Psoriasis flares can cause itchy, painful plaques and lesions to develop. Finding out that a child has psoriasis can be difficult news for parents or caregivers.
While there is currently no cure for psoriasis, many treatments are available to help children with this condition live comfortable, social, and active lives.
In the United States, about one-third of people with psoriasis experience symptoms before 20 years of age. However, psoriasis can develop at any age.
In this article, we look at how psoriasis develops in children and how doctors treat the condition.
Psoriasis is an inflammatory condition that affects the skin.
When a person has psoriasis, they will develop patches of discolored, scaly skin on different parts of the body. Skin discoloration will vary depending on a person’s skin tone and the type of psoriasis they have.
Psoriasis tends to be pink or red on those with light or fair skin tones and the scale silvery white. On medium skin tones it can appear salmon-colored and silvery-white scale. On darker skin tones the psoriasis could look violet and the scale gray. Or it can also appear dark brown and difficult to see.
These patches will often worsen or flare and then go into remission. Remission is a period where symptoms of psoriasis disappear completely.
Several different types of psoriasis can develop in children.
Plaque psoriasis
The most common type of psoriasis in both adults and children is plaque psoriasis, in which well-defined patches or plaques develop on the skin. In many cases, these patches first appear on the scalp in children.
Learn more about plaque psoriasis here.
Guttate psoriasis
Another type of psoriasis that often develops in children is guttate psoriasis, which leads to small,
Other upper respiratory infections are also common triggers for psoriasis. Guttate psoriasis can clear without treatment. However, it may become persistent in some people and evolve into chronic plaque psoriasis.
Learn more about guttate psoriasis.
Inverse psoriasis
Inverse or flexural psoriasis refers to smooth patches of sore skin that form around folds in the skin, such as those in the armpits, groin, eyelids, or genital area.
Learn the causes, symptoms, and treatments of inverse psoriasis here.
Pustular psoriasis
This is a rare and severe form of psoriasis more often seen in older adults than in children. However, it can develop at any age. Symptoms of pustular psoriasis include the development of white or yellow painful, pus-filled bumps and inflamed or discolored skin.
Learn more about pustular psoriasis here.
Erythrodermic psoriasis
Another rare type of psoriasis is called erythrodermic psoriasis. This form of psoriasis can be life threatening and often affects the entire body. It can disrupt the body’s temperature and fluid balance, which may cause shivering and edema — or swelling in the feet and ankles.
Symptoms include severe discoloration and shedding of skin over a large area of the body. A person may also experience severe itching, pain, and increased heart rate.
A person should look out for several symptoms to identify psoriasis. Psoriasis
Some of the symptoms that help distinguish psoriasis from other conditions in children include:
- nail pitting or discoloration
- itching, pain, or general discomfort
- severe scales on the scalp
- dermatitis around the area of a diaper
- plaques similar to those of adult psoriasis on the arms, legs, and trunk
If a rash or lesion does not respond to over-the-counter (OTC) treatments, its cause may be an underlying inflammatory condition. Psoriasis might strongly resemble eczema or seborrheic dermatitis, so close observation is necessary.
The most significant difference between adult and child psoriasis is simply the age of onset. Otherwise, a child with psoriasis may experience many of the same symptoms and triggers as an adult.
Other potential differences in children include a
Treatment for psoriasis focuses on reducing the severity of a flare and helping with the emotional stress of having psoriasis.
However, before a child undergoes any of the possible treatments, their parents or caregivers should discuss the risks and benefits that treatment carries with a primary care doctor or dermatologist and ask whether it is medically essential.
A dermatologist is a doctor or physician who specializes in skin care.
Topical therapies
People use topical therapy in the form of lotions, foams, creams, tars, bath solutions, and shampoos to treat most cases of psoriasis. Some OTC topical treatments are available, while others are only available by prescription.
This treatment involves medicated creams and lotions, such as topical steroids and creams containing anthralin, synthetic vitamin D3, and vitamin A. The FDA approves the use of salicylic acid and coal tar in OTC psoriasis treatments.
Topical therapies may resolve mild to moderate skin symptoms without any further treatment.
Phototherapy
Phototherapy involves
Because UV light plays a role in developing skin cancer, it is generally not suitable for use in child psoriasis cases. People with mild plaque or guttate psoriasis tend to respond best to phototherapy.
A dermatologist will typically prescribe phototherapy.
Systemic medications
Systemic medications directly treat specific parts of the immune system, addressing the root cause of psoriasis. These may be oral tablets and capsules or injectable solutions.
Typically, people use these for moderate to severe presentations and only take them for short periods. Doctors rarely prescribe them for psoriasis of the scalp.
If the plaques or lesions do not respond to other treatments, doctors might sometimes prescribe
Doctors may recommend injectable medications for psoriasis. The frequency of administration will vary between drugs, and doctors will monitor people for any potential side effects throughout the course of treatment.
Injectable medications for psoriasis include:
- Etanercept: A person or caregiver will administer this medication twice a week. If symptoms do not improve after 12 weeks, a doctor will cease treatment.
- Infliximab: A doctor will administer this drug through an intravenous drip. A person will typically receive three infusions in the first 6 weeks and then one infusion every 8 weeks. A doctor will recommend that treatment end if no improvement is visible after 10 weeks.
- Ustekinumab: A person will receive a dose of this drug at the start of treatment, another at 4 weeks, and then every 12 weeks thereafter. Treatment will cease if symptoms do not improve after 16 weeks.
- Adalimumab: A person will receive a dose of this medication every 2 weeks. If no improvement is visible after 16 weeks, a doctor will cease treatment.
Parents or caregivers seeking alternatives treatments can try a range of natural treatments. Using natural treatments can be effective for some people alongside traditional treatment options.
However, alternative medicines should never replace doctor-recommended treatments. Parents or caregivers of children with psoriasis should always check with a medical professional before using alternative treatments.
Before applying topical treatments, a person should carry out a patch test on the child to check for an allergy. They should also monitor the child for adverse reactions or a worsening rash, stop usage and immediately consult a healthcare professional if the child experiences any side effects.
Some potential alternative treatments include:
Additionally, some parents and caregivers may wish to seek psychological therapy or counseling on behalf of a child with psoriasis. If a child has the condition, it can lead to them feeling isolated and developing self-image and confidence issues early on in life.
Parents or caregivers should also supervise children when taking medication or using home treatments.
Discover 12 at-home remedies for psoriasis flares here.
Diet
Additional steps for managing psoriasis in children involve maintaining overall health. People with psoriasis who follow gluten-free, low carb, and high protein diets may experience milder symptoms.
The researchers behind the survey also advise that a vegan, paleo, or Mediterranean diet could help reduce symptoms.
While they do not recommend any single diet over the others for people with psoriasis, they do suggest that the common thread between these diets is that they can aid weight loss.
Researchers have been unable to determine the exact cause of psoriasis.
However, most agree that it has a strong genetic pattern. A person may pass it on to their children in the genes.
Beyond this, researchers have concluded that the incorrect function of the immune system leads to the overproduction and buildup of skin cells, which results in the characteristic plaques and lesions of psoriasis forming.
Some known triggers that may cause psoriasis for the first time or cause or worsen a flare include:
- stress
- infection in the throat or upper respiratory tract
- injury
- weather
- medication
Psoriasis is not contagious, and one child cannot transfer it to another. Therefore, there is no need to prevent contact between children.
Instead, parents and caregivers should encourage the child to socialize with others, as this can help them build a support network and reduce feelings of isolation.
It is very important for children to see their doctor if an unexplained rash develops and does not respond to OTC treatments.
Parents or caregivers should also consider the child’s family history. If they or someone else in the family has psoriasis, a new rash on a child is more likely to result from this condition.
Children with psoriasis are likely to have the condition for the rest of their lives.
Psoriasis that is mild to moderate is unlikely to lead to major medical complications. However, children with more severe psoriasis may develop psoriatic arthritis.
It is important to take a child’s emotional well-being into account while treating psoriasis. People caring for a child with the condition should be aware of the emotional and physical effects that it may have on them.