Finding School Success With Psoriasis
These foundational tips can help kids in kindergarten through 8th grade feel comfortable and confident in their own skin.
Psoriasis brings different challenges at every age—a 2018 study found that it even impacts the quality of life for really small children. But psoriasis can simply be part of your youngster’s life—not rule it–if you know the situations to help them prepare for along the way. Use this school-age guide to help the kids you love navigate the journey through their elementary and middle school years and make the whole experience a little less stressful for everyone.
School Phase: Early Elementary (Kindergarten-2nd Grade)
The first years of school provide a special challenge for kids with psoriasis. These kiddos haven’t developed enough verbally and emotionally to confidently advocate for themselves. That’s why tag-teaming with school employees and arming kids with helpful strategies is key. Try this:
Talk to the faculty. Looping in school nurses, teachers, and administrators can be a huge help in making school days a success. First, those people can stand in for you when it comes to looking over your child’s care throughout the day like reminding them to reapply moisturizer after washing their hands and not to scratch plaques. And they can be mindful of stepping in when any bullying moments (i.e. other kids thinking your child has dandruff and making fun of them) pop up if they understand what your child is dealing with and how their peers might perceive it. With a little help from you, “teachers can become more conscious about that type of behavior and it might help them educate other students about chronic diseases in general,” says Karan Lal, M.D., a dermatologist at UMass Memorial Medical Center in Worcester, MA, and marketing committee chair for the Society for Pediatric Dermatology.
Plan for flakes. Research shows that scalp psoriasis is one of the most common types found in children. The first step is to try to address the flakes at home, says Mona Gohara, M.D., associate clinical professor of dermatology at Yale Medical School in New Haven, CT, and Vice President of the Women’s Dermatologic Society. “There are prescription shampoos and scalp oils that can help a lot!” There are fragrance-fee over-the-counter options, as well. But on days when flakes pop up out of the blue, Dr. Gohara suggests heading to your youngster’s closet and “grabbing some vibrant clothing with prints to help camo any breakthroughs!” Plaques will take a backseat to a shirt with bright polkadots or fun superheroes printed all over it.
Role play at home. One common piece of advice you may see about kids with chronic conditions is to role-play different scenarios they may encounter at school while at home. Confidence grows when kids feel prepared so they’re not taken by surprise when questions or teasing pop up may help. “It's like cognitive behavioral therapy—they learn to manage the situation when it arises,” says Dr. Lal. To do: take on the part of a new “classmate” and approach your kid like a peer might by asking about their “gross” flakes and scaly patches. Then let your child think through how he or she would like to explain what psoriasis is (i.e. “a condition that makes my skin a little itchy and scaly”), providing cues when necessary. One helpful phrase you can help them learn: “It’s not contagious. That means you can’t catch it!”
School Phase: Later Elementary (3rd-5th Grade)
As kids become more aware of themselves and each other, staying on top of their psoriasis can mean the difference between a good day and a bad day. Here, three must-tries for children ages 9 through 11.
Encourage participation in recess. One thing to be aware of: “Pediatric psoriasis is associated with obesity,” says Dr. Lal. In fact, one 2018 research review found that obese children are at higher risk of developing psoriasis, and obesity severity correlates with psoriasis severity. “My biggest target when talking to teachers and faculty is making sure that kids remain active,” says Dr. Lal. “I think those behaviors of maintaining an active lifestyle—especially when taught early on—are really important.”
Give lunchbox reminders. Letting your kids take charge of remembering to keep their skin moisturized or handle their topical medications once they’re old enough to follow directions can be a good idea. “I think it is good to empower the kids by giving them a sense of responsibility,” says Dr. Gohara. But that doesn’t mean you can’t jog their memory. Her advice to parents: “Put in a little note in their lunchbox attached to a little treat as a reminder!”
Reach for a mini-moisturizer. Tuck a travel-size moisturizer into their backpack for on-the-go hydration. Dr. Lal’s pick: “A nice emollient moisturizer, something like either Vaseline or Vanicream,” which will help address dry plaques throughout the day. And bonus: “Applying those will make dryness and scaling less apparent, so they won't look as flaky to other people.”
School Phase: Middle School (6th-8th Grade)
As backpacks get bigger (and heavier) and kids become more independent and self-conscious (it’s that tween thing), helping them keep on the right track can be tricky for parents. These tips could up your chances of smooth sailing to high school.
Choose the right ‘pack. Backpacks can cause trouble for kids with psoriasis, thanks to a phenomenon called koebnerization. “Basically, what that means is any type of trauma to the skin can cause psoriasis to appear in the skin a couple of weeks later,” explains Dr. Lal. One common source of trauma he sees in preteens is friction from backpack straps. Keeping it light will help but so, too, will choosing one with very padded straps (like the L.L. Bean Comfort Carry Laptop Pack, $70, llbean.com). Dr. Lal also suggests going for a backpack on wheels–if your kid will go for it, that is.
Add padding for sports. Back to that idea of koebnerization—it can also pop up with sports injuries in soccer, lacrosse, and physical activities like skateboarding and bike-riding. Kids should wear knee and elbow pads in contact sports and activities where they might bang those areas, says Dr. Lal. Because of the constant wear and tear, flares can be triggered. “Psoriasis loves the elbows and knees,” says Dr. Lal.
Bring in outside support. As insecurities start to pop up, it’s a good time to consider a session with a therapist or find local or online support groups that can help link your kid up with other kids who also have psoriasis. But if your child expresses interest earlier, that’s great, too. The right time, according to Dr. Gohara, is “whenever they feel that they need it. Mental health is of paramount importance!” One place to start: The National Psoriasis Foundation.
Psoriasis and Quality of Life in Small Children: An Bras Dermatol. (2018.) “Impact of psoriasis in the quality of life of children, adolescents and their families: a cross-sectional study.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6256235/
Psoriasis of the Scalp in Young People: Psoriasis. (2016.) "Psoriasis in Children." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5683121/
Pediatric Psoriasis and Obesity: Pediatr Dermatol. (2018.) “Association between obesity and pediatric psoriasis.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379070/