Debbie Begent is a speech and language therapist from Buckinghamshire. She works at a busy NHS hospital, helping stroke patients to regain their speech. She then has to dash off to pick up her two daughters - Ellie, 7, and Freya, 4 - from school, and get home to prepare supper for her girls and her husband, Paul.

Many people struggle to balance work and family life, but, unlike Begent, 37, what we don't have to contend with is someone at the supermarket asking: “What's wrong with your face?” She says that's what she finds disabling. “It always completely floors me; it's so unex-pected.” Although she is completely at ease with her birthmark - a large port wine stain that covers half of her face - she remains unsettled by other people's response to it.

“It's not my facial difference but people's reactions to it that disables me. No one asks a bald man what's wrong with his head, but I get asked if I've had a burn or been involved in an accident. Someone once asked me if I'd been kicked by a horse!”

Living with facial disfigurement

How to live with a birthmark

It inspires admiration and alarm in equal measure, but one writer loves her ‘nature’s tattoo’

• Baby reins: good or not?

Related Links

• What is a birthmark?

Like many of the 500,000 people living with a facial difference in the UK, Begent has learnt how to accommodate other people's inability to accept how she looks.

Earlier this year, the charity Changing Faces published research showing that nine out of ten people still tend to make negative assumptions about those with facial disfigurements. The findings also revealed that people with facial disfigurements were likely to be marginalised because little is expected of them socially or professionally.

Begent has had personal experience of this; having decided to become a speech and language therapist, she found her college careers adviser trying to put her off, saying it was a “very competitive career”.

“I presume he meant well, but it didn't deter me,” she says. “True, it took me seven months and endless interviews to get my first job. I was always told it was because of my lack of experience, but maybe my birthmark did put some people off. But now I am judged on my ability and experience and it's not an issue at work. I've never had a patient express shock or surprise at my appearance.”

Despite the occasional rough patch when she was younger, Begent is comfortable with her birthmark. The eldest of two sisters, she was brought up to believe that having a port wine stain on her face was no bar to living a full life. “My mum was a fantastic support when I was growing up. She taught me that I could do anything I wanted. And if people were unkind, then they weren't worth bothering with.”

But sometimes, unknown to Begent, her mother would try to make life easier for her. “I found out recently, when talking to my mum, that she went and talked to all the children at Brownies to explain to them before I joined.”

Accepting difference

And what of her own children? “It's just Mummy's birthmark. We have lots of kids around all the time and they don't ask either. Once, my eldest daughter was playing with some pretend make-up and she took the blusher and painted herself a birthmark like mine, to be like me.”

And her birthmark was never an issue for her husband Paul, who, after 15 years together, she married last year. “On my wedding day, my sister said, ‘You're not going to wear camouflage make-up are you? It wouldn't be you if you did.' And I didn't.”

She had previously tried specialist cover-up make-up, called camouflage make-up, as well as laser treatment. Although port wine stain birthmarks cannot be removed completely, it is possible to reduce their severity with lasers, which close off some of the cap-illaries in the skin.

“I had some treatment when I was in primary school, but it wasn't successful. After I had my second daughter, my birthmark seemed to darken again, so I had some laser treatment to help get it back to how it was before.”

She has now decided to stop treatment. “It mattered more when I was younger, around 19 or 20. But these days, going to the clinic to have painful treatments every couple of weeks is not worth it - I've got better things to do!”

And now Begent is a tele-vision star. Changing Faces recently launched its Face Equality campaign, and asked her to feature in the video. “They invited me to be a face champion and asked me to be filmed for the campaign.” She agreed immediately and the advertisements are being shown in selected cinemas across the country.

Why did she want to do it? “I feel that by speaking out I might make people think twice about how they view someone with a facial difference. And if a younger person reads that I was worried that I wouldn't ever have a happy life, a career, or a family, and they see that I have achieved all these, it may help them in some way.”

She believes that one day our attitudes to facial disfigurements may change, so that people are more understanding of those who look a bit different.

“Once it was remarkable to have female or black newsreaders, now it's not. When people with a facial difference become more visible in the mainstream, it will become less of an issue. And that's the way it should be.”

For campaign details, or to watch the video, go to www.changingfaces.org.uk/News-and-Campaigns/Face-Equality-Campaign

Times recommends

• The Joy of Sex: why you need help in bed
• Don't move - improve
• Adoption: finding my birth mother