Parents’ Top Questions About Pediatric Psoriasis
Keep worries about your little one in check with advice straight from the doctor.
If your child has psoriasis, she’s in good company: This common skin condition affects more than 8 million people in the U.S., according to the National Psoriasis Foundation, and about one third of people develop the condition before the age of 20. There’s a lot we know about this disease, including some pretty successful ways to treat it. But if your child has recently been diagnosed, it’s likely that you still have important questions that need to be answered. From playing sports to taking meds, we asked some of the country's top pediatric psoriasis experts to weigh in on the best path forward, so you can put your mind at ease.
Does psoriasis affect more than just my child’s skin?
Short answer: Yes. Psoriasis is an autoimmune disease in which the immune system is not functioning correctly. Along with itchy skin plaques, the disease results in inflammation throughout the body. It can also lead to joint issues, called psoriatic arthritis (PsA). Left untreated, PsA can cause swelling, stiffness, and pain in the joints. Psoriasis is also associated with other serious health problems such as diabetes, heart disease, and depression, so it’s good to keep tabs on your child’s overall health with PsO, not just his skin.
Will my child always have psoriasis?
Unfortunately, there is not yet a cure for psoriasis. “Psoriasis is a chronic, life-long condition with periods of remission and flares,” says Sammy Kang, M.D., a pediatric dermatologist at Anne Arundel Dermatology in Millersville, MD. Dr. Kang explains that while it may be hard to predict when a flare of symptoms will occur, sometimes there are explanations after-the-fact. “Infections (particularly with streptococcal organisms), cold weather/dry skin, and injuries to the skin are well-known triggers for psoriatic flares,” he says. The good news is that psoriasis treatment has been revolutionized in the last decade, and there are now many medications available to help your child reach remission.
Are there psoriasis medications for kids?
There sure are! “Depending on the severity and extent of skin involvement, there are numerous treatment options available for children,” says Dr. Kang. “These may include topical lotions and creams (both steroidal and non-steroidal) and systemic treatments such as oral medications and biologic injections." In cases where your child also struggles with psoriatic arthritis, which affects about 20% of the PsO crowd, your doctor may look into options for a systemic treatment that would address any joint issues, explains Dr. Kang.
Can my child’s diet make a difference with psoriasis?
While there is no one special diet that can cure your child’s psoriasis, food choices still matter when it comes to optimizing your child’s health. “Many studies have shown a higher prevalence of metabolic syndrome such as obesity, hypertension, and insulin-resistance/diabetes in patients with psoriasis compared to those without,” says Dr. Kang. “From that standpoint, a healthy diet should be encouraged to avoid developing these potentially associated conditions.” Helping your child choose foods that are full of nutrients and fiber like fruits and vegetables and limiting high-calorie snack foods will help him achieve a healthy weight and reduce his risk of some of the diseases associated with psoriasis.
Can my child plays sports with psoriasis?
It’s a healthy lifestyle must! “Staying active with sports is highly encouraged for the overall wellbeing of a child with psoriasis,” says Dr. Kang. The latest research bears this out: In a study in the journal Medicine, investigators found that physical activity is related to a reduction in the prevalence of psoriasis. The study also demonstrated that regular bouts of physical activity can improve psoriatic skin lesions due to the benefits of sunlight during outdoor exercises. Loose-fitting, breathable clothing may provide the most comfort during exercise, especially in hot weather.
How do I help my child’s self-esteem?
Self-esteem is important for all of us, but especially so kids, whose inner confidence guides their life choices and interactions with the world. If you suspect your child’s skin condition is negatively impacting self-esteem, the first step is to talk to them about what they are feeling, advises Faye Mishna, Ph.D., a professor of social work and dean at the University of Toronto in Ontario. “First, it is important to validate their feelings and not minimize their experience with their skin condition,” she says. “Let them know you understand the toughness of the situation.”
Then, you can show them different ways to improve their self-esteem. “Help them to surround themselves with friends who love them and encourage them to do things each day that they can feel good about,” she says. And most of all, help your child put hurtful comments in their place. “Say something like, ‘You may have a skin issue, but you are not ugly and gross,’” says Mishna. “Let your child know that their worth and self-esteem is more than skin deep.”
How should I handle bullying?
The bottom line, unfortunately, is that bullying does happen with differences. “If you suspect your child is the target of this negative behavior, then gently ask if they are being bullied,” advised Mishna. “Find out if it’s cyber bullying or face to face and if it is happening at school.”
If it’s occurring on school grounds, speak to the school administration privately. You might also talk with your child’s teacher about coordinating a general conversation with kids about differences and tolerance without mentioning the issue. “It is also important for the children in your child’s class to be taught how to stand up against bullying and who to go to if they see it happening,” Mishna says. “It’s vital that your child understands bullying is not O.K. in any situation.”
Pediatric Psoriasis Overview: National Psoriasis Foundation. (May 2021.) “For Parents.” https://www.psoriasis.org/for-parents/
Kids and Medication: National Psoriasis Foundation. (May 2021.) “Why Treat Psoriasis?” https://www.psoriasis.org/why-treat/#:~:text=That%20is%20why%20treating%20psoriasis,often%20referred%20to%20as%20comorbidities.
Autoimmune Condition and Symptoms: National Psoriasis Foundation. (May 2021.) “Understanding Psoriatic Disease.” https://www.psoriasis.org/understanding-psoriatic-disease/
Symptoms of Psoriasis: Up to Date. (May 2021.) “Clinical Manifestations and Diagnosis of Psoriatic Arthritis.” https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-psoriatic-arthritis
Kids and Sports: Medicine. (July 2018.) “Association Between Physical Activity and Risk of Prevalent Psoriasis.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6076093/