foot when I attempted to hide it, because I was just wallowing in self hatred and ensuring that state never changed.
To a certain extent, people will treat you how you expect to be treated, once you get to know them. Not much you can do about strangers being arsey because they always will be, just try to move on and not dwell on any such incidents.

So having said that, I think your DP needs to really work on his self esteem and self perception if surgery isn't an option. After all, if it's not going away, why not accept it? Relax into it, laugh about it if only to himself, learn to love himself as he is. I know these things are easier said than done, but the road to self acceptance is long for most of us anyway, so he may as well start now. Perhaps a bit of counselling could help him. Unfortunately, he has to want to deal with it himself; you can't make someone learn to love/accept themselves as they are.

Wow thankyou all so much for your replies.. I'll just answer them all in one post!

Counselling - This is something we are in the process of sorting out, although it seems to be a long process because he can't get time off work easily and the only appointments they will offer him are during work hours. We need to try and get an early appointment as 1 out of 3 weeks he starts later in the day, however it's more difficult than you would think though as the IAPT centre near us has a very small amount of staff and they have a lot of problems with staff sickness/holiday, etc.

Laser treatment - Doesn't really seem like an option as DP knows somebody who's had this on the exact same birthmark and he know looks worse for it, he badly scarred and his hand is now permanently swollen. DP worries that if this happens to him then he will regret it and feel even worse than he does now.

nomedoit - thanks for all of your posts, it's been really helpful hearing your story. He won't wear a t shirt as it is really noticable and he just can't handle people looking at it or asking about it, etc. He is very sensitive about it and it's a very difficult subject to talk about with him. I know that it's easy to say 'noone will look at it' and i'm sure he has had lots of things said to him in the past that he still thinks about now and like you said he is always bombarded with people in magazines and on telly, etc that are wearing clothes that he would love to wear but doesn't feel that he can. It's so sad to see him watching other people and wishing he could be like them. I'm glad your DH has helped you and I really want to do the same.

CMOT - I'm glad your friends DS has had luck with the laser. Has the area scarred at all or made it any worse? I think I'm gonna look into the laser a bit more and see if I can find some more information out. The anxiety only seems to be a problem when it is severely hot and he wants to do something but doesn't feel he can, eg go to the beach without a top on. We are trying to sort out the counselling as I said above.

SingOut - thankyou so much for sharing your story. I totally agree with you that people react to the signals you give them. I know that if he went out in a t shirt acting confident and his usual self then people wouldn't be awkward about it. Yes they will look, realise what it is, then carry on and treat him as they usually would. It's just so hard for him to get to that point and do it. I know that if he just took his jumper off at work, all of his colleagues would look once and then never think about it again. But he thinks they will talk about it behind his back or look at him differently. I've told him that if they do then they seriously need to grow up but he doesn't want to risk it. You've given some really good advice in your post and I will get DP to read it as you explained really well how you felt and I can't do that because I've never been in a situation like yours or his. Thankyou.

I don't post a lot, but this reminds me so much of my experiences with NHS attitudes to "cosmetic" treatment that I had to say something. I had very bad acne in my late teens/early twenties and was left with a lot of scarring on my face, chest and back. I felt so awful about it that I avoided looking at myself in mirrors for years and basically totally covered myself up all the time so noone could see anything below my neck. So I hated things like going swimming, hot weather etc. Apart from drug treatments to control the acne, the only thing the NHS dermatologist I saw suggested about dealing with the scarring was to do one of those NHS camouflage makeup courses. No bloody suggestion that it could actually be treated permanently whatsoever.

I then moved to the US in my mid-twenties and when I was seeing a dermatologist about something else, she took a look at my scarring and said she thought it would respond well to laser therapy. I've had several courses of laser treatment now and it has virtually all disappeared, to the point where I don't have to wear make-up if I don't feel like it. I'm so, so glad that I moved to the US, because I don't think I would ever have found out about laser treatment if I'd stuck with the NHS.

So I think it's highly likely that there are treatments for your DH which you just don't know about yet, especially if your only source of information is your GP. Without wanting to GP bash, you can't expect GPs to be totally up to date on what the latest specialized treatments are, especially if it's something the NHS may not offer. If I were in your position, I would insist on a referral to a dermatologist, make it clear how badly this is affecting your DH's life, and if they still say there's no treatment, or give you options you aren't happy with, ask if they practice privately and whether there are any treatments that are available privately that they haven't mentioned. I would also contact a couple of private clinics and see what they can offer.

I don't know whether getting private treatment is an option for you financially, but if that's what it takes to deal with this and you can afford it, I would say it is well worth it, because this is clearly having a terrible effect on your DH, which then affects everyone else in the family. Lovely as the NHS is in many respects, I think the attitude you often encounter that things like this are cosmetic is just total bollocks, because they have terrible psychological effects on people. And the thing that especially annoys me is that doctors and GPs will sit on knowledge that they have about alternate treatments and not tell you about them, just because they are only available privately - when loads of them practice privately anyway!

So in a nutshell - I would advise you to look for further treatment options. Your DH shouldn't have to put up with this if it's possible to do something about it. Best of luck with whatever you decide. Sorry this is so long.

Just saw your new post, OP, and wanted to say that yes - I totally recognise the things you say about your DH getting miserable about seeing images of people on the telly and in magazines. Reading magazines was just torture for me because of all those airbrushed pictures of women with perfect skin - you know that they're not real and that it shouldn't matter to anyone else that there's something different about your skin, but you know that that's the standard that people subconsciously judge you by, and that the way you look does affect the way people interact with you. And being angry and upset that I was the only person among my peers or in my family that had anything like this - why did it have to be me - and then feeling guilty for being so disturbed by it all because I wasn't bleeding to death or dying of cancer or something.

It's such an awful situation to be in. I really hope you can do something about it.

OP, I don't have any advice about helping your oh feel better about his mark, but I can tell you about something that might help ...

My DH is very sensitive to sun. He does a lot of work outdoors. He always wears a long-sleeved cotton shirt (not polycotton or anything else ... no hang on, he has worn hemp), sleeves down, collar turned up. He is more comfortable in that than in a T shirt because it keeps the sun off his skin. Just wondering if that small change might help your DP ...?

My friends ds is treated at the Royal Free (started at Great Ormand, and transferred to adult services). No scarring at all, just a huge reduction in the colour . I can't remember the exact details, but I know its a very new laser of a specific type that just targets the blood vessels, not damaging the skin

FairPhyliis is right. There are often treatment options you don't know about. PLEASE don't dismiss the laser, OP. Your DH really can't predict his outcome based on his friend's experience. There are different lasers and they are evolving all the time. There are clinics in the US that specialize and are very experienced. If you have the funds, I would look at the US as well as the UK. It is not as expensive as you might think.

I was going to say pretty much what CMOTdibbler did :)
A work colleague had green light (laser) treatment to a port-wine stain on her face & neck. We'd never realised how badly she felt about it - she only used cover makeup for formal nights out, not daytime or evenings down the pub. Anyway, she clearly did and undertook this green light thing. It required lots of treatments and, over time, it started disappearing (it went in bits, not an even fade-out, the whole mark was losing its rosiness.) I left before she'd finished the treatment so haven't seen the final result.

She said it might not completely fix the colour - something about different kinds of blood vessels - but it most definitely made a difference. As the birthmark's on her face and she handled it well, she wouldn't have taken any big risks with it. She was treated on the NHS.

She'd done a lot of counselling when younger, which probably explains her confidence. She was also a member of a group for people with similar disfigurements and was clearly very fond of them.

Like everyone else, I suspect the counselling & confidence work is the more important factor in any approach DH takes. It's got to be worth finding out about contemporary treatments, though, and maybe taking a printout along to your GP. Good luck :)

Your partner sounds like a wonderful man, and you sound like a lovely partner to him.

I can relate to your partner's concerns. I also have a birthmark that I am very self-conscious about. It is true, as someone else said, that people do look at these differences. You can't tell someone that "no-one will notice" to reassure them; most do notice and will look. I think, though, that whereas your partner will feel that someone is giving him a disdainful, judgemental, disgusted stare (due to his own feelings about his birthmark), the reality is that it's much more likely to be a curious stare, or people's eyes just naturally being drawn to different skin tone. Then, as you say, people get used to it and get over it and treat people as the people they are. (Though of course there are probably always some awful people out there who would be cruel - a very small minority that aren't worth paying any attention to, who are no doubt cruel in many other ways too.) I remember going on an overseas trip and noticing that every female in the group (of about 16) had a birthmark/ skin disfigurement of some sort - but showed no embarrassment about it and wore whatever they wanted to (unlike me). Birthmarks and skin differences are much more common than your partner may think, based on seeing clothed people - many people have some kind of "blemish" but these are often hidden by clothing.

Some things that have helped me/ that your partner can do:

• As others have said - get him to insist on a new referral to a dermatologist, and have him really be honest about the negative psychological impact that this is having on him - he shouldn't play it down, it will encourage them to err on the side of "leaving it". He should insist on finding out about the latest treatments - the stuff people have said about the US sounds promising.

• Switching to lighter clothing - surely he can wear a long-sleeved light cotton/ hemp collared shirt without the jumper? Or does he wear a uniform? I'm sure your partner could find clothes out there that he feels comfortable in, that are more his style and more appropriate for warmer weather. I know a lot of people who try to wear long sleeves in hot weather anyway to protect themselves from the sun. In many hot countries your partner would be dressed perfectly normally. His shielding himself from others' eyes is probably doing a lot towards protecting his skin from sun damage and skin cancer (and I'm not saying these things flippantly - just trying to put things into a context and point out genuine positives to his situation).

• Dermablend products may help - www.dermablend.com/

Perhaps he could use Dermablend on the areas of skin that fall outside a T-shirt - e.g., lower arm or lower part of neck?

• Exposure to countries/ cultures where there is not such an emphasis on "picture perfect" bodies. I have been to many developing countries where human difference is just accepted. I understand how painful your partner must find his birthmark but going to these countries makes you realise how much worse it can get, and/ or how "normal" these differences are - I am talking about places like Cambodia (landmine injuries) and African countries and just generally places where people struggle and don't have access to the same healthcare/ services they can access in developed countries. In these countries you commonly walk past people who have blemishes, as well as disfigurements and disabilities (I know these words can hurt to read but I don't know how else to get my message across). My point is - life isn't fair, people are afflicted randomly with things, your partner is perfectly normal and just unfortunate to live in a society where advertisers/ corporations pound in the idea that appearance is everything.

• Your partner is upset about the fact that he has a birthmark and doesn't have "normal" skin - but there are many hidden conditions that these people with "normal" skin will have, that he doesn't have (e.g., medical conditions that he may not wish to have, including terminal or hugely life-altering conditions). And he will have assets/ positive qualities that these envied people will also never have. We just have to make the most of what we're dealt.

• As others have said, and as I have observed, psychological issues have such a huge role to play in all this. Your partner's negative interpretation of people looking at him all comes back to his own self-image/ negative thought processes. I truly think there are people out there who, in your partner's position, would celebrate/ cherish their uniqueness (at the other extreme end of the spectrum). So I think counselling, if possible, may help a lot. Also looking at people who are thriving despite physical limitations - e.g., Nick Vujicic - www.lifewithoutlimbs.org/

• Paul McKenna has some really good books out about improving your confidence and loving your body - "Instant confidence", "I can make you thin" (helps with positive body image), "Change your life in seven days", "I can make you happy". These may all help to shift his mindset - the accompanying CDs are crucial to listen to.

Anyway I hope these ideas help. I'm sure your partner would love a suggestion that magically takes his birthmark away - I'm sure most of us in similar situations would jump at such an opportunity - but he is in a very normal situation that millions of people deal with and I hope he can gradually come to terms with the life that he has. This is his one life and he needs to learn to make the most of it!

Wishing you and your partner all the best.

Thanks again for all of the posts since I was last on.

FairPhyliss - Thankyou for sharing your own experience. We are definately going to push for a referall to the dermatogolist and I'm going to try and go with him to appointments aswell as I'm not sure he is completely honest about how it affects his life and that's probably why his GP has never refered him before. I'm doing a lot of research aswell about private treatments he can have and I'm maybe going to have a ring around to see what sort of prices they would be. We're not massively well off but if it came to it i'm sure we could cut down costs in other areas and make sure we could afford it. It would definately be worth it in the long run if it worked!

Cruelladepoppins - Thanks for that advice, i've never really thought about the type of clothing he is wearing. I will have a look around for some long sleeved white cotton shirts. Hopefully that will be a bit cooler for him. Anything's worth a try!

CMOTdibbler - Do you know how long your friends ds has been having the treatment? I've had a look on the Royal Free website and it's got a lot of information on there (very helpful - thanks!) and it says you have to have it done every 3 months. I just wondered if you knew how long it took to notice it fading and possibly how long your friends ds will have to have the treatment for?

Garlicnutter - Thankyou for sharing your colleagues experience. I've been looking more into the laser treatment since starting this post and i think that DP can reconsider it because the person he knew who had it done has obviously not taken to it and had a bad experience, so it could easily work for DP.

MountainOceanSea - Thankyou for all of the helpful things you have written! I really appreciate your long post. You are right, many people do have skin blemishes/birthmarks, etc but you don't notice because they cover them up. DP feels like there really aren't many people like him, he feels like 90% of people have 'normal' skin and he hasn't seen many people at all with a birthmark like his. We're definately going to insist on a referral to a dermatologist and I am going to have a look online now to see if I could find some more suitable clothing for him. He does have a uniform but they are a lot more leniant when the weather is hot, they can wear whatever they like on their top half. Thanks for the advice on the dermablend, i've had a good look at that and am defiantely going to get some. He doesn't think he will wear it everyday as he thinks it will upset him to feel like he 'has' to put it on and cover up every day. But he said he would definately use it at weekends, for days out, etc. He did use foundation when he was younger but he always found that it rubbed off on his collar and then it was obvious he was wearing make up. But this stuff looks like its decent enough not to do that! I'm glad you mentioned about people with 'normal' skin having hidden conditions. I do sometimes feel like he is being selfish when complaining about his appearance because it doesn't bother me, i'm just happy that he's healthy! I've said this to him so many times before, that yes he is unfortunate in having a birthmark but at least he has a healthy body and a lot of people don't. I've tried to get him to feel lucky for having a good life, good relationship, etc and to understand that the shallow people who are cruel about his birthmark probably don't have a happy life and that's why they are so bitter, but obviously he finds it too hard to think of like that because only he knows how deeply this is affecting him. I'm sure he does feel guilty about moaning about his looks when there are terminally ill people, etc out there who haven't got a cure or the chance to carry on with life. I always think about how I would feel if I was in his position but I just have no idea, obviously you do because you are in a similar situation yourself and you seem to be very strong and dealing with it in a brilliant way. DP is very sensitive about it at the moment but i'm sure once we can sort out the counselling and look into treatments with a dermatologist he will become stronger and stop it ruling his life so much. That's what i'm hoping for anyway! :) Thankyou again.

I know that he has been having treatment for a good number of years, but only 2 or less with the new laser. I know he noticed the difference after one treatment (am pretty sure he only has a bit done at a time due to the size).
I think they have said that he might always have top up treatments as the blood vessels regrow.

I was also thinking that a UV rash vest might be a good coverup for your dh - I have a long sleeved, high neck one as I burn so badly, and they are very cool to wear, so he could wear one as an underlayer to a tshirt and be covered but cool. Lots out there, but you can see the sort of thing here