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The effects of physical appearance on self-esteem when you have a visible difference

We explore how physical appearance and self-esteem are related, and how you can improve your confidence if you live with a visible difference.

Physical appearance and self-esteem are often closely linked. Our perception of how we look can have a big impact on the value we place on ourselves and how much self-confidence we have in our day-to-day lives.

Although low self-esteem can be a particular problem for people living with a visible difference, it is not fixed and there are things we can do to improve it.

On this page, we explore the effects of physical appearance on self-esteem. We also look at how you can improve your self-esteem if you are living with a visible difference or disfigurement.

What is self-esteem?

Self-esteem is the value and worth we attach to ourselves as a whole. It can be influenced by several things. One is how we feel about our appearance, also known as our body image. If we don’t like something about how we look, it is often difficult to feel good about other aspects of ourselves.

Self-esteem is often connected to self-confidence. Self-confidence is the level of trust you place in yourself to do well in a particular situation, and it can vary for all of us depending on our mood, our recent experiences or the context. For example, you might feel confident in your ability to do your job well, but less confident about socialising with work colleagues.

If your sense of self-esteem is low, it can leave you lacking in self-confidence as you approach different situations in your life.

How are physical appearance and self-esteem related?

You may find that your feelings about your physical appearance and self-esteem go hand in hand, particularly if you experience frequent negative reactions or comments. You may be familiar with being stared at every day. People may even make unkind or pointed comments.

Although this says more about others than it does about you, it can be difficult to feel confident when you frequently experience people acting thoughtlessly or unkindly. Understandably, you may fixate on these negative reactions, leading to feelings of worry, depression, distress, upset or anger, as well as apprehension that others will stare or be unkind. This can make you avoid certain situations or feel anxious about going out at all.

It’s never nice when people say unkind things about how I look. When I was younger, I used to take it really personally and feel really bad about myself. Now I’m older I just think it’s really sad that people have to say horrible things about how another person looks – they must be really miserable. Fair enough if people are curious, but what possible reason does anyone have to be that unkind to someone they don’t know?


How does self-esteem develop?

People are not born with high or low self-esteem. Self-esteem develops over time and can fluctuate. This is the same with body image – your perception of your own appearance may change over time, along with how much emphasis you place on your appearance. Feelings about our physical appearance and self-esteem are often related because we live in an image-orientated society.

Feelings of self-esteem can vary depending on whether you were born with a visible difference or disfigurement, or acquired it early in life, or experienced a change in appearance later in life.

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Early life

If you were born with a visible difference or acquired this early in life, you may have had some difficult early-life experiences. This could include being teased or bullied, spending long periods in hospital, not being able to play with others, or being unable to do things you saw others around you doing.

If people made comments about your appearance, you might have started to feel negatively about your physical appearance. In turn, this may have affected your self-esteem early on, making it difficult to see positive qualities in other aspects of yourself and leading to a general lack of self-confidence.

Later life

Self-esteem and body image can change over time. If you have experienced a change in appearance later in life, you may have developed low self-esteem because of the visible difference or disfigurement. It may have affected your sense of identity – perhaps you feel like you don’t recognise yourself or that you don’t know who you are anymore.

Many people experience a strong sense of loss as well – a loss of self-image, self-identity and of the person they were before the change in appearance.

What affects our self-esteem?

We have limited control over the things happening around us and other people’s actions (our external world). How we interpret these situations and behaviours affects how we think and feel about ourselves (our internal world). Our self-esteem is influenced by the interaction between our external and internal worlds.

This can explain our behaviour as well as how we feel. Being SCARED connects our feelings to our actions:

Self-consciousact Shy
Conspicuous (standing out)Cover yourself up
Angry or anxiousbe Angry or anxious
Rejected – like people don’t want to know youRetreat – pull away or hide from people
Embarrassedbe Evasive – ignore people
Differentact Defensively – try to protect yourself

How you can improve your self-esteem

Although we have little power over our external world, we do have some control over how we react inside to what is going on around us. Learning how to take control of our internal world is one way of disconnecting our physical appearance from our self-esteem when living with a visible difference or disfigurement.

After I got help with my anxiety and depression, that’s when I looked at things completely differently. You are in control of how you respond to a question or statement. That thing that puts you in the driving seat is confidence.


Here are a few of the thought processes that can negatively impact our self-esteem and some tips on how to avoid them:

Comparing yourself to other people

You might make comparisons with other people you know or admire celebrities and want to be more like them – in looks, skills or achievements. This can affect your self-esteem, as comparing yourself to someone you think is “better” may mean you are unable to appreciate your own qualities or achievements. It’s easy to let physical appearance and self-esteem become closely connected in our highly image-orientated society.

The reality is that everyone is different – in appearance, talents and abilities. We all judge ourselves against others, but part of building confidence is about recognising our own qualities, talents and abilities too.

Not seeing your good points

You may find it hard to recognise your good qualities, focusing instead on all the things you don’t like about yourself or feel you can’t do well. You may lack confidence in your abilities, qualities, and judgement. If you live with a visible difference, this may relate to your worries about your appearance.

But while everyone has weaknesses, there are many things we all do well. If you find yourself focusing on the negatives, counterbalance this by thinking of one skill you have or one thing you have done this week that you are pleased with.

Thinking that no matter how hard you try, you will never be accepted

Worries about our visible difference may make us feel like we are not worthy, valued or wanted by other people as a friend or partner. This is an understandable feeling in a world where so much value is placed on appearance, but real relationships are based on so much more.

Think about your relationships and reflect on what is it you like or love about those people – it probably isn’t how they look! More likely, you value things like their personality, the activities you enjoy together, their sense of humour, their warmth or their conversation. Other people will think of you this way too.

As well as taking on negative thought processes, there are other practical ways to tackle low self-esteem related to how you feel about your visible difference or disfigurement:

  • Have a good support network around you (family / friends).
  • Don’t suffer in silence, speak to someone if you feel low.
  • Do the things that you enjoy. Have things in your life that make you happy or fulfilled.

“I have found remaining positive challenging at times but can honestly say it is the best path to take. My disfigurement has made me feel inferior, unloved, inadequate at times and it is difficult to replace these feelings with positive ones particularly if you’ve had negative experiences. Over the years I have also learnt that my disfigurement is a small physical part of me so I make sure that when I go out I take care with the rest of my appearance. I make sure my hair looks nice, that my clothes are presentable and I wear accessories. I find a pretty scarf or a chunky necklace distracts attention from my face.”


We hope this guide helped you better understand the effects of physical appearance on self-esteem – for practical tips, take a look at our confidence-building tools below.

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Three tools which you can use to boost your confidence, including a technique suggested by Alison, who has a visible difference.