Using the prism of skin disease, this short letter examines the overall impact that disfigurement can have on sufferers' lives. Often trivialised by health professionals and laypeople alike, the common misconception that skin disease is not 'serious' is challenged. Looking in turn at the overall psychosocial impact and psychiatric co-morbidities, the effects of stigmatisation are examined as well as the coping strategies to which patients turn. By providing a brief overview of the factors that must be considered in clinic, the worthiness of adopting a holistic approach to one's patients is emphasised.