It’s as old as cinema itself: if you want to drive home a bad guy’s nefarious nature, give them a big facial scar. From Darth Vader to The Lion King’s imaginatively named Scar, for as long as films have existed, film-makers have conflated disfigurement with mental instability or malevolence. The trope is still going strong in Avengers: Infinity War and Solo: A Star Wars Story – physical otherness equals evil.

It goes back a long way: in 1926, Nosferatu gave Count Orlok overgrown teeth and a huge nose, while Boris Karloff is the scarred Monster in 1931’s Frankenstein. Nowhere is the trend more obvious, however, than in the baddies of the Bond films, where five of 007’s major adversaries – Ernst Blofeld, Renard, Emilio Largo, Le Chiffre and Raoul Silva – as well as numerous henchmen – are notably scarred or disfigured. In the Star Wars franchise, a high proportion of the bad guys have scars or other disfigurements: Darth Vader, Darth Sidious, Supreme Leader Snoke, Cornelius Evazan, Kylo Ren, and now, courtesy of Solo: A Star Wars Story, Dryden Vos. Last year, Wonder Woman featured a female villain in Isabel Maru, notable for her facial disfigurement hidden with a ceramic mask, while Black Panther and Avengers: Infinity War had scarred villains in Ulysses Klaue and Thanos.

But what of heroes with facial differences? “There are limited ones,” says Phyllida Smith, a representative of the charity Changing Faces. “Wonder is definitely positive and pretty accurate given it covers the issues faced by a young boy with a craniofacial condition, although it’s contentious that they decided to cast a boy without the condition and instead used prosthetics. In terms of scars, we tend to only really be able to refer to Harry Potter as a positive portrayal.” Harry Potter’s scar is, of course, world famous – but having gained it at the hands of his mortal enemy, it doesn’t quite reflect the reality for many people living with facial differences.

One of the most famous examples of differences between the real world and Hollywood is that of Joseph Merrick, or The Elephant Man, whose life was turned into a 1980 drama directed by David Lynch. Although John Hurt gave an excellent (and Oscar-nominated) performance, the film has been criticised by historians, who noted that the film portrayed Merrick as a victim of exploitation and a generally tragic figure, when in reality, he had been quite the canny businessman, who chose to exhibit himself. The haste to position those with facial differences as either villains or victims misses out on so much middle ground.

What’s significant about the likes of Avengers: Infinity War and Solo: A Star Wars Story is that these films are aimed primarily at a family audience – younger viewers are still being taught by cinema to distinguish good from evil based on physical appearance, sensitising viewers to see evil where none exists. This trend is not limited to live action cinema either – a new study published in the British Journal of Dermatology has found that within the top 50 grossing animated films below a 12A rating, 76.5% of villainous characters had skin conditions of some kind, including scarring, blemishes and wrinkles, whereas only 25.9% of heroes did. Some 50% of the films in the study were produced after 2010, suggesting the trend towards visual codification in this manner is still prevalent. “The animated films we watch as children tend to stick with us, with many of us being able to fondly recall our favourites with ease,” says Matthew Gass of the British Association of Dermatologists. “We watch them in formative years when we are learning about good and evil, and whether they mean to or not, it’s likely that they impact our biases and associations.”

Becky Hewitt, chief executive of Changing Faces, agrees. “The film industry has such power to influence the public with representations of diversity, and yet in films we still see scars and visible differences being used as a shorthand for villainy or vulnerability. It’s particularly worrying to see that young people don’t tend to make this association, until they are exposed to films that influence their attitudes towards disfigurement in a profoundly negative way.” The fact that younger audiences do not make the same associations between facial difference and negative traits is significant – this prejudice is learned, not inherited.

Agnes, who has lived with facial scarring for almost all her life, is acutely aware of the difference between on-screen representation and real life experience. “Not only are heroes rarely shown with anything but dashing good looks but people with scars are naturally the villain in most films,” she says. “Quite interestingly it’s quite the opposite in real life, or at least it has been for me; I have always been praised by people for being strong and positive person.”