Hannibal Lecter had alopecia areata, or hair loss; the Wicked Witch of the West, verruca vulgaris, more commonly known as warts.
But unlike the villains in "The Silence of the Lambs" and "The Wizard of Oz," the movies' heroes, Clarice Starling and Dorothy Gale, were fresh-faced and unblemished, which is all too typical of Hollywood, according to a study published Wednesday in JAMA Dermatology.
Three dermatologists examined the top 10 of the American Film Institute's list of the 100 greatest movie heroes and villains. They found that six of the villains had skin problems, compared to two of the heroes.
And while the skin issues suffered by famous villains might send some moviegoers searching for their sunscreen, the authors say the trend unfairly targets "dermatologic minorities" and can lead to prejudice against people who have the conditions.
"The results of this study demonstrate Hollywood's tendency to depict skin disease in an evil context, the implications of which extend beyond the theater," Drs. Julie Amthor Croley, Vail Reese and Richard F. Wagner Jr. wrote.
"Specifically, unfairly targeting dermatologic minorities may contribute to a tendency toward prejudice in our culture and facilitate misunderstanding of particular disease entities among the general public."
The villains and their conditions were:
Dr. Hannibal Lecter ("The Silence of the Lambs," 1991) — alopecia (hair loss that occurs when the immune system attacks hair follicles).
Mr. Potter ("It's a Wonderful Life," 1947) — alopecia.
Darth Vader ("The Empire Strikes Back," 1980) — alopecia, deep rhytides (that's the ten-buck word for wrinkles), facial scarring and periorbital hyperpigmentation (dark circles under the eyes).
The Queen ("Snow White and the Seven Dwarfs, 1938) — periorbital hyperpigmentation, deep wrinkling, warts, rhinophyma (a ruddy, bulbous nose, sometimes a side effect of rosacea).
Regan MacNeil ("The Exorcist," 1973) — periorbital hyperpigmentation, scarring.
The Wicked Witch of the West ("The Wizard of Oz," 1939), verruca vulgaris or warts.
Meanwhile, the only two heroes with less-than-perfect skin were Harrison Ford as Indiana Jones in "Raiders of the Lost Ark" and Humphrey Bogart as Rick Blaine in "Casablanca." These heroes, however, simply had scars but no chronic condition or disease. (Which brings to mind a villain that didn't make the list, Scar in "The Lion King.")
Of course, alopecia is not the only hallmark of the face of evil. Previously, people have noted a recent tendency for movie villains to be blond; recall King Joffrey ("Game of Thrones") and Draco Malfoy ("Harry Potter").
But Hollywood has a longstanding tradition of equating traditional standards of beauty with goodness, and anything outside of the norm as evil. It's a relic of the earliest days of film, when directors of silent movies were constrained by the primitive medium.
"In a time during which immoral character could not be conveyed through spoken word, filmmakers relied heavily on using dermatologic conditions to convey wickedness visually," the authors wrote.
The face and scalp, in particular, were "prime real estate" for showing depravity, and over time, the "degrading stereotypes" remained, even as some groups, such as the National Organization for Albinism and Hypopigmentation, protested with little success.
"Although abnormal skin can also be presented realistically, sympathetically or independent of character roles, perhaps its most prominent use in film is to illustrate underlying immoral depravity," the authors said. They concluded that today's filmmakers are tasked with addressing "biased portrayals."
They also showed admirable professional restraint in not urging the villains to seek a dermatologist's help. That's good, because the average wait to get an appointment with a dermatologist is now 32.3 days, the longest of any specialty, according to a recent report in Becker's Hospital Review.
While they're waiting, the Queen and the Wicked Witch might have tried a home remedy for their warts. Even the American Academy of Dermatology says that applying duct tape sometimes makes warts go away.