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How I learned to embrace my 40cm scoliosis scar – even in summertime

Tilly Armstrong underwent surgery to correct her spine's alignment, leaving a scar down her back
Tilly Armstrong underwent surgery to correct her spine's alignment, leaving a scar down her back

“Wow, that’s one hell of a scar.” I’m at the GP having a check-up and the doctor is looking at my back, a mixture of surprise and awe on her face. I am fifteen and suddenly very aware that although I can’t see the scar – 40 centimetres long and the width of a piece of string running down my spine – other people can.

A month before I had undergone surgery for scoliosis, a condition that causes the spine to curve significantly. Although the condition is not uncommon, only around three in every 1,000 children require treatment, either wearing an (often painful and constricting) brace or having major corrective surgery to straighten the spine. For me, it was the latter, with two titanium rods, 14 screws and the scar to prove it.

The first whispers of my condition came one year earlier during the school summer holidays. When putting sun cream on my back, my mother noticed that my hips were oddly asymmetrical. As it turns out, this is a common sign of scoliosis, and I had a curvature that was bending 43 degrees to the right. Flash forward to the next summer and a reddish-purple line now took centre stage on my back, neatly separating it into two halves.

Although extremely grateful for the success of the surgery and my newfound symmetry, like many teenage girls I resented anything that could make me look even slightly different. I struggled with the inevitable exposure that came with the summer months; when everyone was throwing on their beach clothes and sunbathing, suddenly my body became visible to the gaze and comments of strangers. Not to mention the loud and very public reminder of my internal metalwork that came every time I set off all the alarms at airport security.

Left: Before the operation, Tilly's spine bent 43 degrees, sending her hips out of alignment. Right: An x-ray showing the metalwork used to correct her scoliosis

Whether on the street, in my local park or by a pool on holiday, I dreaded the moment when someone would notice it and the questions would begin: “Oh my God, what is that?”, which in turn also brought up some difficult emotions and memories. Although people mostly expressed an awe and wonder similar to the doctor’s, in my mind the scar was grotesque and gruesome, a bright red line that set me aside as weird, unattractive and unlovable.

Of course, this isn’t a feeling reserved only for those of us who have undergone surgery. According to the British Skin Foundation, 70 percent of British people have visible skin conditions or scars that they are self-conscious about.

As I got older and left adolescence behind, I began to enjoy showing it off and wearing clothes that exposed it. I began to see it no longer for what it looks like, but rather what it represents as a visible sign of something I have faced and overcome.

When Princess Eugenie publicly displayed her own scoliosis scar in a custom-made dress at her wedding last October, I felt a real pang of pride. Although it had been nearly a decade since my operation (it will be ten years this December), I couldn’t help but think back to that person who thought that a scar could somehow have a detrimental effect on my future.

As my scar has faded over the years, attitudes towards visible skin difference have also been changing. No longer the first thing to be smoothed over by Photoshop, scars are now being seen as something to celebrate. Leading the way is photographer Sophie Mayanne, whose campaign ‘Behind the Scars’ is attempting to change the way we see skin by showcasing portraits of people with caesarean-section scars, burns, skin conditions, self-harm scars and everything in between, alongside the stories behind the marks. What might once have been the subject of glares, tuts or laughter, are now being seen as they should be, as symbols of resilience and survival.

For people publicly displaying their skin for the first time this summer, the prospect can be daunting – and for some, covering up is the most appealing option. Changing Faces, a charity which provides support for people with a visible difference, have developed a potentially life-changing solution: skin camouflage creams and powders, individually designed to reduce the appearance of marks, scars or skin conditions.

As Pippa Donovan, director of services and innovation at the charity explains, the most important thing is giving people practical support and freedom over how they look. “Our service gives people with visible differences a choice over their appearance, giving them control over how they want to look day to day. This can help to build confidence and self-esteem so that they feel empowered and able to lead the lives they want,” she says.

For those who make the choice to openly exhibit their scars, it’s important to take precautions to protect this sensitive skin. “Don’t go in the sun straight away, and within the first year you need to be careful to avoid the risk of infection,” says Dr Suchitra Chinthapalli, a London-based consultant dermatologist. “Because scars are sensitive to begin with, I would generally keep them covered and avoid a sun tan for approximately a year. Any kind of tanning while the skin is healing up can alter the way the eventual scar looks.”

Too much sun exposure early on can lead to post-inflammatory hyperpigmentation, which can cause the scar to darken in colour. Although, Dr Chinthapalli explains, this will improve over time, the process is often slow. The best way to avoid any change in pigmentation and to allow the scar to heal is to cover up, or if you do go in the sun, use an SPF factor 50 sun cream.

For me, the prevailing memory of my first summer after surgery is sitting in the shade, my mother diligently applying a perfect line of sun block along my scar. Although impossibly annoying at the time, I am hugely grateful for that now. I am also grateful that as I have come to love my scar, the tide has been changing, allowing people to make the choice about how they want to show their skin, without, or in spite of, the risk of judgement from others. Now the only thing I have to worry about in summer is holding up the line at airport security.

The best suncare products for scars, approved by dermatologists

1. Kelo-cote scar gel with SPF 30

Silicone gel designed to protect from UV exposure and improve the appearance of raised or discoloured scars

2. La Roche-Posay Anthelios range

SPF 50+ products for very high protection, including a sensitive areas stick for easy application and tinted fluid for facial marks

3. Ultrasun Extreme Sensitive SPF 50+ sun lotion

Ultrasun has an extensive range of products, but the very high protection from UVA and UVB and lack of perfume, emulsifier or preservatives in this lotion make it ideal for sensitive skin

4. Eucerin Superior Sun Protection Range

A range of high protection products tailored for individual skin needs, including face and body products for preventing sun-induced hyperpigmentation

Changing Faces is the UK’s leading charity for everyone who has a mark, scar or condition that makes them look different. If you or a loved one have a visible difference and need some advice or support please get in touch www.changingfaces.org.uk 0345 450 0275