Children and Psoriasis
Although psoriasis in babies and young children is relatively rare, it is estimated that a third of people develop the condition before the age of 16.
Teenagers and young adults with psoriasis can visit our dedicated website, www.psoteen.org.uk
It is quite rare for babies and young children to have psoriasis, especially if there is no family history of the condition. Studies suggest that there are ten times as many people affected by psoriasis at 18 years old than there are under one year of age. Those who do develop psoriasis young tend to come from families with a history of psoriasis although, as with all aspects of the condition, there are exceptions to the rule, and children with no family history can and do develop psoriasis.
The most common form of psoriasis in children is plaque psoriasis on areas such as the elbows, knees and lower back, and the scalp is the most frequent site of onset in children. There may also be some involvement of sensitive areas, such as the face and flexures (ie. armpit, groin, back of the knees). Psoriasis in children tends to be less flaky than psoriasis in adults, and psoriasis in sensitive areas tends to be bright red and shiny, rather than flaky, but will still be well demarcated- so you can clearly see where psoriasis ends and normal skin begins.
Guttate psoriasis is also more common in childhood and teenage years. This form of psoriasis is often triggered by the Streptococcus bacteria, and therefore often follows a throat infection. Guttate psoriasis looks like a rash of small, scaly patches up to 1cm in diameter, over the trunk, limbs and occasionally scalp. Guttate psoriasis generally clears well, but may take several weeks or months. Some people may never experience guttate psoriasis again, whilst others can have repeat episodes, often after a sore throat. There are also some people who will go on to develop plaque psoriasis - but some never will. Psoriasis is hugely complicated, and hugely frustrating.
What treatments are available for children with psoriasis?
Most people with psoriasis, regardless of their age, will begin with topical treatments (creams and ointments that are applied to the skin), and for many people, these treatments are sufficient to manage their psoriasis.
Moisturisers and emollients are vital in the treatment of psoriasis - they help to smooth and hydrate the skin in order to keep it in good condition and help the active treatment creams and ointments work more effectively. They can also be soothing, reducing itch and soreness, and therefore helping the child to feel more comfortable and reducing lost sleep. There are many emollients and moisturisers to choose from, from oils to put in the bath, to creams, lotions and ointments to put directly onto the skin. Contact us for a full list of emollients and moisturisers that are suitable for use in children with psoriasis. Other more active creams and ointments include coal tar-based applications, vitamin D analogues, topical steroid treatments and dithranol applications. Some of these are available over the counter and some need to be prescribed by a GP.
If a child’s psoriasis is more severe, and cannot be adequately controlled through topical treatments, they may be referred to a dermatologist. Dermatologists are able to offer other stronger forms of treatment such as ultraviolet light (UV) therapy and systemic tablets. Other forms of treatment, such as biologics, may become available to them as they get older.
Psoriasis is a visible and uncomfortable condition, and it can have an impact on a child’s self-confidence. Below are some tips for day-to-day coping with psoriasis:
• Children should lead as normal a life as possible - psoriasis is only one part of who they are, and it should not prevent them from playing with friends, taking part in sports, or swimming.
• Parents and children may have different views about treatments -
it is important to talk this through and respect their views. If they do not like a treatment, encourage them to explain why- there are many treatments out there, and it may be possible to change, or to alter their treatment regime. The most effective treatment is usually the one that is used as directed.
• Cotton clothing, underwear and bedding may be more comfortable for your child during a psoriasis flare. Similarly, old pyjamas and bedsheets are often useful when applying an active treatment or particularly oily ointment, in case of staining.
• Inform your child’s teacher in case they need time off school to attend appointments, or to help in explaining the condition to their classmates - for example, that it is not contagious.
• Establish a treatment routine, but do not let it rule you or your child’s life. Whilst routine is good, it should be flexible enough to allow a normal life.
• Have a small pot of moisturiser that will fit in a handbag or school bag to use when away from home - this can help soothe itchy or sore skin that may be bothersome in the daytime.
If you’d like more information on psoriasis in children, please do not hesitate to contact us. We would be happy to send you a copy of our Psokids CD-ROM, which helps to explain the condition to 5-10 year-olds, through fun and colourful cartoons and games. We also have a Parents’ Guide for parents of children with psoriasis.
March 2013 (Review: 04/14)
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