What is it?
Psoriasis is a skin condition which results in raised, thick, red patches of skin on the body. It is rare in young children (usually it won't show up until a child is in their teens), but when it does occur, it is most likely to be a type called plaque psoriasis, which affects the elbows and knees, lower back and sometimes the face and scalp.
The patches are caused by the body's skin cell production going into overdrive: usually skin cells are replaced on a four week cycle; dead skin cells on the surface fall away as new ones are formed underneath. When psoriasis is present, new skin cells might be being formed every three to four days. This causes a build up on the surface of the skin, creating unsightly and uncomfortable scaly patches. No one is entirely certain what causes psoriasis, but genetic factors play a part – if you or a close family member suffers from psoriasis, there is an increased risk that your child will do at some point, too. The condition is triggered by certain things – for example, stress and anxiety, an injury to the skin, an insect bite, or a throat infection caused by streptococcus bacteria can all lead to a flare-up.
Sometimes, psoriasis is mistaken for eczema – and they do share some symptoms. The affected skin will feel dry and itchy, and the patches will come and go. However, a doctor should be able to diagnose psoriasis upon examination and then advise on the best course of treatment.
What can I do?
First of all, go to your GP as soon as you see a problem with your child's skin. Psoriasis a chronic condition, meaning there is no cure, but the sooner you start managing it the better.
Treatment will depend on the severity, but it's likely to start with some heavy moisturising ointment (to be used frequently, as it will help a lot with the itching) and possibly some topical steroid cream, which works by thinning the skin. You might also be given a bath emollient (to soften the water), or creams containing vitamin D or coal tar (designed to help remove some of the scales and thin out the raised patches).
Occasionally, the patches can become infected (usually because of scratching) and if this happens, a course of antibiotics will be prescribed. It's almost impossible to completely stop children from scratching when they are itchy, so keep their nails short and their hands clean.
If the initial treatments seem not to be helping, your child is likely to be referred to a dermatologist who will be able to offer stronger medications and may also suggest some UV light therapy, which might take place at your local hospital, on a regular basis for several weeks.
There are other things you can do at home to ease your little one's discomfort during a flare-up. Make sure they have pure cotton clothes, pyjamas and bed linen to keep their skin cool. If they are having trouble sleeping because they are feeling itchy at night, ask your doctor or pharmacist about getting some liquid antihistamine – it can help to reduce the itch and can act as a mild sedative, meaning they get some proper rest.
If your child is at school or nursery, speak to their keyworker or teacher and make sure they have a pot of moisturising cream to apply during the day. They also might be able to help if your child is feeling a bit down about the appearance of their skin – children can get quite 'icky' about anything that looks like it's catching. Psoriasis isn't catching, so teachers should explain that to the class and offer support to your child if they're feeling blue.
Although it is not possible to cure psoriasis completely, it is manageable and hopefully, with the right support, you can keep the flare-ups to a minimum.
What else could it be?
If your child has patches of red/pink pimples or pink, thickened skin on their face or other parts of their body, they might have eczema.
If the skin is flaky/scaly and the areas affected are the forehead, hairline, scalp, eyebrows and above the ears, your baby might have cradle cap.
Much more information and advice about psoriasis is available from The Psoriasis Association.
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