By Jane Elliott
BBC News health reporter
Meeting Lucy Palmer it is difficult to imagine she has a serious skin condition that has left her feeling so 'disfigured' that she is embarrassed to go out without her special camouflage 'make-up' on.
Lucy Palmer suffers from vitiligo
Lucy has vitiligo, a condition in which melanin (which gives the skin its colour) is removed in patches.
She has large sections of skin, particularly on her face, hands and feet, which are devoid of colour. She felt so conspicuous she was sure people were staring at her.
"It had got to the point where I was very self-conscious about going out and my make-up was getting thicker and thicker in a desperate attempt to cover it."
Then Lucy, 33, from Tring, Hertfordshire, heard about the Red Cross Skin Camouflage Service, which has just celebrated three decades of helping patients like her, but is still not widely known about.
They showed Lucy how to use their special prescription-only creams to help mask the condition.
She had three lessons from a trained volunteer and now applies her own camouflage.
"I do feel much better. I wish I had the confidence to go out without it on, but I don't," said Lucy.
Skin problems affect up to 25% of the population and form between 15-20% of a GPs workload
The service began in 1975 and is free
Patients have to be referred by a GP or dermatologist
The service was established in 1975 at the request of the Department of Health.
This followed a nationwide survey of dermatologists, which highlighted the psychological and social damage which could be caused by disfiguring skin conditions.
In the 1950s the British Red Cross had established a Beauty Care service in hospitals and psychiatric units across the UK to restore a sense of well-being and aid recovery of patients through the use of massage, cosmetics and hand care treatments.
The Department of Health saw the new service as an extension of this and gave a £5,000 grant to train 50 skin camouflage practitioners.
The skin camouflage clinics, which take only patients referred by their GP or dermatologist, now has more than 250 centres across the UK.
Sheila Simon, a former beautician, who has been working in the service for 29 years, said it has advanced tremendously since it was first started.
"When I first started, I had only three different types of creams and only about five or six colours. Now I have a lot more colours and that makes skin toning much easier.
Skin camouflage can be used to cover a number of visible conditions including burns, surgery scars, acne, rosacea, birthmarks, tattoos, skin discoloration and other dermatological conditions
It can stay on the body for up to four days and on the face for 18 hours
"I can do a much better job now.
"Also we are much better respected now by the medical profession, who know our work.
"I can remember my first two patients. The first had stretch marks and I knew they were going to be difficult to cover and they were. I did not do a very good job of it and I could see the doctor watching me thinking 'that was not very good."
"But then my next patient was someone with rosacea (an inflammatory skin condition which can leave the face swollen and lumpy) and I managed to cover that well and did a good job and the doctor even took pictures of that."
She said that, over the years, the service and herself had become more skilled and had better and more varied products to work with, meaning they were even more effective at covering disfiguration.
The service helps people cover blemishes
"I see all sorts of age groups. The youngest I saw was a baby of just six months with a birthmark whose mother wanted some help before a family christening.
"I also saw an 80-year-old who had discolouration on her legs.
"She was going to Australia and wanted to be able to wear her shorts.
"I saw her when she came back and she said the cream had enabled her to do that.
"When I first started the service was not very well known at all. I barely saw one person every six weeks, but now I can see between 4-10 people each month.
But she said the service was still unknown by many people who could use it.
Sheila Hannay, of the British Red Cross, said it is an invaluable service.
"When the medical staff can do no more, dermatologists and doctors know that camouflage offers a way to help people cope.
"How we look affects our self-esteem and for those people coping with disfiguring skin conditions, the pressure can be particularly hard in our image-conscious society.
"For many clients, the Skin Camouflage Service really has changed their lives. In this, our 30th year, we are committed to reaching even more people in the UK who may want to use this valuable service."
Dr Nick Lowe, consultant dermatologist at the Cranley Clinic, London, and a spokesman for the British Skin Foundation, said the service was an invaluable resource.
"It is really very valuable service for people with disfiguring skin problems and diseases, ranging from somebody with bad acne-scarring to somebody with birthmarks," he said.