There are some questions kids ask that you’ll instantly know the answers to. But when your child starts asking tough questions about why your skin is covered in red, scaly patches, knowing how to address their concerns in an age-appropriate way can make teaching them about the skin condition a bit less daunting—whether they’re barely school-age or well into their teens.
Symptoms of psoriasis—a non-contagious skin condition characterized by well-defined red plaques with thick scales that affects approximately 3% percent of Americans—typically start showing during childhood and adolescence. By age 40, nearly three-quarters of psoriasis patients will show signs of the skin disease. Since many parents fall into the demographic, your child may notice your rough skin and start asking a lot of questions about your condition, from how you got it to what they should tell their friends.
To help you navigate their concerns with skill and insight, we asked experts for their best advice on how to answer your kid’s toughest questions about psoriasis. Here, they share smart tips for what to say to your child in every circumstance.
How did you get psoriasis?
One of the first questions your kid is likely to ask is how you got psoriasis in the first place—but the truth is, even experts say they aren’t exactly sure what causes it. “Because the exact cause of psoriasis is not known, this can be a tricky question to answer,” says Zain Husain M.D., a board-certified dermatologist and owner of New Jersey Dermatology and Aesthetics Center. “There are genetic predispositions, environmental factors, and immune system responses that come in to play, but this is difficult to explain to children—so it's best to use analogies and terms they can understand,” he suggests. Don’t worry, we’ve got a bunch of ideas you can use to make psoriasis seem way less or scary.
What is happening to your skin?
“I'd preface the answer by explaining that everyone's body is different and not everyone's body works the same way,” Dr. Husain says. Then, go on to explain how psoriasis works in terms your child can easily relate to. He recommends saying: “My immune system is working much faster compared to other people's. Let's say when the cells we have in our skin reproduce, they have to walk up a flight of stairs before they reach the surface of the skin. While other people's cells are walking up the stairs, mine are running. That’s why my skin cells reach the surface much faster and reproduce more frequently, causing the patches you see on my body.”
Is psoriasis contagious?
“It's important to explain to kids that this disease is not contagious, because you don't want them to be scared they could catch it from you,” Dr. Husain says. “If I touch a psoriasis patch of yours, that does not mean I will get psoriasis as well—the disease does not spread to other people in such a way,” he explains. For younger kids, Dr. Hussain suggests explaining it to your child this way: “Think about it as if you have a scrape on your knee because you fell down. Your friend won't get a scrape on their knee if they touch your boo-boo; they would have to fall down themselves in order for them to scrape their knee.” Let them know the same is true for psoriasis. For older kids, Monique Chheda, M.D., a Maryland-based dermatologist at Maragh Dermatology, Surgery and Vein Institute, suggests reminding your child, “This is not an infection. It is an autoimmune skin condition that causes the skin to grow too fast. You cannot transfer psoriasis to anyone else by touching them.” So, your kid doesn’t need to worry about skin-to-skin contact.
Will you always have psoriasis?
“Unfortunately, psoriasis is a chronic illness that may have recurring flare-ups,” Dr. Husain explains. “It's important to explain this to a child but to also normalize the skin condition,” he says. “I would explain the answer as: Psoriasis is often a lifelong condition, but that's okay. Just like how people have good days and bad days, my skin can have good days and bad days too. Some days, my skin will be just fine, and I may not feel itchy, but other days, my skin may feel irritated and need extra attention. Medicine is going to help my skin have more good days than bad, so that's why it will be important to use it when I have a flare-up.”
Why is your skin always so itchy?
“Psoriasis is a type of inflammation in the skin and inflammation in our skin can often cause pain or itching,” says Brandi M. Kenner-Bell, M.D., an assistant professor of pediatrics and dermatology at Northwestern University Feinberg School of Medicine in Chicago. To help younger kids understand, she suggests explaining, “Like poison ivy, which is an allergic reaction to the plant, the inflammation causes my skin to itch.” Dr. Husain adds: “Triggering factors can also induce a psoriatic outbreak, such as a stressful event or skin injury.”
What makes it feel better?
“Decreasing the inflammation in the skin through medicated creams and sometimes medicines you take by mouth or by injection under the skin can make psoriasis feel better,” says Dr. Kenner-Bell. Common psoriasis treatments include AmLactin, a topical cream containing lactic acid which reduces scales, injectable medications, like Humira, or UV light therapy treatments.
Can a doctor fix it?
“A dermatologist (a doctor who specializes in skin problems) can definitely help fix psoriasis,” Dr. Kenner-Bell says. “Right now, we have really great treatment options for psoriasis, meaning we are able to get skin clear almost 100% of the time,” Dr. Kenner-Bell says. “However, none of our current treatments are a cure—meaning if you stop using your medicines, it is very likely that your psoriasis will come back at some point.”
Does having psoriasis mean that you’re sick?
Comfort a worried child by assuring them that having psoriasis doesn’t mean you are sick or unhealthy. “You can explain this is not an infection,” Dr. Chheda says. “It is an autoimmune skin condition that causes the skin to grow too fast.” And while you can remind your kid the skin condition itself is not life-threatening, be sure to tell them all of the ways you and your doctors are working together to stay as healthy as possible to keep your psoriasis—and overall health—in check, such as eating healthy foods, exercising often and going to yearly check-ups.
Why don’t any other parents we know have it?
If your child doesn’t know other adults with psoriasis, they might worry that you’re facing this skin condition alone, so it helps to remind them that psoriasis is actually quite common. According to the National Psoriasis Foundation, more than 8 million Americans and 125 million people worldwide have psoriasis, making it one of the more common skin conditions. Sharing these facts with your child—and perhaps showing older kids supportive online communities for people with psoriasis, like a specialized Facebook group—can help normalize your condition and let them know there are lots of other adults dealing with psoriasis just like you, even if your family doesn’t happen to know them personally.
Why can’t you always play sports with me?
Aside from occasional dryness or itching, most adults with psoriasis don’t notice it affecting their ability to stay active or play with their child. But if you have more severe psoriasis or if you have it on your hands or feet in particular, certain activities may be very difficult or impossible to engage in, Dr. Kenner-Bell acknowledges. Being cautious about not going overboard and unintentionally scaring them, simply explain that certain sports moves—like gripping a baseball bat or swinging a tennis racquet—can cause the sensitive skin on your palms to hurt or even bleed, which is why you can’t always play sports with them, even though you’d really like to. Instead of simply saying no, try suggesting alternative games, like kickball in lieu of baseball for example, that you can engage in more comfortably as a way to keep having fun with your kid.