Most movies that feature skin disease use it to represent evil.

A common example is facial scarring. In the Oliver Stone film "Platoon", there is an ongoing rivalry between two soldiers:



Willem Dafoe: Clear complexion = Good

Tom Berenger: Scars = EVIL

Since movies are visual, there is nothing like a defective peel to tell an audience that a character is a bad apple, with a not-so-healthy core. Scars have been extensively used because they are easy to replicate with makeup. They also suggest a violent past with a quick glance. Of all skin conditions seen in movies, scars are by far the most prevalent.

The earliest example of dermatology in the cinema we have yet uncovered is this scarred gangster in "The Musketeers of Pig Alley." This black and white silent film was released in 1912, and villains with facial imperfection were already becoming a stock cinematic symbol. These days, scars are a significant cosmetic problem and can be lessened by surgery, laser treatments, chemical peels, and cortisone injections.

Paul Muni in Scarface(1932)

Al Pacino in Scarface(1983)

By the 1930's, scars as sinister signals were so standard that calling a character "Scarface" meant to film goers he was no good. Pacino's version has developed a lasting legacy among the hip-hop gangsta set, where scars and tattoos can be associated with street "cred." Occlusive treatments, either containing silicone or not, can soften and shrink some scars. If Scarface wants, he can apply use these devices under a bandage, calling out, "Say hello, to my leedle fren!"

    Got scars? "Freddy" from "A Nightmare on Elm Street" does--extensive burn scars. In the real world, burn victims are not morally scarred.

    But they can experience intense stigma. In the teenage horror film, "The Craft", Neve Campbell plays a girl who has burn scars on her back. She is ostracized by her fellow students and therefore becomes a witch. That's high school for you. Later in the film, a spell backfires, causing prominent facial scarring. Most high school tenures aren't nearly so dramatic.

    Many children's films feature examples of pernicious characters with problem skin. The Disney flick "The Lion King" stars Jeremy Irons as the voice of the merciless villain who is named after his "Scar" (seen across his eye). As one of the most popular home video releases in the United States, one wonders how many children subconsciously equate scars with evil.

"Frankenstein Unbound"

Frank's monster with his Bride

Looking, er, matrimonial...

...And a lot like Marcia Cross from TV's "Melrose Place"

The Frankenstein story seems irresistible to creators of celluloid product. Since 1910, at least eighty movies feature the poorly stitched monster and his charming bride. It is so ingrained in our culture that it seems to immediately spring to mind when patients have to consider facial surgery for medial (such as skin cancer removal) or cosmetic reasons. This British version, "Frankenstein Unbound," is particularly dramatic, the bride showing hair loss and a poorly healed scalp wound. Presumably, the sutures broke open, also becoming "unbound." Actually, in trained hands and barring infection or complications, faces and scalps usually show the best healing of any body location. Also interesting is the coincidental (?) similarity of this monstrous bride with "Desperate Housewives" star Marcia Cross' psychotic character on the steamy 90's TV soap "Melrose Place." Same hair color, hair loss, and spooky scarring. Is this theft of creative property?? If so, the movie version might be called "Lawsuits Unbound."

Normal skinned Cowboy John Wayne confronts...

...Previously skinned varmint Lee Marvin.

This keloid has made its home on the range.

Movie westerns have admittedly not been as rich a source of skin issues compared to the horror, but when they shoot, they score. A rugged classic, "The Comancheros," stars heroic John Wayne, who confronts villainous Lee Marvin. In a run-in with indigenous folk, Marvin survived a scalping. Though alive, he is left with a large raised hairless scar on his pate. Thick scars are called keloids, and usually result from surgery, large acne cysts, or piercings gone awry. Rather than surgical removal, a different type of shooting is considered. Small "shots" of cortisone can work to gradually reduce the thickened collagen. This, and the avoidance of scalping attacks, are recommended.

Pretty boy Travolta...

...musically drag races...

...the extensively acne-scarred "Craterface."

Ah, the 1950's. Things were so simple then. Good kids were your pals, and if they weren't you would race hot rods in the LA canals, beat 'em, and then stage an entire musical number. In "Grease," John Travolta plays the rare teen with a complexion as clear as the windshield of a new Thunderbird. Even his pomade-pumped hairdo didn't cause a breakout. His archenemy wasn't quite so lucky. Actor Dennis Stewart plays "Leo," tenderly called "Crater Face," a fierce fella who cackles until he realizes that acne scarring is no easy fix. In the 1950's, doctors occasionally turned to radiation therapy to treat bad acne. In retrospect, this greatly increased patients risk of skin cancer. Fortunately, medicine has come a long way for acne treatments, but not necessarily for acne scars.

Gary Oldman in "Hannibal": a meaty role, or just leftovers?

Character actor Gary Oldman may have reached a pinnacle of sorts in the big budget B-film "Hannibal." He's uncredited and essentially unrecognizable as the one surviving victim of cannibal Hannibal Lecter, Oldman's extreme scarring comes from being (literally) chewed out. Horrendously scarred by nearly becoming an appetizer, Oldman has served up a skinematic main course. Is there possibly another role that can act as a dermatologic dessert? We hope not. And despite the temptation, we'll avoid any further culinary humor.

© 1996-2007 Vail Reese MD

Union Square Dermatology