Remember, your child's psoriasis will not, generally, affect his or her general health, growth, and development. Itching is often more common in children with psoriasis; however, scratching can aggravate the skin and make the condition worse. Here are some practical tips:
- Keep your child's nails short and cover hands with cotton gloves as needed.
- Baths with oil or oatmeal added can be soothing.
- Bathe in lukewarm - not hot or cold - water.
- Regularly apply moisturizers, especially after bathing.
- Apply topical corticosteroids as prescribed by your doctor.
- Oral antihistamines may be recommended by your doctor and can help reduce the tendency to scratch. If your child scratches at night, the nighttime use of antihistamines can both reduce scratching and aid in sleeping. A doctor should be consulted before using antihistamines as overuse can result in excessive sedation.
- To treat the redness and scaling of psoriasis in children, your doctor might prescribe topical corticosteroids.
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| Psoriasis In Infants |
Kayla is a 10-year-old girl who has had psoriasis since she was approximately 5 years of age. Initially, her psoriasis began in a localized area on her left calf. In the past few years it has gradually and progressively become more widespread, now involving most areas of her body. When she came to see me, she complained that her skin was itchy, and she noted the psoriasis was involving her arms, back, legs, scalp, and, more recently, her face. There is a family history of psoriasis (her grandmother).
In the past, Kayla had tried a number of topical therapies, which had initially helped clear the scaly, red, raised areas and reduced the itching. More recently, the topical steroid creams have not been effective, even in increasing strengths. She had also tried topical tars, but had found these to be irritating to her skin. Because she had failed these topical treatments, she was prescribed ultraviolet light, three times weekly for the past two years, which had helped at first, but was no longer effective.
When I first met Kayla she was noticeably shy and withdrawn. Her father explained to me later that her psoriasis was having a significant impact on her self-image and confidence. She was becoming more withdrawn and was unwilling to engage in physical activities that exposed her skin, She had occasionally been teased at school by some of the other children.
When I examined Kayla's skin, approximately 70 percent of her body was covered with psoriasis, sparing only areas of her face and several areas on her trunk. Kayla was certainly one of the most severe cases of psoriasis that I had seen in a child. It was clear to me why many of the topical therapies she had tried were no longer working. In patients with extensive psoriasis like Kayla, topical therapies are usually neither practical - requiring considerable time and effort to apply to such widespread areas - nor effective. Typically we need to use phototherapy or consider systemic therapies (oral or injections) to obtain a response.
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| Psoriasis In Infants |
Another dermatologist had referred Kayla to me because the phototherapy was no longer effective, and we were conducting a clinical study for psoriasis in children. This study involved using a novel agent that worked by blocking a protein called tumor-necrosis factor (TNF). TNF is important in helping the immune system to function normally. In patients with psoriasis and psoriatic arthritis, however, TNF is increased and plays a key role in causing the thick, red, scaly skin and swollen joints of psoriasis and psoriatic arthritis. Our clinical study involved blocking TNF and had been proven highly effective in treating psoriasis and psoriatic arthritis in adults. I discussed the risks and benefits with Kayla and her parents, and they were very interested in proceeding with this study.
When I saw Kayla two weeks after starting the therapy, she was significantly better as approximately 50 percent of her lesions had cleared up; at two months after starting the therapy, she was virtually clear. What was most striking to me was not the improvement in her psoriasis, but the improvement in her outlook, mood, and personality. Where she had been withdrawn and shy, she became quite bubbly, was happy to be in the office, and readily engaged in conversation. To find out more, you can check out Psoriasis In Infants.