Anxiety and self-consciousness in patients with minor facial lacerations

Background. Although minor facial injuries are relatively common, their psychological impact is an area neglected in the literature. For physiologically major injuries (such as facial cancers, burns and fractures), the face has been suggested to be a psychologically significant area of the body and disfigurement has been found to have numerous potential social consequences for patients. Aims. This paper reports the findings of an inquiry that explored the psychological impact of minor facial injuries and the influence of patient and scar characteristics in relation to self-consciousness and anxiety levels. Method. Data were collected in 2001 in an accident and emergency unit from patients with a visible laceration over 1.5 cm that was treatable in an outpatient setting. The Derriford Appearance Scale (with general and social self-consciousness subscales) and the State-Trait Anxiety Inventory were administered to 63 patients 1 week later; data on 50 patients were also available 6 months after the injury. Results. Larger scar size, living alone and aetiology of injury were significantly related to self-consciousness and anxiety levels, although gender, age, socioeconomic group, location of scar, satisfaction with appearance and number of scars were not. General self-consciousness improved at 6 months but social self-consciousness and anxiety remained the same. Patient factors were not related to changes in general self-consciousness over time. Conclusions. Minor facial scars can have significant psychological impact for some people. Awareness training for health professionals, social skills training for affected patients and a patient information leaflet are recommended.