William Shakespeare may be partly to blame for the social stigma associated with disfiguring skin conditions, say experts.

They point to memorable insults in his plays that refer to skin blemishes and scarring, reflecting an Elizabethan obsession with flawless, pale complexions.

One of the most graphic insults occurs when King Lear launches into his scheming daughter Goneril, declaring: “Thou art a boil, a plague sore, an embossed carbuncle”.

Other examples include use of the phases “a pox upon him” in All’s Well That Ends Well and “scurvy knave” in Romeo and Juliet, while in Henry IV part one a man’s red nose is described as “an everlasting bonfire light”.

Marcius Coriolanus wishes “boils and plagues” upon his enemies, and a young couple in A Midsummer’s Night Dream are exhorted to have children with “never mole, hare lip nor scar”.

Dermatologist Catriona Wootton, from Queen’s Medical Centre, Nottingham, who took part in a language analysis of Shakespeare’s plays, said: “Rat-infested and with open sewers, overcrowding and sexual promiscuity, Elizabethan London was a melting pot for diseases such as plague, syphilis and smallpox. Many of the diseases of the time involved lesions or sores on the skin, so skin imperfections were seen as a warning sign for contagious disease.

Nobody is suggesting that we edit Shakespeare, but maybe we should ensure that new films and books don’t reinforce this stereotype

“This was not limited to signs of infection, but to any blemishes or moles, which were considered ugly and signs of witchcraft or devilry.

“Shakespeare uses these negative undertones to his advantage, employing physical idiosyncrasies in his characters to signify foibles in their behaviour.”

The researchers argue that the Bard’s colourful language has helped to perpetuate negative attitudes towards imperfect skin.

Nina Goad, from the British Association of Dermatologists, said: “It is interesting to note that much of the Elizabethan stigma over disfiguring skin disease still persists today. Over the last few decades dermatologists have tried to address the effect this can have on patients. However, even now, many examples exist in films and literature where visible disfigurements are used to represent villainy or malice.

“This is particularly concerning when such films are aimed at children, who learn that beautiful, flawless people are kind and trustworthy, and scarred or blemished people are to be feared.

“Nobody is suggesting that we edit Shakespeare, but maybe we should ensure that new films and books don’t reinforce this stereotype. Many skin patients require psychological support to deal with the visual aspect of their disease.”

The findings were presented at the British Association of Dermatologists’ annual conference in Glasgow.

Shakespeare

Most memorable insults

• ‘Thou art a boil, a plague sore, an embossed carbuncle’– King Lear

• ‘Thou art a perpetual triumph, an everlasting bonfire night. Thou has saved me a thousand marks in links and torches’ – Henry IV

• ‘A pox upon him’ – All’s Well That Ends Well

• ‘Never mole, hare-lip nor scar... shall upon their children be’ – A Midsummer Night’s Dream