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To Face The World (280:138 px).png

We all have a relationship to beauty: on appearance, cosmetics and ethics. 

From a young age I have questioned the relationship we have individually and collectively to beauty, appearance and our body.

Born with my birthmark, I was always reflected and reminded of my look in the eyes of another. 

But how do we relate collectively, individually and tolerantly to beauty, appearance and the ethics to it?

I see an enormous demand for cosmetic treatments and I am not the only one. A lot of research has revealed to us the intricacies behind the impact of beauty ideals, cosmetic intervention and acceptance of ourselves.

The demand and focus on beauty stems from an ideal image, the beauty ideal.

If we start with 'what is beauty and is there such a thing as universal beauty?', then we can delve into history.

Historic notions of beauty

The ancient Greeks already thought about beauty and, for example, Pythagoras (that dude from math-class in high school I surely didn't like) said for instance that “beauty can be expressed in numbers”, something I widely discussed myself with my cum laude quantum and technical mathematical dad who to this day still believes ‘I am good with numbers’, while my high school results barely reflected that belief. 

An aspect intimately associated with beauty and attractiveness is symmetry. Symmetry contributes to liking something and therefore also liking a face or the appearance of someone.

A little after the Greeks, the Golden Ratio (Gulden Snede in Dutch) was also considered an expression of beauty. Research shows that when people have a lot of this ‘divine proportion’ to their face or body, they are considered very attractive.

Over the centuries, many other ideas about beauty have been added, such as in the Middle Ages, where the Divine received much more attention and was also seen as that beauty is not something that can be expressed in numbers, but beauty is something that is inspired by the divine. And with that, that the body and the face are the channels for the divine to be shown. 

In Romanticism, a little later, in the 19th century, it was understood that when someone had something unique, that that would make someone beautiful or attractive. 

The idea of ‘the unique’ or ‘the individual’ became more important in the 20th and 21st centuries.

A little more contrary to the ‘unique’, there have been many artists who have collected and put together all kinds of images of female faces, combining these images resulting in an 'average face' that was seen as very attractive, a universal face.

Thanks to the rise of global media and technological advancements, we can easily superimpose images and share them with each other. And perhaps something like universal beauty can emerge.

Yet, why is beauty so important?

Research shows that appearance and beauty are not just linked to how attractive someone is, but when someone looks beautiful, that person is also seen as someone who is likely to be healthy, someone who is fit, youthful, and even someone who has a good character. 

This is called The Beauty Is Good-bias with the opposite happening too: someone who is not attractive or is not considered beautiful is also seen as someone who is not healthy, does not tell the truth, and could be a bad person. On top of this, one can internalize the conditioning and believe, for instance, he or she is a bad person for not looking a certain way. 

You understand that this can cause problems and even discrimination. This was the topic of my graduation research at the VU University Amsterdam: discrimination based on appearance, lookism, stigma and beauty. This too was also the initial wink for me to start To Face The World. 

We are not always aware of the effects of how we relate to beauty.

We can trace this back to the Middle Ages, where a very pockmarked face was associated with someone having the plague, and which therefore was believed you had to stay away from.

Today the remnants of these problematic beliefs still live in us. When someone has bad skin, we tend to stay away from them, unconsciously believe they are not clean or are eating unhealthily or any other intenalized bias. 

I myself can easily recall the times when I was found myself in quite busy public transport without anyone sitting next to me and me thinking that it was because of my face, which it indeed may have been. The question then what this does to the person experiencing this beauty-bias, is what I have studied extensively - psychodermatology; the relationship between mind and skin. 

To take it a little deeper, beauty is something that determines our identity. John Goffman, who in 1960 wrote about the impact of stigma, identity and the 'self', wrote that our face is the home of our identity. We think that our 'self' is located in the head with the face as the billboard of our selves.

Nevertheless, the perception of beauty is always subjective.

Even when it comes to perceiving your own beauty. When you look in the mirror, or into your phone camera, you see yourself, but you look at your own appearance through the eyes of someone else. 

This is where the ideal of beauty plays a role; we have the ideal and gaze of the group in our heads and through that gaze is how we view ourselves. 

On top of that, we don’t look the same every day. As a woman you go through a monthly (hormonal) cycle, which affects your appearance, the perceived symmetry of the face and tones of skin. We all recognize the feeling that some days we think we are more beautiful than others, dependent on so many factors but combined with the group's view in the back of our minds, this has an effect on how we see ourselves and others too.

Beauty and attractiveness play a major role in our lives. Because of our relationship to beauty, the conditioning we are exposed to and the age-old beliefs we carry, discussions are arising whether beauty should be compensated. Or whether cosmetic treatments should be reimbursed by health insurance, because otherwise it would cause discrimination.


When we look at cosmetic treatments, we see that these treatments are becoming increasingly normal. Just like going to the dentist or hairdresser, we can now go to the cosmetic clinic. With technological developments, treatment becomes more common and accesible; it begs the question, why you wouldn't do cosmetic treatment if you can?

The possibilities alter our (collective) behaviour and technology is not only one-sided in its effects anymore. Today it is not merely us using and developing technology, but arguably perhaps technology is developing and using us. 

With laser treatments widely available and used by many, our collective understanding of what is normal and what is not is changing. For example, with so many removing body hair, we can start to believe body hair should be removed. With this development we accept body hair less and less. Technology is influencing and changing our behavior and understanding of appearance, normalcy and beauty. 

For me personally the question arises is whether the ones who have access leave behind the ones who have not. I, for one, know that with my portwine stain birthmark not all cosmetic treatments will be accessible for me. Will I then lack behind when it comes to trends, beauty ideals and normalcy?

Aside from personal considerations, recent research was done on young people in the Netherlands and how they view cosmetic treatments, showing that young women with an average age of 21 have an exaggerated idea of how many people undergo cosmetic treatments. Their belief that many women undergo cosmetic treatments (which does not correspond to reality and the actual numbers of whom undergo cosmetic treatments) partly leads to cosmetic treatments becoming more and more normal. When you think that many people undergo cosmetic treatments, you are more likely to do it yourself.


Another interesting phenomenon is that meeting beauty ideals comes with ethical dilemma’s. Research containing interviews with dermal therapists in the Netherlands (from the University-track Dermal Therapy that I teach in patient communications, psychodermatology and quality of life to red.) shows the dilemma that professionals in the cosmetic industry are regularly confronted with where parents, both mothers and fathers, want their child to undergoes cosmetic treatment, who strive for the ideal for their son or daughter, often when the child is not yet concerned with beauty or can say that they would like that treatment themselves. For example, when removing a wine stain like I have.

My parents decided to stop laser treatment in the 1990s when one of the treatments went terribly wrong and I was burned by the laser. Because of this experience, they realized even more they wanted to give me the choice to continue with treatment or not and to give me the opportunity to decide for myself what I did or did not want for my own face and body.

Does the professional go along with the parent out of fear that the child will be bullied about the port wine stain? Or do we immediately assume that you are being bullied with a port-wine stain?

Or will the professional support the child and postpone the (very painful) treatment of the port-wine stain until the child can decide for himself?

Do we focus on the resilience of the child, or the malleability of the body?

Naturally, for myself and with my clients, I focus on the resilience of every person.

To close off this ethical dissertation, there is the popularity of anti-aging treatments, at age 30 or younger, to combat the show of ageing skin. This phenomenon has to do with the phenomenon of 'self-group distancing'; ensuring that you remain part of a certain group for as long as possible (the youthful), with the added feeling that if you belong to a certain group, you are no longer attractive (elderly) and with all the associated effects we spoke about early that can inflict discrimination (less fit, less intelligent, less beautiful). We call this selfgroup-distancing affect and the implications of discrimination on the basis of age as a consequence of it, ageism

How do you determine age? Yes, by looking at the skin, the wrinkled skin.

However, growing to old age, isn't that coming with and showing wisdom?

Shouldn't you show respect for an ageing appearance because it is essentially a biological process? Isn't accepting the ageing body a wise decision?

All you have read so far is all part of the discussion and discourse on beauty, appearance, lookism and cosmetics with ethics combined. I continue to do research on these subjects and teach on in university. 

When I ask you what beauty is

My most treasured question remains: how do we take care of ourselves when all the beauty ideals are thrown around us on social media, with influencers (driven by money) showing all kinds of ideal images and all of us having a deep universal yearning to be seen as good, beautiful, attractive and worthy individuals?

I always arrive at the deepest and most universal understanding of beauty…

When I ask people what they think is beauty and beautiful, the answer is never "someone with the smoothest skin, full lips and no hair". 

Everyone says "that has to do with radiance, a beautiful radiance emanating", 

and cosmetic treatments can contribute to this. But then two things are important:

1) the decision must be made autonomously

2) the treatment must be carried out by a very good professional

Autonomy is needed for us to truly feel good about our appearance and the decisions we make for it. We need distance and autonomy from the conditioning and beliefs we are inflicted with as described in this whole article. 

Because with autonomy we can make decisions for ourselves about our relationship to beauty, cosmetics, and appearance, without pressure from our environment making us insecure.

With autonomy, we can go as far as we decide with treatments, knowing of radiance shining through appearance, realizing that for that radiance to shine outwards through our appearance, completely different things are needed that have perhaps very little to do with external treatments and perhaps more with the deeper layers of relating to beauty <3 

with love,

This article is inspired on academic research, including but not limited to; the work of Goffmann, Notes on the Management of Spoiled Identity, Naomi Wolf’s The Beauty Myth, research  To Face The Work: an ethnographic study into the experiences of people with visible differences in the workplace by Tessa Schiethart for VU University 2019. 

Ps. for reactions, your contemplations and visions on this article, please send an email to


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