Apr
Caring for a child with psoriasis can be challenging, as this chronic skin condition can cause physical discomfort, emotional distress, and social stigma. As a parent or caregiver, it is essential to understand the unique needs of children with psoriasis and to provide them with gentle, effective care that promotes healthy skin and overall well-being.
In this article, we will explore the top gentle ways to manage pediatric psoriasis, including skincare routines, topical treatments, lifestyle modifications, and complementary therapies. By implementing these strategies and working closely with healthcare professionals, you can help your child achieve clearer skin, reduce symptoms, and improve their quality of life.
Understanding Pediatric Psoriasis
Pediatric psoriasis is a chronic autoimmune skin condition that affects children and adolescents under the age of 18. It is characterized by the appearance of red, scaly patches on the skin, which can be itchy, painful, and emotionally distressing for young patients.[1] While the exact cause of pediatric psoriasis is unknown, it is believed to result from a combination of genetic and environmental factors.
Causes and Triggers
Several factors can contribute to the development and exacerbation of pediatric psoriasis, including:
- Family history of psoriasis
- Infections, such as strep throat
- Stress and emotional trauma
- Skin injuries or irritation
- Certain medications
Identifying and avoiding triggers can help manage the condition and reduce the frequency and severity of flare-ups.
Symptoms and Diagnosis
The most common symptoms of pediatric psoriasis include:
| Symptom | Description | |
|---|---|---|
| 1 | Red, scaly patches | Raised, well-defined patches with silvery scales |
| 2 | Itching and burning | Intense itching and burning sensations |
| 3 | Nail changes | Pitting, thickening, or discoloration of nails |
Diagnosis of pediatric psoriasis involves a thorough evaluation of the child’s medical history, physical examination, and sometimes a skin biopsy to rule out other conditions.[2]
Impact on Quality of Life
Pediatric psoriasis can have a significant impact on a child’s quality of life, affecting their physical comfort, self-esteem, and social interactions. Children with psoriasis may experience feelings of embarrassment, isolation, and depression due to the visible nature of their skin lesions.[3]
When to Seek Medical Attention
Parents should seek medical attention for their child if they notice any signs of psoriasis, such as persistent red, scaly patches on the skin. Early diagnosis and treatment can help manage symptoms, prevent complications, and improve the child’s overall well-being.
Gentle Skincare Routines
Establishing a gentle and effective skincare routine is crucial for managing pediatric psoriasis and promoting healthy skin. A well-designed routine should focus on cleansing, moisturizing, and protecting the skin while minimizing irritation and inflammation.[4]
Cleansing
When cleansing a child’s skin with psoriasis, it is essential to use mild, fragrance-free, and soap-free products that do not disrupt the skin’s natural barrier. Some tips for gentle cleansing include:
- Using lukewarm water instead of hot water
- Applying cleanser with gentle, circular motions
- Patting skin dry with a soft towel instead of rubbing
- Avoiding harsh scrubs or exfoliants
Moisturizing
Keeping the skin well-moisturized is essential for managing pediatric psoriasis, as it helps prevent dryness, itching, and flaking. When selecting a moisturizer, look for products that are:
Topical Treatments and Medications
Topical treatments and medications are the first-line approach for managing pediatric psoriasis, as they target specific areas of the skin and help reduce inflammation, itching, and scaling.[7] The choice of treatment depends on the severity of the condition, the location of the affected areas, and the child’s age and overall health.
Topical Corticosteroids
Topical corticosteroids are the most commonly prescribed medications for pediatric psoriasis. They work by reducing inflammation and slowing down the growth of skin cells. These medications are available in various strengths and formulations, such as:
- Creams
- Ointments
- Lotions
- Foams
- Solutions
Topical Vitamin D Analogues
Topical vitamin D analogues, such as calcipotriene and calcitriol, are another class of medications used to treat pediatric psoriasis. These medications work by slowing down the growth of skin cells and reducing inflammation.[8] They can be used alone or in combination with topical corticosteroids for enhanced efficacy.
Topical Retinoids
Topical retinoids, such as tazarotene, are derived from vitamin A and can help improve the appearance of psoriatic plaques by normalizing skin cell turnover and reducing inflammation. However, these medications can cause skin irritation and dryness, so they may not be suitable for all children with psoriasis.
| Treatment | Mechanism of Action | |
|---|---|---|
| 1 | Topical Corticosteroids | Reduce inflammation and slow skin cell growth |
| 2 | Topical Vitamin D Analogues | Slow skin cell growth and reduce inflammation |
| 3 | Topical Retinoids | Normalize skin cell turnover and reduce inflammation |
In some cases, a combination of topical treatments may be necessary to effectively manage pediatric psoriasis symptoms. Working closely with a dermatologist can help ensure that the child receives the most appropriate treatment plan tailored to their specific needs.[9]
Lifestyle Modifications
In addition to medical treatments, lifestyle modifications can play a significant role in managing pediatric psoriasis and improving overall skin health. These changes can help reduce triggers, minimize flare-ups, and enhance the effectiveness of topical treatments.[10]
Stress Management
Stress is a common trigger for psoriasis flare-ups in children. Encouraging stress-reducing activities can help manage symptoms and improve the child’s quality of life. Some effective stress management techniques include:
- Deep breathing exercises
- Mindfulness and meditation
- Engaging in hobbies and enjoyable activities
- Counseling or therapy
Diet and Nutrition
While there is no specific diet for pediatric psoriasis, certain dietary modifications may help reduce inflammation and improve skin health. Some key dietary considerations include:
| Dietary Change | Potential Benefit | |
|---|---|---|
| 1 | Increasing intake of fruits and vegetables | Provides antioxidants and anti-inflammatory nutrients |
| 2 | Limiting processed and high-fat foods | Reduces inflammation and promotes healthy weight |
| 3 | Consuming omega-3 fatty acids | Helps regulate inflammation and supports skin health |
It is essential to work with a pediatrician or registered dietitian to develop a balanced and nutritious meal plan that meets the child’s specific needs.[11]
Physical Activity
Regular physical activity can help improve circulation, reduce stress, and promote overall health in children with psoriasis. Encourage children to engage in age-appropriate activities they enjoy, such as:
- Walking or hiking
- Swimming
- Cycling
- Dancing
It is crucial to ensure that children wear comfortable clothing and use appropriate sun protection during outdoor activities to minimize skin irritation and sunburn risk.[12]
Phototherapy and Light Treatments
Phototherapy and light treatments are effective options for managing moderate to severe pediatric psoriasis when topical treatments alone are insufficient. These therapies involve exposing the affected skin to controlled amounts of ultraviolet (UV) light to reduce inflammation and slow down the growth of skin cells.[13]
Narrowband UVB Phototherapy
Narrowband UVB phototherapy is the most common light treatment for pediatric psoriasis. This therapy uses a specific wavelength of UV light (311-313 nm) to target psoriatic skin while minimizing exposure to surrounding healthy skin. Treatments are typically administered 2-3 times per week in a dermatologist’s office or specialized phototherapy center.
| Treatment Frequency | Session Duration | Treatment Course | |
|---|---|---|---|
| 1 | 2-3 times per week | Gradually increased based on skin response | 6-12 weeks |
Excimer Laser Therapy
Excimer laser therapy is a targeted form of phototherapy that delivers high-intensity UV light to specific psoriatic plaques. This treatment is particularly useful for localized psoriasis affecting small areas of the body. Excimer laser therapy may require fewer sessions than traditional phototherapy and can be an effective option for children who have difficulty tolerating prolonged light exposure.[14]
Home Phototherapy
In some cases, home phototherapy units may be prescribed for children with widespread psoriasis or those who have difficulty attending regular office-based treatments. Home phototherapy involves using a portable narrowband UVB light unit under the guidance and supervision of a dermatologist. Proper training and monitoring are essential to ensure the safety and effectiveness of home phototherapy.
When considering phototherapy or light treatments for pediatric psoriasis, it is crucial to discuss the potential benefits and risks with a dermatologist. Possible side effects of these therapies include:
- Skin dryness and itching
- Sunburn-like reactions
- Increased risk of skin aging and skin cancer with long-term use
Regular skin checks and a comprehensive sun protection plan are essential for children undergoing phototherapy or light treatments to minimize potential long-term risks.[15]
Complementary and Alternative Therapies
Complementary and alternative therapies (CAM) are sometimes used in conjunction with conventional treatments to manage pediatric psoriasis symptoms and improve overall well-being. While these therapies may provide some benefits, it is essential to discuss their use with a dermatologist to ensure safety and compatibility with the child’s current treatment plan.[16]
Natural Supplements
Some natural supplements may help reduce inflammation and support skin health in children with psoriasis. However, it is crucial to consult a healthcare professional before starting any supplement regimen to ensure proper dosing and safety. Potentially beneficial supplements include:
| Supplement | Potential Benefit | |
|---|---|---|
| 1 | Omega-3 fatty acids | Anti-inflammatory properties |
| 2 | Vitamin D | Supports skin cell regulation |
| 3 | Turmeric (curcumin) | Anti-inflammatory and antioxidant effects |
Mind-Body Techniques
Mind-body techniques can help children with psoriasis manage stress, which is a common trigger for flare-ups. These techniques focus on the connection between the mind and body and may include:[17]
- Yoga
- Meditation
- Guided imagery
- Biofeedback
Incorporating mind-body techniques into a child’s daily routine can help promote relaxation, reduce stress, and improve overall well-being.
Herbal Remedies
Some herbal remedies have been traditionally used to manage skin conditions like psoriasis. However, it is essential to exercise caution when using herbal remedies, as they can interact with medications and cause side effects. Some commonly used herbal remedies for psoriasis include aloe vera, tea tree oil, oregano oil, and chamomile. Before using any herbal remedies, it is crucial to consult a dermatologist to ensure safety and compatibility with the child’s current treatment plan.[18]
Coping Strategies for Children and Families
Pediatric psoriasis can be challenging for both children and their families. Developing effective coping strategies is essential to manage the physical and emotional impact of the condition. Here are some strategies that can help children and families cope with pediatric psoriasis:[19]
Emotional Support
Providing emotional support to children with psoriasis is crucial. Parents and caregivers can help by:
- Listening to the child’s concerns and validating their feelings
- Encouraging open communication about the condition
- Helping the child develop a positive self-image
- Seeking support from mental health professionals if needed
| Organization | Description | |
|---|---|---|
| 1 | National Psoriasis Foundation | Offers support groups and resources for families |
| 2 | Psoriasis Support Group | Online community for people with psoriasis and their families |
Stress Management
Stress can trigger psoriasis flare-ups, so it’s important to help children manage stress effectively. Some stress management techniques include deep breathing exercises, progressive muscle relaxation, and engaging in enjoyable activities.[20]
Lifestyle Modifications
Making lifestyle modifications can help children better manage their psoriasis symptoms. Encourage children to:
- Eat a balanced diet rich in fruits, vegetables, and whole grains
- Stay hydrated by drinking plenty of water
- Get regular exercise, which can help reduce stress and improve overall health
- Practice good sleep hygiene to ensure adequate rest
By adopting these lifestyle modifications, children with psoriasis can improve their overall well-being and potentially reduce the severity of their symptoms.[21]
Working with Healthcare Professionals
Collaborating with healthcare professionals is essential for the effective management of pediatric psoriasis. A multidisciplinary team approach can help ensure that children receive comprehensive care and support.[22]
Dermatologists
Dermatologists are the primary healthcare professionals involved in the diagnosis and treatment of pediatric psoriasis. They can:
- Provide an accurate diagnosis and assess the severity of the condition
- Develop an individualized treatment plan based on the child’s needs
- Monitor the child’s response to treatment and make adjustments as needed
- Offer guidance on skincare routines and lifestyle modifications
| Frequency | Purpose | |
|---|---|---|
| 1 | Initial visit | Diagnosis and treatment plan development |
| 2 | Follow-up visits | Monitor treatment progress and make adjustments |
| 3 | Annual check-ups | Assess long-term management and screen for comorbidities |
Pediatricians
Pediatricians play a crucial role in the overall health and well-being of children with psoriasis. They can:
- Monitor the child’s growth and development
- Screen for comorbidities associated with psoriasis, such as obesity and diabetes
- Provide guidance on healthy lifestyle habits and emotional well-being
- Coordinate care with dermatologists and other specialists as needed
Mental Health Professionals
Children with psoriasis may experience emotional distress, such as low self-esteem, anxiety, or depression. Mental health professionals, such as psychologists or counselors, can provide valuable support by:[23]
- Helping children develop coping strategies to manage stress and emotions
- Providing therapy to address any mental health concerns
- Offering guidance to parents and caregivers on supporting their child’s emotional well-being
By working closely with a multidisciplinary team of healthcare professionals, children with psoriasis can receive comprehensive care that addresses both their physical and emotional needs.[24]
Frequently Asked Questions
No, pediatric psoriasis is not contagious. It is an autoimmune condition that is not caused by bacteria or viruses and cannot be spread from person to person.
While some children may experience a remission in their psoriasis symptoms as they age, there is no guarantee that they will outgrow the condition. Psoriasis is a chronic condition that often requires ongoing management.
Common triggers for psoriasis flare-ups in children include stress, skin injuries, certain medications, and infections such as strep throat. Identifying and avoiding individual triggers can help manage the condition.
While there is no specific diet for managing pediatric psoriasis, some children may benefit from a balanced diet rich in fruits, vegetables, and whole grains. Omega-3 fatty acids found in fatty fish, nuts, and seeds may also help reduce inflammation. It is best to consult a healthcare professional for personalized dietary advice.
The frequency of dermatologist visits depends on the severity of the child’s psoriasis and their response to treatment. Initially, more frequent visits may be necessary to establish an effective treatment plan. Once the condition is well-controlled, follow-up visits may be scheduled every few months or as needed.
Yes, children with psoriasis can participate in sports and physical activities. Exercise can help reduce stress, a common trigger for psoriasis flare-ups, and improve overall health. However, it is essential to take precautions to avoid skin injuries and to moisturize the skin regularly.
Yes, there are several support groups available for children with psoriasis and their families. Organizations such as the National Psoriasis Foundation offer online communities, local support groups, and educational resources to help families cope with the challenges of living with psoriasis.
Reference list
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- Bronckers IMGJ, Paller AS, van Geel MJ, van de Kerkhof PCM, Seyger MMB. Psoriasis in children and adolescents: Diagnosis, management and comorbidities. Paediatr Drugs. 2015;17(5):373-384.
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- Eichenfield LF, Paller AS, Tom WL, et al. Pediatric psoriasis: Evolving perspectives. Pediatr Dermatol. 2018;35(2):170-181.
- Osier E, Wang AS, Tollefson MM, et al. Pediatric psoriasis comorbidity screening guidelines. JAMA Dermatol. 2017;153(7):698-704.
- Augustin M, Reich K, Glaeske G, Schaefer I, Radtke M. Co-morbidity and age-related prevalence of psoriasis: Analysis of health insurance data in Germany. Acta Derm Venereol. 2010;90(2):147-151.
- Becker L, Tom WL, Eshagh K, Benjamin LT, Paller AS. Excess adiposity preceding pediatric psoriasis. JAMA Dermatol. 2014;150(5):573-574.
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- Papp K, Thaçi D, Marcoux D, et al. Efficacy and safety of adalimumab every other week versus methotrexate once weekly in children and adolescents with severe chronic plaque psoriasis: a randomised, double-blind, phase 3 trial. Lancet. 2017;390(10089):40-49.
- van Geel MJ, Oostveen AM, Hoppenreijs EP, et al. Methotrexate in pediatric plaque-type psoriasis: Long-term daily clinical practice results from the Child-CAPTURE registry. J Dermatolog Treat. 2015;26(5):406-412.
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