The first time Piroska Cavell, a 56-year-old skin specialist from Whitstable, was aware that she had a birthmark on her face was when she was around five years old.
"A child said something mean to me at school and it upset me, so I came home and told my mum," says the mother-of-two.
"Mum told me not to worry about it, that my birthmark made me special and that I should ignore the comments. She handled it beautifully, perhaps because she also had a visible scar on her eye from where she had been bitten by a spider as a child.
"She must have realised the comments I would face throughout my life so wanted to give me confidence. It really helped. From that day onwards, I looked at my birthmark in a different way, as something that made me unique."
More commonly known as a ‘port wine stain’, capillary malformation such as hers is caused by widened capillaries which cause a red or purple mark on the skin, most frequently on the face and neck. About one in every 330 babies is born with one and they are roughly twice as common in girls.
They do not usually cause other symptoms. But charities such as Changing Faces and The Birthmark Support group say that those with facial birthmarks are at an increased risk of low self-esteem and problems with self-image.
Hurtful comments from strangers
Cavell admits that her birthmark isn’t as large as many. But it hasn’t stopped cruel remarks from strangers and she admits that in her younger years, these careless comments hurt.
"I once walked into a pub in my early twenties and a group of young lads started shouting ‘Mole!’ at me like in the film Austin Powers and I was horrified," she says. "Another time I had popped into a cosmetics store and one of the demonstrators asked me if I’d like my make-up doing. I agreed and told her I was going on a hot date that night. She said, ‘Oh you’ll want that [birthmark] covering up then won’t you?’ I said, 'Actually, no, I’d like to keep it.'
"A few years ago, when I was working in a hospital as a midwife, one of the senior doctors said to me, ‘You know you can do something about that birthmark don’t you? I’m amazed your parents didn’t get it removed.' By this point, I would laugh about remarks and said to him, ‘I’m amazed that your parents didn’t do something about your face too!"
But despite the stares and the comments, Cavell has never thought about any kind of treatment to remove her birthmark. In fact, today she is the founder of an aesthetics and weight loss clinic, helping others to feel better about their reflection.
Self-conscious teen years
"I went through my childhood not really caring about my birthmark, but once I hit my teenage years, I began to feel more self-conscious about it," she says. "Of course, I tried covering it up. When I left school, I trained in hair and make-up and part of the course was cover-up make-up for people with birthmarks and scars.
"I practiced on myself and I hated it. When I looked in the mirror and couldn’t see my birthmark it didn’t look like me so I decided to leave it alone. Now I’ve noticed that in photographs, I always present my birthmark towards the camera because it’s such a big part of me, I don’t want to hide it."
"Children do stare at me but that’s normal and if they ask me about it, I tell them it’s where an angel kissed me and left a heart, because it’s heart-shaped. But most of the time I forget it’s there."
After a career in midwifery, Cavell set up her own wellbeing clinic clinicsese.com and freely admits that she has regular tweakments such as Botox, although she still feels no need to hide her birthmark.
"I first had Botox when I was 48 working as an agency midwife in the Channel Islands," she explains. "I had been working a lot of shifts and was also on a mission to get super-fit for my 50th birthday. Lots of heavy-lifting and night shifts is a great recipe for intense crows feet!"
On her first ever Botox session, she says, "I loved it immediately. I looked fresh and awake. I have Botox roughly every six months now. I don't have it to the degree where it freezes your face so I've kept my normal facial expressions. When my lines and wrinkles begin to reappear between treatments I'm not horrified, but I just feel better when they aren't so obvious – the same as grey hair."
She can see the irony that she hides her crows' feet with Botox but wears her birthmark with pride.
"My birthmark has always been there and is part of my identity whereas lines and wrinkles haven’t," she explains. "They are a visible sign of ageing and I'm just not ready for them yet. Some see this as contradictory but it comes back to what bothers you personally, not what others see and may assume would bother you."
Looking young and healthy
"It's all to do with not feeling as old as my chronological age," she adds. "I don’t want to look like I did in my twenties, that would be ridiculous but I don’t see anything wrong with looking as good as you can at the age you are. People don’t comment that I look younger than I am and I don’t believe Botox alone can achieve that for you. I'm also passionate about maintaining a healthy lifestyle."
From a work point of view, Cavell says living with and learning to love her own birthmark has given her a better insight into the minds of her customers who want to make changes.
"When clients come to see me, I always ask them to look in the mirror and tell me what they see because I may see imperfections that they’re happy to live with and they might see imperfections in their own face that I don’t see," she says. "It really gives you a different perspective but I’m all about making people feel good about themselves at the age they are now.
"I really don’t like the bog-standard ‘beautiful face’ – all the same eyebrows, lips and tans. Thanks to social media, I think young women – and some young men – are under so much pressure to look a certain way and it hides their natural features which is such a shame.
"But I know that being in the beauty industry and having such a visible blemish is unusual, so I pre-empt any questions, by mentioning my mark and saying how happy I am that it’s part of me. It’s great because I’ve had clients who say to me that they’ve become more confident about their own imperfections – whether it’s acne scarring or pigmentation – thanks to seeing how I deal with mine.
"They’ve been really self-conscious about theirs but I’ve helped them see that it’s part of them and they’ve gone out into the real world feeling better about themselves. That’s brilliant. I want to help people shine a light on their uniqueness and truly celebrate it."
Watch: Changing Faces: People with a visible difference speak out