Parental guilt is a common reaction to having a child who develops psoriasis. No parent wants to see their child uncomfortable, or itchy, or embarrassed about how he or she looks. Add to that stress the discussion of “genetic susceptibility” to psoriasis and it’s perfectly understandable that parents would take it hard.
But it’s not a good direction in which to head. Psoriasis is a “multifactorial” disorder, influenced by both genetic and environmental factors, most of which are out of our control, and many of which scientists have still not even identified. So blaming yourself doesn’t really make sense.
Instead, use this frustrating and worrisome development to help your child learn resilience, and empower your child by making her or him an active participant in their treatment plan. You can educate yourselves about psoriasis together, have your child come up with some questions to ask at a doctor visit, and perhaps spark inspiration in your child to study science with an eye to curing the disease as a grownup.
The good news is that as with adults, lots of childhood psoriasis is mild, and can be treated safely and effectively with topical ointments, and sometimes just time in the sun (without sunburn).
But we don’t want to sugarcoat things: psoriasis can also be extremely difficult for some children (as for adults). It can be harder for children due to peer pressure, bullying, and fragile self-esteem. Plus, for children whose psoriasis is moderate or severe, treatment decisions can prove tricky.
Most of the leading psoriasis treatments are not FDA-approved for minors. They can be prescribed “off-label” by physicians for your child, but that can sometimes pose insurance reimbursement issues, and it means that research on children for that treatment is very limited and thus safety in that age group has not been formally established. There is also the question of whether to “undertreat” a child’s psoriasis to spare the child possible side effects from some treatments, versus treating it aggressively to spare the child the physical and emotional pain of living with psoriasis, particularly if it is visible.
We urge you, if at all possible, particularly when dealing with a child with psoriasis, to seek a dermatologist who has treated other children with psoriasis. Fortunately, the long-term prognosis for children with psoriasis is truly bright. It just may be a bumpy road along the way.
Two more things, parents: it is important to keep an eye on the mental health of children with psoriasis, as mood disorders like depression and anxiety can be present along with or at some point following a psoriasis diagnosis. And you should also be willing to seek professional counseling or the advice of a physician if your child’s battle with psoriasis is adversely affecting your mood on a continuing basis.