8 Ways to Instill Confidence in Your Teen With Psoriasis
Plaques from PsO can be tough to hide. Here’s how to bolster a young person’s self-esteem to better face an often skin-deep world.
Adolescence is a time when kids start to figure out who they are and find their place in the world. Most desperately want to fit in and be accepted—which can mean, all too often, not standing out in the crowd. That’s hard to do when the first thing everyone sees are the red, scaly plaques from psoriasis (PsO) on their skin.
“When teens have a condition like psoriasis that’s very visible, it becomes part of how others see them. Teens with psoriasis begin to notice that they’re different from their peers,” says Rachel Piszczor, Psy.D., a pediatric psychologist and associate professor at Midwestern University in Downers Grove, IL.
Whether maliciously or out of thoughtless curiosity, kids can say the cruelest things. “People who don’t understand psoriasis, or why a child’s skin looks the way it does, may be afraid to sit next to kids with psoriasis. They may assume it’s contagious or that there is something wrong with them,” Sasha Jaquez, Ph.D., assistant professor in the Department of Psychiatry and Behavioral Sciences, Dell Medical School at The University of Texas in Austin. “Kids with skin conditions get called so many terrible names—names that, when I hear them, I can't even believe somebody came up with them.”
When PsO flares are a regular occurrence, research shows how an adolescent’s self-esteem and body image can take a big hit. Parents, this is where you come into the picture. Here are eight ways of bolstering confidence in your teen with psoriasis:
1. Spotlight Your Teen’s Strengths
In our looks-obsessed society, even the tiniest flaw gets magnified a million-fold in a teen’s mind (especially on social media, where so many teens live these days). Our experts recommend shifting away from the exterior by looking within. “Focus on all the positive strengths or skills they bring that aren't completely related to appearance,” Jaquez suggests. “Show them that their skin is a part of them, but their skin does not make them who they are.”
Is your son an amazing singer? Can your daughter recite Pi to 100 digits, or crack the funniest jokes? Spotlight and celebrate your teen's talents and abilities, whatever they might be. One of those abilities might even be resilience in facing a chronic skin condition like psoriasis.
Sometimes a parent’s praise seems biased to a skeptical teen. So go ahead and heap your teen with well-served kudos for their special skill or talent, but don’t expect them to buy it on face value just because it falls from your mouth (though it is sinking in somewhere, we promise). When your teen scoffs—and they will—challenge them to ask their friends to list their most admirable strengths and qualities. Their pals will almost certainly oblige, and your teen will likely put much more weight on what their peers tell them over what their parents say at this stage. In the end, the message is delivered and everyone wins, says Jaquez.
2. Celebrate Their Differences
Teens may be primed to view “different” or “other” as a bad thing. It’s not, so tell them so. “I want them to embrace the difference,” Jaquez says. “I don’t want them to be ashamed of it.”
Psoriasis is a lifelong disease. Though its symptoms can come and go, teenagers will deal with this condition on some level for the rest of their lives. And while self-acceptance isn’t easy, it can be learned. Young people can take small steps toward accepting their situation by recognizing how they’re doing everything possible to control it. That means closely following their medication regimen and taking great care of themselves, physically and emotionally, to help keep flares at bay.
Next, remind your teen how they are so much more than their skin—and then encourage them to honor and even promote their differences. Need some role models to help build your case? How about success stories like supermodel Winnie Harlow (who has an even more obvious skin condition, vitiligo, which she proudly displays in glossy fashion shoots; Shaquem Griffin, a one-handed linebacker for the Seattle Seahawks; or singer Billie Eilish, who shot to fame with neon green hair and oversized clothing, refusing to allow her talent to be reduced to mere sex appeal as a rising female pop star.)
3. Roleplay a Response
Some kids are naturally curious. And when they don’t “get” something—like why your teen’s skin is so red –they can say things that sound mean, when, in reality, "they're really just trying to understand,” Jaquez explains. “Once we tell them why, they're fine with it.”
Being open about a health condition can be hard, even for adults. That’s where a little preparation can help. Sit down with your teen and talk about what they want to say when kids make comments or ask questions that may seem hurtful but could simply be information-seeking, like: “Is that contagious?”
This means helping your teen write and memorize a personalized script so they know exactly what to say in the moment when it inevitably arrives. “That’s going to be different for each individual,” Dr. Piszczor says. Some teens naturally have more self-confidence and ability to stand up for themselves than others.
Your kid’s script might go something like this, according to Jaquez: “My skin is just different, because sometimes my body makes extra skin cells. But it’s OK, you can’t catch it.” Parents should play the role of curious (or, yes, sometimes mean) classmates, acting out the scene together a few times until your child feels comfortable saying the lines.
4. Put Your Teen in Control
Teens are always jockeying for more control over their own lives—that’s part of growing up. More control equals greater confidence, but flares strip away that layer of predictability that gives kids a sense of being in charge of their own destiny.
One way to give your teen back some control is by letting them decide when, and to whom, they disclose their condition, advises Jaquez. They also should be able to choose whether or not they wish to cover up their plaques from psoriasis. If they prefer hiding their skin beneath a long-sleeved shirt, pants, or a hat, for example, that should be totally up to them. “If a kid wants to cover up, that's their choice," says Jaquez.
The opposite is also true. Don't scold them for leaving the house in a tank top that reveals their condition. "I don't want parents to say, ‘You should cover your skin so no one sees it,’ because I think that really brings shame to the table,” Jaquez advises.
5. Let Them Vent
When your teen expresses dismay at their appearance, your natural inclination may be to step in and say, “Don’t think that way. You look great.” But by trying to make the self-criticism disappear, you may only invalidate their feelings. “We don’t want our kids to feel that way, but we also want to allow that space for them to say, ‘I’m feeling really upset about it,’ and to simply listen and validate and show that you understand that it’s hard,” Dr. Piszczor says.
Instead of negating how your child feels, ask what you can do to help them feel better, she suggests. Maybe it’s a pretty new top with fluttery long sleeves for a special treat. Maybe it’s just a hug. But by asking, you’re acknowledging their pain and offering your teen some much-needed comfort, too.
6. Promote New Interests
Living with a chronic disease can be all-encompassing, to the point where everything else in your teen’s life fades into the background. They can start to lose some of what it means to be a kid. To bring back some of the fun and normalcy of the adolescent years, support them in trying a range of positive new activities.
“Encourage teens to explore what they are interested in,” Jaquez suggests. For example, if your child is into music, suggest they try out a few instruments, audition for an acapella group, or try their hand at writing an original song. Joining a sports team has the added advantages of giving kids a sense of belonging and inclusion, she says, which can act as a buffer against low self-esteem and bullying.
7. Call for an Expert
Sometimes even the most encouraging parents can’t cut through the emotional strain of living with psoriasis. A medical professional, whether it’s a pediatrician, a nurse, or psychologist, should do regular checks of your teen’s emotional health. “Just kind of checking in and making sure that they’re OK, and maybe giving them some tips and tricks on how to approach the teenage years living with a chronic condition,” Dr. Piczczor advises.
If your child shows warning signs—like not wanting to go to school, pulling away from their friends and activities, or covering up their skin from head to toe—it may call for an intervention. “Those are the times when we want to explore getting a mental health professional involved,” Jaquez says.
The psychologist or counselor you choose doesn’t necessarily need to have experience treating teens with psoriasis, Jaquez adds, but they should at least feel comfortable addressing this skin condition and the nuances of living with a chronic disease.
8. Find Allies
Living with PsO can be a lonely place. So, in addition to the rock-solid support you, as a parent, offer your teen, seek out other allies your child can both trust and lean on. This could mean a close friend or a teacher, Dr. Piszczor suggests. Just be sure that you ask your teenager for permission to disclose their condition before you talk to someone else about it, she adds.
Because even the most well-intentioned friends may not understand what it feels like to live with a skin condition, a psoriasis support group—like those listed through the National Psoriasis Foundation—can be a great resource. Speaking to other young people (either online or in person) who’ve gone through similar experiences can offer a blueprint for how to navigate and cope with their condition.
That, and alleviate feelings of isolation, too. “Support groups show teenagers that they're not alone,” Jaquez says.
- Psoriasis and Quality of Life?: Dermatology: (2016.) “Systematic Review of Health-Related Quality of Life in Adolescents with Psoriasis.” https://www.karger.com/Article/FullText/450826