· History of Skin Camouflage
In response to questions often asked, and to link with pride the history of BASC, here is an outline of the gradual evolution of skin camouflage, including Joyce Allsworth’s inspirational role.
Joyce instigated the camouflage service within the British Red Cross and founded The British Association of Skin Camouflage. She also wrote and published in 1985 Skin Camouflage – A Guide to Remedial Techniques (now out of print).
The history of wearing skin camouflage products has been concealed by the passage of time; most records are lost and, sadly, a lot of information relies more on rumour and hearsay than fact. However certain dates and names are available from archive sources and from those we can begin to create a picture of events.
Before any product became available there had to be a cause – a reason that made wearing cosmetics (and camouflage) socially accepted and marketed. We know that throughout the history of cosmetics, wearing make-up had always been considered the prerogative of the rich, as well as having an association with those involved in the performing arts and prostitution. Those who wore any form of artifice had to make their own products or have a servant to do that menial task for them. During the late 18th century opinions changed. No longer did the rich wear obvious make-up, and the wearing of any cosmetic morphed to be a social sign of falsehood, a vanity that did not equate with good and god-fearing behaviour. From the numerous social and political upheavals of the 19th and 20th centuries we can begin to appreciate the causes that permitted use of make-up and skin camouflage to become socially acceptable. Once the social climate had changed, manufacturers began to produce an array of products. Today the cosmetics and toiletries industries show annual multi-billion dollar sales.
The women’s suffrage movement (which gained momentum from the middle of the 19th century) not only resulted in women having a political voice and the opportunities of better education and employment, emancipation also gave them choices – one was to wear make-up without encountering social discrimination. In New York, during the early years of the 20th century, the women marching in support of the female textile workers’ strike wore bright red lipstick. Interestingly, Elizabeth Arden joined the march, even though most of the strikers would not have had the means to afford most cosmetics on sale at that time. During the same timeframe, at the other side of America, another movement was affecting society’s perception of beauty. The cause of this massive interest in cosmetics was the invention of the film industry. The popularity of the cinema did much to promote a flawless complexion – and ushered in an era in which women would also want to look like their screen idol. The ‘beauty business’ had begun! Because of the intense lighting required during filming, there was a need to create make-up that would withstand the performer’s perspiration. Undoubtedly in those pioneering days the main contributor to perfecting such durable make-up was Max Factor. Max Faktor (1877–1938) emigrated from Poland to the USA in 1902, and it was then that a spelling error occurred in his surname. Factor moved to California in 1908–9 and had, by 1914, perfected a flexible greasepaint make-up suitable for those early filming requirements. His other major make-up innovations, especially pan-cake (Academy Award 1928), without which it would have been impossible to take full advantage of the light and shade sensitivity of Panchromatic film, led the way for natural looking film, television and street make-up. For decades he was the un-crowned king of Hollywood and his make-up became an international leading brand. His concealer, pan-stick and pan-cake cosmetics are still sold today.
In 1918 Max Factor created the ‘colour harmony’ principle, in which all products were harmonised to tone with the wearer’s natural skin, eye and hair colour. It was the first time in cosmetic history that powder, rouge, eye make-up and lipstick were co-ordinated to suit blue-eyed blondes, brown-eyed brunettes and so on. Because audiences wanted the same cosmetic look as their screen idol, Factor launched his cosmetics for general sale in 1927 – his brand advertisements were the first to use celebrities to endorse the products. As a wigmaker, Factor also perfected human hair wigs and false eyelashes for the film industry, which, in turn, filtered their way onto general sale. He also worked with American plastic surgeons after World War I to create a cosmetic suitable for use as skin camouflage – performers having scars and dermatoses that needed concealing too – but mainly for veterans who had been severely burned.
In 1928 an American university graduate, Lydia O’Leary, utilised her knowledge of chemistry and love of painting to develop a make-up foundation that would conceal her facial port wine stain. Her product, Covermark®, became the first foundation to receive a patent by the US Patent & Trademark Office and paved the way for camouflage products to become accepted as a medical aid, rather than a beauty product. Her original formula was a thick liquid, which later became the camouflage crème we know today. Interestingly it was estimated in 1928 that approximately 15% of sales were to men.
Max Factor died in 1938, the same year that his company was requested by the Ministry of Defence to formulate shades of pan-cake make-up for commandos to use as camouflage during World War II (for example, ‘jungle green’). At the same time the qualities in the product were recognised by the medical profession to use as skin camouflage to mask injuries, so his Factor Company began to create colours suitable for street, as well as theatrical wear.
World War I and World War II led to acceleration in advances in medical techniques. Survival from horrific injury became more achievable and plastic surgeons tested new procedures that would, later in the century, transform both the medical and beauty professions. Although only 32 years old when World War I began, Major Harold Delf Gillies (FRCS RAMC) pressured the Ministry of Defence to open a centre (Queens Hospital, Sidcup, Kent) to develop plastic surgery techniques to repair facial injuries. He performed thousands of pioneering operations there, and was considered by his patients to be the hero of the Somme. In 1920 Dr Gillies published Plastic Surgery for the Face, and was later knighted in recognition of his work. Sir Harold was instrumental in founding the British Association of Plastic Surgeons (B.A.P.S.) and was its First President; 36 people attended the first meeting, which was held on 20th November 1946 at the Royal College of Surgeons, London. In 2006 BAPS changed their name to British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS).
New Zealand-born Gillies (1882-1960) persuaded his cousin to forsake general for plastic surgery. Archibald McIndoe (1900–1960), also born in New Zealand, came to the UK in 1930, taking up an appointment as clinical assistant in the Department of Plastic Surgery at St Bartholomew’s Hospital, London. In 1938 he was appointed consultant to the RAF and, when war broke out in 1939, he selected the newly built Queen Victoria Hospital at East Grinstead as his base. Sir Archibald McIndoe was also involved with the forming of BAPS and was its third president. He was knighted in 1947.
Sir Archibald pioneered saline baths (for burn injuries) during his work at the Queen Victoria Hospital. However, Sir Archibald knew that his patients also needed to regain their self-esteem to enjoy a happy and fulfilled life. His philosophy was that treatment should always be 50% medical and 50% psychological. He allowed his patients to wear their uniforms and civilian clothing (rather than pyjamas) and gave them the liberty to go outside the hospital whenever they wished to local dance halls and public houses. McIndoe realised that his patients could help each other by mutual support; in 1942, with 28 founder members (there were 649 by the end of the war), the first patients’ support group (run by patients for patients) was born. They called themselves ‘the Guinea Pig Club’ as much of their surgery was experimental. McIndoe described it as the most exclusive club in the world, adding that the entrance fee was something most men would not pay. He also appreciated that to help them with reintegration, his guinea pigs might also benefit from a durable skin coloured preparation – skin camouflage! Whether Sir Archibald had seen samples of Covermark remains uncertain, but he was familiar with Max Factor’s pan-cake.
Eve Gardiner (1916-1992) worked in close association with Sir Archibald and Sir Harold Gillies during World War II when the Max Factor Salon in Bond Street, London also offered their services for war victims. Eve is probably best remembered for her remarkable work in teaching those who are partially sighted and blind to apply make-up; she later instigated a training programme with the British Red Cross for them to provide that service. We know that Eve and Joyce Allsworth were colleagues, although when their friendship began is not documented.
Records suggest that Sir Archibald also contacted his friend Thomas Blake (an analytic chemist) to create a topical crème that was skin coloured to help conceal burn scar tissue. Thomas Blake set about this task, perfecting Veil Cover Cream, which was first used by the Guinea Pigs at East Grinstead and eventually went on general sale in 1952. Thomas Blake initially created just three skin tone colours (Natural was shortly followed by Medium and then the misnomer Dark – because it was darker than the other two). Later, Joyce Allsworth was very instrumental in helping Veil develop new colours. Brown and Yellow were her ideas and she also helped by suggesting other skin tones and complementary colours. Thomas Blake died in 1979.
Elizabeth Arden also knew Harold Gillies and, during World War II, created a crème to help conceal. Known as ‘scar cream’, she toured hospitals throughout the USA in the post-war years (children’s wards in particular) promoting her products. Elizabeth Arden was invited during World War II to create a morale-boosting make-up kit for the American Marine Corps Women’s Reserve. She was thrilled to observe them drilling at Camp Wilmington, North Carolina – all wearing her red lipstick, rouge and nail polish that matched their uniform’s chevrons. Cosmetics manufacturers were quick to realise that camouflage products have a rightful place in their ranges and most, if not all, now sell concealers.
At the time of printing, The British National Health Service lists the following five brands of camouflage within the Monthly Index of Medical Specialities (Borderline Substances) and the British National Formulary for reimbursement on form FP10 (which means they can be obtained, at doctor’s discretion, on NHS prescription). These are Covermark, Veil, Keromask (originally developed during the late 1950s by Innoxa USA to camouflage port wine stains, and recognised by the British Medical Association shortly afterwards); the leading German brand Dermacolor (devised by Kryolan during the 1960s) which has over 200 colours to its range, and Dermablend (which was formulated by American dermatologist Dr Craig Roberts in 1983 and now owned by L’Oreal-Vichy) was taken off NHS prescription in 2005 but reinstated in 2011. Additional to the above, other products that are included on the Chemical & Drug Price List can be obtained via a doctor’s hand written prescription.
In the late 1950s a cosmetics company called Atkinsons realised that skin care products could do much to improve the morale of hospital patients. An experimental scheme was set up at St Clement’s Hospital in the East End of London; it proved so successful that in 1959 the British Red Cross was then asked to take over from the nurses trained by Atkinsons and organise a Beauty Care Service in hospitals throughout Great Britain. Joyce Allsworth became an instructor for this service, which was directed in London by Ruth Russell. By 1977 the Red Cross had celebrated training its 3,000th beauty care volunteer.
Another pioneer was Doreen Trust – born with a facial birthmark – who founded the Disfigurement Guidance Centre. She did much to promote camouflage, writing papers for The British Journal of Dermatology and publishing Skin Deep, An Introduction to Skin Camouflage and Disfigurement Therapy (Paul Harris 1977). Doreen Trust remains energetic in promoting laser treatments, especially for port wine stains.
Joyce Allsworth was serving with the WAAF at North Weald, Essex during World War II and was shocked by the facial burns of one particular airman. She came to realise that it was not enough to feel empathy but that something more should be done to help burn survivors. Records suggest that Joyce was aware of the pioneering work by Sir Harold Gillies, Sir Archibald McIndoe and Thomas Blake although no documentation exists of their first interaction. She studied beauty therapy and theatrical make-up artistry skills at the London School of Fashion, but it was not until the Stockport air disaster (1967) that Joyce transferred her skills to concentrate exclusively on skin camouflage techniques.
At the request of Mr J S P Wilson (consultant plastic surgeon at St George’s Hospital, London) Joyce opened an outpatient clinic to help patients who would benefit from skin camouflage. Joyce, who at that time was the chief trainer and examiner for the Red Cross London Beauty Care Service, began to lobby politicians, medical professionals, and indeed anyone she thought might help her promote a skin camouflage service within the Red Cross. In 1975 the Department of Health and Social Services carried out a survey which found that dermatologists were anxious to have this specialised provision in their hospitals. The DHSS approached the British Red Cross Society offering to assist with funding for a training programme to provide a skin camouflage service. A meeting was organised; Ruth Russell and Joyce Allsworth were invited to attend. Joyce’s dreams were at long last being fulfilled when (with an initial DHSS grant of £1,500) she instigated the training programme at the Society’s training centre at Barnett Hill, Surrey. Within three years she had trained 90 students who were providing a Red Cross camouflage service in approximately 50 locations within Great Britain. Joyce continued to train Red Cross skin camouflage practitioners for the following eight years until she left the service.
It occurred to Joyce that National Health Service skin camouflage provision excluded patients who attended private clinics, and those who did not wish to get their doctor involved for fear of being accused of vanity. She also realised that a textbook was needed to encourage people to learn the skills of skin camouflage, either for their own personal use or for use on others. Founded in 1985 BASC is the direct result of a request to form a national support association for skin camouflage professionals through which the principles, skills, expertise and new techniques could be shared – and the rest, as they say, is history! In order to protect its members from financial liability, BASC became a Company Limited by Guarantee in 2007 and in 2008 BASC became a Charity registered in England and Wales. Cover, the principles and art of para-medical skin camouflage was launched during the Silver Jubilee Celebrations (October) 2010. The book, which has been adapted from Joyce’s original work by Elizabeth Allen (principal tutor for BASC) is a comprehensive instruction manual designed to meet the requirements for NVQ students and qualified medical and therapy professionals who wish to increase their expertise and provide this specialist service.
When Joyce died in 1994 she had devoted over 50 years to promoting skin camouflage and training practitioners. Thanks to her tireless work, skin camouflage is no longer a service that has to be hidden away! The British Association of Skin Camouflage proudly continues the pioneering work of Joyce Allsworth and the other pioneers and innovators who made such critical contributions during the 20th century. Now, in the 21st century, BASC is at the leading edge of skin camouflage, drawing on its rich history and experience, to continually look at ways of perfecting techniques and services for patients whilst motivating and encouraging health professionals and other practitioners to become involved with skin camouflage.
BASC trained practitioners pride themselves on the principles and arts they practice the skill of skin camouflage application and their role in helping others in facing the world, with confidence.