Psoriasis is an autoimmune skin condition that can cause scaly patches of skin and may affect infants. It may look different depending on your baby’s skin tone.

Psoriasis is a chronic skin condition in which the production of new skin cells speeds up. This results in an accumulation of extra skin cells.

These extra cells form scaly patches or plaques with sharp borders and gray to silver-white flakes called scale. They may feel itchy.

Psoriasis appears differently depending on your skin tone, according to the American Academy of Dermatology Association (AADA).

  • On light skin tones, psoriasis patches may appear reddish with white scale.
  • On medium-toned skin color, it may appear as salmon-colored patches and silvery-white scale.
  • On brown skin tones, it may appear violet with grayish scale.
  • On dark skin tones, patches may be dark brown and potentially difficult to see.

People with medium to dark skin tones may also experience temporary dyspigmentation. This can include light or dark spots where the psoriasis was before it cleared.

Psoriasis affects people of all ages. About 33% of cases begin during childhood. Psoriasis rarely occurs in infants.

Psoriasis is a noncontagious autoimmune disease that affects the skin. Most types of psoriasis result in scaly discolored patches of skin on various parts of the body. The patches may be itchy and painful or even crack and bleed.

In infants, the most common locations for these lesions include the:

  • face
  • diaper area
  • neck
  • elbows
  • knees
  • scalp

Infants’ psoriasis rash may start on the head or face (often the scalp) or as a diaper rash. It may itch.

Babies may have trouble sleeping and become irritable because of the discomfort.

Baby with psoriasis on body.Share on Pinterest
Psoriasis can cause lesions on the face and body. © Branisteanu et al. CC BY-NC-ND 4.0
Baby with psoriasis.Share on Pinterest
A baby with pustular psoriasis. © Branisteanu et al. CC BY-NC-ND 4.0
Baby with napkin psoriasis.Share on Pinterest
A baby with napkin psoriasis. © Branisteanu et al. CC BY-NC-ND 4.0

Anyone can develop three variations of psoriasis, including:

Plaque psoriasis

Plaque psoriasis is the most common type in all ages. Plaque psoriasis looks like raised, scaly patches, particularly on the lower back, scalp, elbows, and knees. The color of the patches depends on the person’s skin color.

In children, plaques tend to be thinner and smaller in size.

Plaque psoriasis has a few names depending on its location. These can include:

Napkin psoriasis

Napkin or diaper psoriasis has skin lesions that occur in the diaper area. They may appear without scaling due to the moisture in that area. This can make diagnosis challenging because infants can develop other, more common types of diaper rash.

Scalp psoriasis

Plaques specifically appear on the scalp, causing raised patches with a buildup of flaky skin cells on top.

Inverse psoriasis

Lesions appear in skin folds, such as under the arms and behind the knees. This type of psoriasis may be accompanied by outbreaks affecting other parts of the body.

Guttate psoriasis

Guttate psoriasis is more common in infants and children, but it’s still the second most common type. It’s the most likely type of psoriasis triggered by a strep infection or a cold. It appears as small, dot-like patches (rather than large plaques) all over the body.

Pustular psoriasis

Pustular psoriasis appears as red patches with a pus-filled center. These pustules most commonly occur on the hands and feet. This type is uncommon in infants.

Erythrodermic psoriasis

Erythrodermic psoriasis is a rare, life threatening type of psoriasis. It results in a psoriasis rash all over the body. The rash is extremely itchy and painful and may cause large portions of skin to come off.

Nail psoriasis

Nail psoriasis is also uncommon in infants. It causes pitting and ridges in the finger and toenails, and may even cause them to discolor or fall off. Nail changes may or may not be accompanied by skin lesions.

Though the cause of psoriasis is unknown, several factors may contribute to its development. These may include:

  • genetics
  • family history of psoriasis or other autoimmune disorders
  • susceptibility to autoimmune disease
  • environmental or infectious triggers
  • an infection, such as a cold or strep throat

Other contributing factors of psoriasis that are more likely to affect older children and adults than infants may include:

  • stress
  • use of some medications
  • cold weather
  • skin trauma
  • obesity

Psoriasis isn’t contagious and can’t be passed from person to person.

Diagnosing psoriasis in babies can be challenging because it can appear similar to other skin conditions on infants. Accessing family history and close observation by a specialist are essential to reach a diagnosis.

If your baby has a rash that has persisted despite at-home creams and treatments, consider talking with a pediatrician. They may be able to identify possible causes of the rash.

A doctor may need to observe the rash over time to diagnose infant psoriasis. Meeting with a pediatric dermatologist may be helpful.

If your baby has psoriasis, there are several treatment options. Many medications used to treat teen or adult psoriasis may be too intense or have too many side effects for babies.

Psoriasis in infants often has only mild symptoms, and treatment may not affect the overall course of the disorder. The best treatment may be the one with the least risk of side effects.

Treatments for babies may include:

  • avoiding heat and cold if these seem to worsen the rash
  • keeping the affected areas clean and dry
  • light therapy
  • lotions and creams, such as topical corticosteroids and topical vitamin D derivatives
  • some exposure to natural sunlight
  • moisturizers designed for psoriasis

Doctors typically do not recommend oral medications for infants.

Psoriasis in infants may resolve and not recur, unlike psoriasis later in life, which tends to come and go over time.

Psoriasis typically comes and goes, and people may go for long periods with few to no lesions. Psoriasis confined to the diaper area in an infant may have a better chance of going away permanently than in other locations and ages at presentation.

Eczema is a common infant skin condition characterized by dry patches of skin. The patches most commonly occur behind the knees, on the arms, and on the face, although they can occur anywhere. The areas with the rash are itchy and may crack or bleed.

Eczema does not have the same scaly buildup of skin cells on top of the patches that psoriasis typically has. Some people with eczema may develop scales, but they usually appear differently than psoriasis scales.

Eczema is also much more likely to respond to over-the-counter (OTC) creams and moisturizers than psoriasis. Eczema rarely affects the diaper area.

When a child has deeply pigmented skin, eczema tends to be diagnosed later in life. Sometimes, the condition is missed because it’s less noticeable.

In brown or black skin, you may see gray to violet-brown skin discoloration rather than red rashes.

It’s also possible for a baby to have eczema and psoriasis at the same time. If your baby has a rash and you are unsure of the cause, talk with a doctor. They can help identify a cause and make a treatment plan.

Psoriasis is a chronic skin condition that can affect babies, children, and adults.

Psoriasis in babies is uncommon and may be challenging to diagnose. The condition can occur on many areas of the body, including the area typically covered by a diaper.

If your baby is diagnosed with psoriasis, treatment may include topical medications, light therapy, and caring for the affected areas.