Infantile Reaction to Facial Disfigurement

The emotional history of a child born with a hairy nevus covering half of his face is presented to illustrate the emotional trauma engendered in infancy by facial disfigurement. The child's reactions are significant because he had the ability, lacking in most young children, of making his anxiety apparent to adults.

It is frequently stated that a surgical procedure in a child under 3 years old is a traumatic experience and that elective surgery is best postponed until at least 5 years of age.^1,2 Separation anxiety and activation of unconscious fantasies about mutilation, castration, and death may traumatize the infantile ego permanently.^3,4 The authors are not in agreement with this concept and feel that the trauma children experience in a hospital environment is due to separation anxiety alone. It can usually be controlled by handling the child in a reassuring fashion and by the mother's presence during the