Psoriasis in Kids

Treatments and Tips to Help Your Child Feel Better

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psoriasis in children

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Psoriasis, a condition characterized by red, itchy, raised and, oftentimes, painful lesions on the surface of the skin, affects about 20,000 kids under the age of 10.

Although psoriasis most commonly manifests as skin lesions on a child's face, buttocks, elbows, knees or scalp, the condition is actually a chronic, autoimmune disorder that causes the body’s immune system to attack its own healthy cells.

This attack on the immune system causes severe inflammation of the skin, resulting in rapid skin cell production. In a person without psoriasis, new skin cells generate every 28 to 30 days. In a person with psoriasis, new skin cells surface every three to four days.

Diagnosing psoriasis in kids can be tough—it can sometimes look like other common childhood skin conditions—so it’s vital to get your kid’s symptoms checked. Not only is psoriasis extremely uncomfortable for kids, but certain stigmas and feelings surrounding psoriasis can hurt their mental and emotional health, too.

Symptoms

It can be hard to diagnose psoriasis in kids because it’s often confused with other skin conditions, like diaper rash, eczema or dermatitis. But if your child’s nails begin to pit and discolor, or they develop thick, inflamed patches of skin that have whitish or silvery scales, make sure to note what the lesions look like and where they’ve formed on the body to help your pediatrician rule out other skin conditions.

Although there are several types of psoriasis, the most common—in both children and adults—are called plaque psoriasis and guttate psoriasis. Both develop lesions on the surface of the skin but have slightly different appearances.

  • Plaque psoriasis causes thick, red “plaques,” or patches, to form on the skin, often with a whitish buildup of dead skin cells on top. These plaques are often very itchy and painful, and can sometimes crack or bleed.
  • Guttate psoriasis is characterized by smaller, dot-shaped lesions. This type of psoriasis has been linked to strep throat infections during childhood. Many people living with psoriasis report having developed it after a bout of strep throat.

If your child begins to show any of these symptoms, reach out to your pediatrician with notes on his lesions and the locations on the body immediately.

Because psoriasis is an autoimmune disorder, it’s been linked to serious chronic conditions that could have a life-long effect on your child’s health and wellness. It’s been linked to cardiovascular disease, cancer, and diabetes, as well as depression, anxiety, and reduced self-esteem.

Causes

There’s no single known cause of psoriasis, but it’s believed to have a genetic component. In fact, according to the National Psoriasis Foundation, researchers believe that about 10 percent of the population has one or more of the genes linked to psoriasis, but only 2 percent to 3 percent of people actually develop the condition.

So, if the gene is so common, why don’t more people have psoriasis? In order for the condition to manifest, the “psoriasis gene” a child inherits from the parent must be triggered by certain factors, like an infection, stress or environmental allergies.

These triggers can cause psoriasis flare-ups or outbreaks of psoriasis lesions.

The development of psoriasis in children has been linked to common childhood infections—particularly strep throat—but once they’ve developed the condition, a number of triggers can cause flare-ups. Some of those triggers include:

  • Injuries to the skin: In some kids, injuries to the skin—even minor ones, like a scratch or sunburn—can make psoriasis develop at the site of the injury. This can make participating in sports or even playing with their friends tough.
  • Stress: Stress is a common trigger for psoriasis and unfortunately, kids have lots of stressors. School, friendships, home life, and dealing with their condition can cause flare-ups.
  • Allergies: Allergens like mold, dust, pollen, pet hair, foods, and ingredients in soaps, laundry detergents, or make-up can trigger psoriasis flares.
  • Extreme weather: Very hot or very cold, dry weather can trigger psoriasis in some kids. It’s especially important to protect your kid’s skin during the summer and winter months.

Diagnosis

Because psoriasis is an autoimmune disorder that's linked to several severe, chronic conditions, it's important to get your kid to the dermatologist when she first starts to present symptoms. Taking charge of the condition early on can help prevent uncomfortable flare-ups and more serious health concerns down the road.  

When you go to your kid's dermatologist appointment, be sure to bring a list of her symptoms, including the location of lesions, the severity of her lesions, and, if possible, when they started to form, as well as any other symptoms, like nail pitting or hair loss. If you've identified some potential triggers for her flare-ups, bring those, too.

There aren't any special tools or tests the dermatologist will use to diagnose your child with psoriasis. Rather, she'll ask a series of questions about your kid's medical and family history—Has she had a case of strep throat? Does anyone in the family have psoriasis? Has she ever had any other skin conditions—and conduct a physical exam. Family history is especially important because approximately one-third of people living with psoriasis have a family member who also has the condition. 

Sometimes, dermatologists will take a skin biopsy from a lesion to examine under a microscope. Up close, psoriasis skin looks much more inflamed than skin affected by eczema and other skin conditions. Biopsies, however, are far less common than conducting an interview and physical exam.  

Treatment

Currently, there’s no cure for psoriasis. Most treatments aim to alleviate symptoms when they occur and reduce the risk of flare-ups.

Be sure to track your child’s psoriasis triggers, so you can take active steps in helping him or her to avoid them. If you find that your child has flare-ups around stressful times at school, work on stress management techniques, like meditation, positive affirmations or exercise; if they have a flare-up after you use a particular soap or laundry detergent, stop using it. These simple lifestyle changes can make a big difference in your child's health and happiness.

Bring your notes to your dermatologist appointments, so they can help you develop a stronger condition management plan. Your child’s doctor may recommend other treatment options, such as:

  • Topical treatments: Mild corticosteroid creams are often recommended for kids because they won’t hurt their sensitive skin. Your child’s doctor may recommend other moisturizers and ointments, in addition to a corticosteroid. They won’t heal psoriasis, but they will reduce some of the itching, redness, and discomfort caused by lesions.
  • Light therapy: Also known as phototherapy, controlled exposure to natural light can help alleviate the symptoms of psoriasis. There isn’t a lot of research into the long-term effects of light therapy on pediatric patients, but it has been proven effective in both kids and adults. Remember: This kind of treatment should always be done under the supervision of a medical professional.
  • Oral or injectable medications: In more severe cases, your child’s doctor may recommend oral or injectable medications, but this kind of treatment for children is controversial. There isn’t a lot of information on long-term effects.

Quality of Life

Psoriasis can have a major effect on your kid’s quality of life and mood. In fact, people living with psoriasis are twice more likely to develop depression than the rest of the population. It’s vital to be sensitive to your child’s feelings about the condition, and take steps to help her feel more confident and empowered.

Try these simple ways to boost your child’s mental and emotional health:

  • Educate everyone: Educate your kid, their friends, their teachers, and your extended family. Informing those closest to your child of the condition—and debunking the stigmas surrounding it—can help prevent low self-esteem and bullying.
  • Don’t focus on psoriasis too much: Never make your child feel like he’s different for having psoriasis. When discussing his condition, stick to the facts—and don’t get too emotional.
  • Give her some control: Give your child a say in the treatments or lifestyle changes they'll undergo to better manage the condition.
  • Understand his feelings: Your child may feel negative, sad, or like everyone is looking at him. Know that he’ll experience a range of emotions and that it’s your job to give him the support he needs.

A Word From Verywell

Psoriasis is chronic and life-long, but with the right treatments and emotional support, it is possible for your child to take charge of his condition and live a happy and healthy life.  Work together with your child's medical team to make both you and your child more comfortable.

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Article Sources
  • Causes & Triggers. National Psoriasis Foundation.
  • About Psoriasis. National Psoriasis Foundation.
  • Lara-Corrales, et al. Treatment of Childhood Psoriasis with Phototherapy and Photochemotherapy. Clinical Medicine Insights: Pediatrics. 2014;8(1). doi: 10.4137/CMPed.S13775.
  • Dhar S, Banerjee R, Agrawal N, Chatterjee S, Malakar R. Psoriasis in children: an insight.Indian J Dermatol.2011;56(3):262. doi: 10.4103/0019-5154.82477.