Psoriasis in children, also called pediatric psoriasis, is a chronic (long-term) disease that causes thick, discolored patches of skin. Psoriasis can affect children of all ages, from 2-year-olds through teenagers. According to the National Psoriasis Foundation, about one-third of people diagnosed with psoriasis are under age 20.

Although children can develop the same types of psoriasis as adults, there are some differences between psoriasis in children and adults. Parents and caregivers may want to learn about the symptoms and treatments for childhood psoriasis and how they differ from adult psoriasis.

Symptoms of Psoriasis in Children

Symptoms of psoriasis in children are similar to symptoms in adults — thick, discolored (pink, red, purplish, or brown), scaly patches of skin. These patches are called plaques and can change in size and location on a child’s skin over time. Other symptoms of psoriasis in children include:

• Pain
• Silvery scales
• Itching
• Stinging
• Burning
• Tightening feeling on the skin
• Hair loss

In children, plaques are most commonly found — and first appear — on the scalp. Psoriasis plaques also frequently appear on the ears, upper eyelids, fingernails, and toenails of school-aged children.

Children with psoriasis are more likely to have other health problems, including:

• Obesity
• Diabetes
• High blood pressure
• Juvenile arthritis
• Crohn’s disease
• Mental health disorders

Juvenile psoriatic arthritis affects up to 10 percent of children with psoriasis and causes swollen, painful, and stiff joints. Proper management of childhood psoriasis is important for a child’s long-term health and wellness.

Other skin conditions, such as eczema, are common in children and can be confused with psoriasis. A pediatric dermatologist specializing in treating skin conditions in children can help determine whether a child has psoriasis or eczema.

Treatments for Psoriasis in Children

Although there is currently no cure for childhood psoriasis, many effective treatments are available. Seeking treatment from a board-certified dermatologist, having a solid support network, and making lifestyle changes can help children manage psoriasis successfully.

Treatments for childhood psoriasis include:

• Identifying and avoiding triggers that cause flare-ups
• Maintaining a proper skin care routine and regularly using moisturizers
• Living a healthy lifestyle
• Using medications

Some medications for childhood psoriasis are topical (applied directly to the skin), and others are taken orally (by mouth) or by injection. Medications for children with psoriasis include:

• Topical treatments, such as vitamin D analogs, corticosteroids, coal tar (Psoriasin), and calcineurin inhibitors (medicines that help prevent the body from rejecting transplanted organs)
• Phototherapy using narrow-band ultraviolet light B
• Systemic treatments with retinoids or immunosuppressant drugs such as methotrexate (Otrexup, Rasuvo, Trexall) and cyclosporine
• Biologic agents that target inflammation, such as etanercept (Enbrel), adalimumab (Humira), infliximab (Remicade), and ustekinumab (Stelara)

Special considerations are needed when treating psoriasis in children. It can be difficult for them to understand and handle the physical and emotional impacts of psoriasis. For example, some children with psoriasis feel embarrassed by their visible skin lesions — and sometimes even experience bullying. As one MyPsoriasisTeam member shared, “I have watched the daily struggle my daughter has gone through.” Another said, “This affects her confidence and self-esteem.”

Pain and itching can make it hard for children to focus at school and sleep at night, as well. A supportive environment, including a support group and care from a pediatric dermatologist, can help children with psoriasis deal with this condition.

Prevalence of Psoriasis in Children

Almost 1 in 3 cases of psoriasis begin during childhood. Psoriasis affects nearly 1 percent of children, according to care guidelines published in the Journal of the Academy of Dermatology. The authors of a 2016 study in the journal Psoriasis: Targets and Therapy reported that the most common types of psoriasis in children are:

• Plaque psoriasis
• Guttate psoriasis
• Scalp psoriasis
• Pustular psoriasis

The rate of psoriasis in children more than doubled between 1970 and 2000. Researchers believe a mix of biological and environmental factors is responsible for this increase.

Risk Factors for Developing Psoriasis in Children

Like psoriasis in adults, psoriasis in children is caused by an overactive immune system. A ramped-up immune response causes the body to make too many skin cells and leads to skin inflammation. Psoriasis in children also has a hereditary component. According to a study in the journal Psoriasis: Targets and Therapy, more than 50 percent of children with psoriasis have a family history of the condition.

Risk factors for psoriasis in children include:

• Viral infections such as strep throat
• Stress
• Skin injury
• Obesity
• Secondhand cigarette smoke
• Discontinuation of corticosteroid use

How Does Psoriasis in Children Differ From Adult Psoriasis?

Psoriasis has similar characteristics in children and adults, but there are several differences. For example, guttate psoriasis is a more common type of psoriasis in children than in adults. Guttate psoriasis is linked to infections such as strep throat. Obesity and psoriasis are also more closely connected in children than adults.

Psoriasis plaques in children are often smaller and thinner than those in adults. Plaques are also more likely to develop on the face, the back of the knees, and inside the armpits, elbows, and groin in children.

The Bottom Line

Psoriasis is a chronic skin condition that can have a significant impact on a child’s quality of life. Parents or caregivers and health care providers need to work together to develop an individualized treatment plan that addresses the physical and emotional needs of the child. With continued research, dermatologists can better understand the causes of psoriasis and work toward more effective treatments and improved outcomes for children with this condition.

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people with psoriasis and their loved ones. On MyPsoriasisTeam, more than 116,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis.

Do you have a child with psoriasis? When did their symptoms first appear? Share your experience in the comments below, or start a conversation by posting on your Activities page.