The British Skin Foundation 30 years on a story of resounding success

In the mid 1990’s, during the Presidencies of Professors Rona Mackie CBE and John Burton, the British Association of Dermatologists (BAD) agreed to establish a new charity – the British Skin Foundation (BSF). 

Its stated objective was (and still is) to raise and distribute significant sums of money to promote and fund research into skin health and disease. In 1996 the charity first took wings and I was asked by Dr Roger Allen (who was himself to become BAD President three years later) to join the first board of Trustees. It was an invitation I was delighted to accept – believing that good quality research was, still is and always will be by far the most important way to improve radically the lives of people affected by skin disorders, and their families, friends and colleagues – not just temporarily, but in the long term.

It is just as pleasing to be asked, now 30 years later, to review the work that the BSF has been able to support – and what a remarkable story it is.

First, it was astonishing (but hugely gratifying) to discover that since it was first established the BSF has raised and distributed £21.5 million to 500 research projects. 

The projects concerned have varied considerably from an examination of dermatitis in the rubber industry (the first listed grant in 1996), through basic science studies on cutaneous and immunological function, infections, skin cancer, many genetic and inflammatory diseases and the epidemiology and impact of skin disease, through to the last grant awarded in 2025 – a study into the possibility of actually making ageing skin stronger again. 

There are some key themes where the BSF’s efforts have been particularly focussed. 

One of these is skin cancer, the commonest cancer overall in the UK and an ever-rising problem in our ageing population. Since 1996, the British Skin Foundation has supported 103 projects in the field of skin cancer research, awarding just under £5,000,000 in total. This has contributed hugely to a better understanding of why skin cancers occur in the first place and to exploring how best to manage them.   

Another key area of support has been inflammatory skin diseases. For example, the BSF has awarded a total of over £2,000,000 shared between 53 projects looking into the basic science, impact and treatment of psoriasis, a condition that affects at least 2 in every 100 of the adult population in the UK. 36 BSF grants went to research into atopic eczema – a scourge of young children, affecting up to 20% in their early years. One of the groups that received BSF funding went on to make one of the most important significant discoveries in this condition ever. More details are given below.

There is also a long, strong track record in areas that often get overlooked by other grant awarding bodies, such as wound healing, where 21 projects have received over £1,000,000.

This is another very important part of the story. 

Over the past 30 years, the BSF has been able to support 752 principal investigators across multiple centres. Most of the grants have been for large projects in established units but around 30% were to younger individuals looking for ‘start up’ funds to help them explore novel ideas and get a foothold on the ladder towards a future career in research, either in the form of fellowships or as small grants. 

Very importantly, too, the geographical reach of the British Skin Foundation has increased hugely as can be seen form these maps, which show the distribution of grants has expanded from a small number of academic centres to a UK- and Ireland-wide network from 2005 to 2025.

In addition, over three quarters on the UK’s 30 top-ranked universities (as judged in the QS Rankings) are backed by BSF grants. 

In other words, the BSF is powering cutting-edge research and making significant contributions to the research climate across the academic world in the UK and Ireland. Vitally, the reach has grown significantly since 1996. By way of example, in 2010 the BSF had supported work in 17 institutions but by 2025 that number has risen to 37.

The research groups the BSF has supported have explored vital areas of uncertainty, and have been able to change the landscape of our understanding in a number of key areas. For example, as a result of work funded by the BSF we have gained a much better understanding of the genetic basis of a number of skin disorders and of the role of the immune system in skin disease. The BSF has also supported many important studies on the treatment of skin disease. It was involved in funding some of the very early work on compounds known as ‘biologics’ in the treatment of melanoma (a life-threatening form of skin cancer), supported important clinical trials in eczema and many other conditions – often leading to significant changes in practice. 

It is also very heartening to be able to record how successful many of our funded researchers have been going forward.  For example:

• Most BSF funded projects have been able to secure further, external funding with the highest follow-on figure being 11 times the original British Skin Foundation grant 

£1 invested by the British Skin Foundation typically attracts £4.75 in subsequent external funding. So, on average for every £100,000 project that we fund, a further £475,000 is being generated for future UK dermatology research. 

• At least 70% of British Skin Foundation-funded researchers have remained in dermatology for five or more years, strengthening the profession and its ability to help patients and their families

And here are some very specific examples of what BSF funding has supported, with some words from the investigators themselves:

Professor Armstrong’s early work, which was supported by significant grants from the BSF, uncovered important information about why melanoma cancer cells resisted the body’s mechanisms for destroying them. This led to the investigation of a molecule called AMBRA1, which became central to a number of subsequent studies between teams in Newcastle, Rome, and Madrid, and more recently Sunderland. Led by Professor Penny Lovat (of whose team Professor Armstrong was a member and who has herself received several BSF grants) these efforts culminated in the development and validation of an antibody-based prognostic test designed to assess metastatic risk in patients with localised melanoma. More recently, our focus has expanded to the role of AMBRA1 in various other aspects of the assessment and management of melanoma, including ongoing efforts to identify robust biomarkers for the spread of the cancer. 

Professor O’Toole is an authority on a number of disabling genetic skin diseases and is co-Director of the Wellcome-funded training programme Health Advances in Underrepresented Populations and Diseases (HARP). She received a grant from the BSF for a study that resulted in important findings about associated co-morbidities in children with a rare congenital disorder, Harlequin Fetus, which has been highly cited and has resulted in changes to guidelines in the management of the condition.

In addition, a grant to study a specific molecule and its role in skin cancer resulted in a collaboration with Cancer Research Technology to develop ways of blocking its action.  This work was so successful that it led to a clinical fellow working on the project being able to obtain a prestigious Medical Research Council (MRC) clinical training fellowship to work on varicella zoster (shingles).  

Professor Armstrong’s early work, which was supported by significant grants from the BSF, uncovered important information about why melanoma cancer cells resisted the body’s mechanisms for destroying them. This led to the investigation of a molecule called AMBRA1, which became central to a number of subsequent studies between teams in Newcastle, Rome, and Madrid, and more recently Sunderland. Led by Professor Penny Lovat (of whose team Professor Armstrong was a member and who has herself received several BSF grants) these efforts culminated in the development and validation of an antibody-based prognostic test designed to assess metastatic risk in patients with localised melanoma. More recently, our focus has expanded to the role of AMBRA1 in various other aspects of the assessment and management of melanoma, including ongoing efforts to identify robust biomarkers for the spread of the cancer. 

One of the most outstanding UK dermatology research groups in recent years was the team lead by Professor Irwin McLean. They identified the causative genes for a large number of human skin diseases, particularly involving a number of disorders of keratins (essential proteins in skin, hair and nails) and other associated epithelial structural proteins. This has resulted in a huge number of publications, including several in Nature Genetics, one of the most prestigious scientific journals in the world. For example, Professor McLean and his co-workers discovered the causative genes for the painful and highly debilitating skin disorder pachyonychia congenita and for a long-standing interest in the genetic basis of disorders of skin fragility. 

Arguably the most important BSF-funded discovery to date, though, followed a grant  in 2004 when the BSF co-funded (with the National Eczema Society) a grant to Professors McLean and Irvine that took their work on to an even higher level, ultimately resulting in one of the most cited dermatology publications of all time on the role that malfunction of the gene coding for the epithelial protein filaggrin plays in ichthyosis vulgaris and in atopic eczema. They showed that inherited filaggrin deficiency – affecting about 1 billion people worldwide – represents the major genetic predisposing factor for atopic eczema and associated allergic conditions, including atopic asthma, hay fever and food allergy. Previously, allergic diseases were thought to be purely immunological.  In recognition of this research, Professor McLean won numerous awards including the Royal Society’s 2015 Buchanan Medal for “distinguished contributions to the medical sciences in general”. 

Professor Ogg leads a group seeking to understand, at the molecular and cellular level, the role of human cutaneous immune responses in mechanisms of disease, treatment and in vaccination.  As well as contributing to an understanding of the causation of skin diseases, Professor Ogg’s research group aims to translate their findings to changes in clinical practice. His work specifically looks at the function of an important part of the immune system – the T lymphocyte. Not only is this work leading to potential clinical benefit in skin diseases, Professor Ogg’s expertise allowed him to lead the vitally important Oxford Covid-19 T cell project that demonstrated strong immune responses to the virus.

The University of Newcastle has long been a pioneer in dermatology research, with a very impressive record in elucidating the background to a number of skin diseases and being a leading force in seeking ways of treating them. They have had a particularly strong record in the relationship between the skin and the gut, in the role of Ultraviolet Radiation in the treatment of skin diseases, in skin pigmentation and the background to, and management of, a number of inflammatory skin disorders. The BSF is proud that our funding to Professor Reynolds’ team in Newcastle led to one of the first precision medicine randomised controlled trials undertaken in dermatology.  This study showed that pharmacogenetic dosing of azathioprine was effective in atopic eczema. The department’s continued work in this area has expanded - with precision medicine forming a key component of the skin and oral disease theme within the Newcastle NIHR Biomedical Research Centre.

Professor Griffiths returned to the UK from the University of Michigan in the 1990’s as the Foundation Professor of Dermatology at the University of Manchester. In 2002 he was awarded £22,414 for an investigation of the wat in which a key immune cell in the epidermis (Langerhans' cell) behaved in patients with psoriasis. The BSF’s very important foundational support for this work pump-primed a programme investigating the remarkable impairment of Langerhans' cell migration from epidermis of uninvolved skin in psoriasis to draining lymph nodes. This collaboration with Prof Ian Kimber led directly to substantial funding from the Medical Research Council (MRC) and a number of other, smaller grants to interrogate this phenomenon in more detail - such as the differences between early and later onset psoriasis. The key publication arising from this work was in the high impact, Journal of Experimental Medicine in 2006 and has led to many more exciting discoveries in this common, debilitating condition.

In conclusion, it is clear that funding from the BSF has helped hugely in the pursuit of knowledge and improvements in the treatment of many skin diseases. It has also provided the springboard for some of this country’s most successful and influential figures in the field. 

The charity has more than fulfilled the hopes of those who set it up in 1996. Under the inspirational leadership of our Chief Executive, Matthew Patey and his amazing team, together with the support of the BAD, many vital industrial partners and generous donors from within the dermatology community and beyond, the British Skin Foundation has enabled a huge number of committed and talented researchers to make valuable discoveries that will benefit generations of patients and families to come. 

Professor Robin Graham-Brown