Vanessa Jane Davies is the founder of Skin Camouflage Services, an independent expert practice offering paramedical skin camouflage, non-invasive scar therapy, and Expert Witness services. The UK’s most experienced provider of Expert Witness opinion on paramedical skin camouflage, Vanessa has provided expert testimony in over 650 cases. She tells us more about her fascinating line of work and why she finds Expert Witness work so rewarding.
Expert Witness work has enabled me to progress my career in a direction I had never imagined.
I began my career as an Expert Witness in 2007. I was working as a skin camouflage practitioner when a client, who is a solicitor, introduced me to the idea of offering my skills and experience as an Expert Witness in paramedical skin camouflage. They nominated me to work on my first case, and it has all grown from there!
Skin camouflage is still unfamiliar to many, including those in the medicolegal field.
I recently had a barrister call me to discuss a case he was representing and wanted to understand how skin camouflage could help his client. He was fascinated, especially when he was able to see ‘before and after’ photographs!
My work is very different from that of other technical or medical Expert Witnesses.
I’m instructed to provide my expert opinion regarding individuals who have acquired visible skin differences, such as scarring or changes to the skin’s pigmentation, as opposed to those who were born with them or developed them due to illness.
I will assess whether skin camouflage is suitable or advisable for their needs and provide a comprehensive report of my findings. My reports include quantum costs according to product requirements; follow-up support over time; and other considerations, such as SPF protection, emollients, and non-invasive scar therapy.
I’m instructed to assess a wide variety of cases.
The most common involve road traffic collisions, dog attacks, and workplace injuries like scarring, burns and electrocution. I’m also instructed on cases involving aesthetic and clinical interventions that have resulted in adverse visible skin differences. I’ve been called upon to provide expert opinion for police officers and members of the armed forces, and cases of self-harm in vulnerable young adults who have experienced trauma in care.
I’m instructed to assess children and young teenagers more frequently than you might expect.
Between the ages of five and 11 is the most common age for a child to be assessed for their future needs regarding skin camouflage, which will become relevant when they are old enough to make their own decisions. It is invaluable and reassuring to both the child and their parents to know there is a plan for the future when they are ready.
Some cases I’m instructed on can be incredibly complex.
To project a person’s current and future requirements and associated quantum costs, I need a clear understanding of what’s happened to them in the past and any implications of future surgery or changes that could affect their needs.
Para-medical skin camouflage is a separate specialism; I am neither medically trained nor required to be.
However, I sometimes turn to Gill, a registered nurse, to help me understand the complex technical language and the medical implications of the claimant’s circumstances.
Gill has a wealth of experience in intensive care, operative surgery and healthcare regulation. She ensures that I understand the medical aspects of some of the more complex cases, which in turn enables me to form my opinion on the expert issues related to skin camouflage.
Having that medical insight helps me make more informed assessments and understand how the person may realistically be able to reproduce the skin camouflage I recommend for them in their day-to-day life.
Skin camouflage can be complex in terms of meeting a person’s specific needs.
I can’t take for granted what a person perceives as their priority. Without exception, the first thing I ask someone at a skin camouflage assessment is, “What do you feel about your scarring/other visible skin difference, and what areas would you like skin camouflage to help with?”
I have had people with significant scarring who want to focus on one aspect of it, while others may see things very differently. Culture and religion can also influence how a person responds or copes with their altered appearance.
Above all else, skin camouflage is about trying to restore some ‘normality’ as far as is possible; it’s not enhancement, and it is not makeup. So many times, people tell me, “I just want to look like me again.”
I never tire of seeing the impact that effective skin camouflage can have.
For some, it really can be life-changing. While it can’t undo what has happened to a person, it does help restore their sense of self and personal confidence. That’s why it is so important for me to see the individual in person and provide them with a practical trial application of skin camouflage, expertly colour-matched and tailored to their specific needs and abilities.
I always encourage people to have a go and demonstrate that they can reproduce what I have shown them. It helps me inform my report in terms of the individual’s engagement and ability, and formulate quantum costs.
Some claimants have already received advice or guidance on skin camouflage before I assess them.
It’s usually been done through the hospital where they were treated or through a charity. In such instances, the breadth of expertise and access to a full range of products and techniques is limited. Although a restricted range of skin camouflage products is available on NHS prescription, funding requires prior approval and is typically restricted to the provision of skin camouflage for the face only.
I consider myself fortunate to own Skin Camouflage Services in its entirety and have no financial or product affiliations with suppliers, manufacturers, or service providers.
To be truly independent is crucial because it gives me the freedom to seek out the best skin camouflage solution for each individual. I make a point of staying up-to-date with product development and availability.
I never fully know what is needed until I begin the colour matching and trial application process.
I carry a considerable range of products to ensure I can meet most needs. When I travel to any of the six locations around the country where I hold clinics, I do not travel light!
Once the individual and I have agreed on the application combination best suited to their needs, I can form the basis for the product prescription and projected quantum costs in real-time.
Usually, scarring or acquired visible skin differences are permanent.
When a person starts using skin camouflage, it is common for them to continue using it in the long term, so follow-up support over the years is necessary. I ensure that there is sufficient ‘wriggle room’ within the projected costs to reasonably allow for the substitution of one product for another over time.
It is rare for a skin camouflage Expert Witness to be summoned to go to court.
I have been called once, and it was a pretty daunting experience. I read and re-read my EWI training notes beforehand! Once it was over, I could appreciate that it was a great learning experience.
What supported me through the cross-examination was being confident about my assessment of the individual being discussed. I had seen them in person, so my recommendations were based on the real-time practical application of products, which informed my prescription and quantum costs accordingly.
My opinion was upheld, which was very satisfying professionally and supported my credibility as an informed Expert Witness.
I believe it is essential to have a real-time face-to-face assessment.
I have felt pressured by my instructed parties in the past to assess claimants remotely. I explain that I don’t provide an opinion and report based solely on photographs and documents, as I can’t be sure that the photographs fully reflect the extent, texture or appearance of the scarring or other visible skin differences.
In practice, lighting and movement of the affected area can significantly impact the appearance of scarring and how it may be addressed, so a photograph is not a reliable source of information.
I will only agree to an assessment via video link in exceptional circumstances, provided that it is followed up by an in-person practical application of skin camouflage.
In my view, where an Expert Witness opinion is provided on the basis of photographs or a video consultation alone, there is a risk that the skin camouflage prescription proposed will not be as required in practice, and the opinion presented may not be robust if challenged.
I am predominantly instructed by the claimant.
Approximately 25% of my instructions are for the defendant, and 15 % are joint instructions. Of course, the primary consideration is that my duty is to the court, and that my opinion is my own and is provided as instructed without bias from the instructing party.
My advice to a skin camouflage practitioner considering becoming an Expert Witness Is…
First and foremost, you need to be a truly experienced practitioner. Ensure your practice is current and that you have a sufficient breadth of experience to provide credible, practical solutions for complex scarring, including burns and other acquired visible skin differences.
Secondly, and equally important, ensure you have recognised training and accreditation as an Expert Witness and take responsibility for your own professional development as both a practitioner and as an Expert Witness.
Expert Witness work is very satisfying.
When I am instructed to assess a claimant, it’s likely their only opportunity for a professional colour match application of skin camouflage applied by an experienced, independent expert who has unrestricted access to the most appropriate products that can help them. Making that difference to help restore a person’s sense of being themself is hugely rewarding.