Skin Camouflage Service NW Boroughs Healthcare NHS Foundation Trust

A pioneering project with "Changing Faces Charity" was initially piloted within 5 Boroughs Partnership NHS Foundation Trust CAMHS (May 2012). Historically, medical skin camouflage treats chronic dermatological skin conditions not scarring from self-harm which can be a chronic condition.


  • From start: No
  • During process: Yes
  • In evaluation: No


  • Peer: No
  • Academic: No
  • PP Collaborative: Yes

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What We Did

A pioneering project with “Changing Faces Charity” was initially piloted within 5 Boroughs Partnership NHS Foundation Trust CAMHS (May 2012). Historically, medical skin camouflage treats chronic dermatological skin conditions not scarring from self-harm which can be a chronic condition.

1 in 250 people in the UK report self-harm (cutting is the most common form of self harm) and it has become our “hidden epidemic” with potential long term implications for chronic ill health/disability and impact on the wider health economy.

The pilot helped promote positive attitudes, reduce stigma, raise awareness around the role of medical camouflage in mental health supported by positive media coverage. It empowered young people and their families, promoting patient centred recovery. Positive pilot data supported a successful bid for Strategic Health Authority Innovation Funding (£225K) to design, deliver and develop the service as part of secondary care mental health recovery packages across all ages.

This service was used by a female service user in Secure Services. All she wanted to do was to go swimming. Camouflage enabled her to do that, after which she made notable progress in her recovery. She was also much more engaged with her care on the ward.


Wider Active Support 

This work would not have been possible without working in partnership with “Changing Faces” and the support of Wigan CCG.

A pilot clinic for 10 young people was held in Wigan, in partnership with “Changing Faces” charity (May 2012). Qualitative and quantitative analysis included evaluation at baseline and 3 month post consultation.


We have a Service User Involvement Group and a specific Involvement Group for CAMHS called “SHOUT”. At all stages young people are included in all our initiatives.

Prospective evaluation of this service included qualitative and quantitative analysis at baseline and 3 months post consultation. Qualitative measures included service user/carer experience questionnaires, user/carer stories, including a short film and reflective diaries completed by staff.

Patient Experience:
98% of service users felt the clinic setting within their mental health team was vital, feeling safe and supported.
95% felt the skin camouflage consultation worked well, improving confidence, enabling them to engage in activities they had previously stopped due to self harm scars.

A positive shift in group average WEMWBS score of between 3 and 8 is clinically significant.  Qualitative data from users/carers was sought and reported reduction in anxiety and improvements in well-being, including reduction in self harming for some.

Patient Stories:
“I was really chuffed when children in my nursery placement did not notice the scars on my arms”

“I went to the hearing voices group and was able to take my coat off for the first time”

“I am very scarred ….. to have confidence back I may now have a better life”

“The staff were great, I felt safe and able to expose my secret …. finally get help…”

Staff Reflective Diaries:
“An inspiring journey and experience, learning a new skill, so simple but so life changing for the service user …. I’m part of a team making a positive difference…. empowering them …. helping them overcome the stigma and secrecy of self harm”

Looking Back/Challenges Faced

We were well supported throughout the project and are happy with the plan we used.

The challenges were to get buy-in and uptake from Service Users who had tried other products unsuccessfully. We worked with a small group and produced a video to show the results.

The initiative has been taken forward and this has not been a challenge as people have seen the remarkable outcomes.



We have expanded the training to Assistant Practitioners and produced a short film.



Further evaluation of the long term impact of medical skin camouflage for self harm, across the health economy, would be recommended as well as further study within the primary care setting and high risk groups, eg: females in the prison setting. An RFPB Grant has been submitted with the University of Manchester to do further study in prisons and several expressions of interest from NHS, third sector and independent sector organisations have been received.



This formed a patient story to our Trust Board, and will be featured in the National Positive Practice MH Guide, and is a previous winner of a National Positive Practice in MH Award.




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