Children can have mild, moderate, or severe psoriasis. It's a lifelong condition with no cure, but you can treat the symptoms with medication. Most pediatric cases of psoriasis are mild and get better with treatment.
Psoriasis isn't contagious. Often, a bacterial infection like strep throat triggers psoriasis for the first time in children. Other kids get certain genes from their parents that make them more likely to get it.
Things that raise a child's risk of getting the disease also include:
- Being obese
- Certain medications, like lithium, beta-blockers, or malaria drugs
- Cold weather
- Cuts, scratches, sunburn, or rashes on the skin
- High levels of stress
Types of Psoriasis in Children
There are five types of psoriasis, but some are much more common in children than others. The symptoms can show up differently in children, too. For example, they're more likely to have psoriasis on their face or around joints.
The two types children are most likely to get are:
- Plaque psoriasis. Most kids who have psoriasis have this type. It causes red, dry patches called plaques. It can also cause silvery scales. The plaques or scales usually show up on knees, elbows, lower back, and the scalp. They're itchy, red, and sometimes painful. They can also bleed. Plaque psoriasis patches are smaller, thinner, and less scaly in children than in adults.
- Guttate psoriasis. This kind is also called "drop-like" psoriasis. It causes small red dots to form on the trunk, back, arms, and legs. It's most likely to be triggered by a strep infection. Many children who get this type of psoriasis also develop plaque psoriasis.
Children under 2 can get psoriatic diaper rash. It happens on the skin that's covered up by the diaper. It may show up like plaque psoriasis, or it may cause a bright red, weeping rash. You can tell the difference between psoriatic diaper rash and regular diaper rash because psoriatic diaper rash doesn't get better with regular diaper rash treatment.
Less Common Types of Psoriasis in Children
Kids aren't likely to get these types of psoriasis:
- Pustular psoriasis: This shows up as blisters on red or swollen skin on the hands and feet. If a child does get it, it's typically either milder than an adult would have or a kind called annular pustular psoriasis that causes a red ring around the blisters.
- Inverse psoriasis: This happens in the folds of the body -- under the knee, in the armpit, or around the groin. It looks very red, smooth, and shiny.
- Erythrodermic psoriasis: This is a severe form that can be life threatening. It causes redness over most of the body. It's very itchy and painful and can make skin come off in sheets.
A doctor usually can tell it's psoriasis by looking carefully at your child's skin, nails, or scalp. To be sure, she might also remove a small sample of skin and send it to a lab for a closer look. She'll also ask questions about your family history and habits to see how many risk factors your child has.
Your child's doctor is likely to recommend an antihistamine (a kind of drug used to treat allergies) to help with itching. Keeping skin moisturized is important, too. She may suggest a petroleum jelly to lock in moisture. And salicylic acid may also be an option for thick plaques, but you shouldn't use it on children under 6 years old.
Other options may include:
- Topical treatments: Most children have mild psoriasis you can treat with cream, lotion, or ointment that's spread onto the skin. These include:
- Light therapy: Your child's doctor might choose this option if plaques are on most of your child's body. Types include artificial light (UV light) and laser therapy. But these treatments are known as second line, meaning your doctor will likely try a topical treatment before light therapy.
- Oral medications: Your child's doctor will probably recommend medicine to take by mouth or by shot only if the psoriasis is severe. Many of the ones doctors use for adults are not as safe in children and have serious side effects.