Psoriasis is a common, noninfectious skin condition. The most common type of psoriasis is plaque psoriasis. For children with the condition, psoriasis tends to show up first on the scalp. It’s also common for psoriasis to affect the face, nails, or skin folds.

An adult rubbing ointment on a child's feet.Share on Pinterest
SBenitez/Getty Images

People with a family history of psoriasis have a higher risk of developing the condition.

According to the American Academy of Dermatology, scientists have found that certain genes increase a person’s chance of developing psoriasis. But it’s also possible to have a genetic risk factor for a condition but never develop it.

This article explores what psoriasis looks like in children, how to identify it, and treatment options.

Psoriasis is an autoimmune condition. This means your immune system responds in a way that causes skin cells to develop much more rapidly than usual and not fall off as they should.

Plaque psoriasis is the most common type of psoriasis. In plaque psoriasis, cells build up on the skin’s surface, causing areas of thick, silvery-white skin. These areas are called plaques. Plaques can occur along with underlying skin redness, which may be less visible on darker skin.

The plaques are usually itchy and covered with thick scales. This process is the result of an overactive immune system.

Other types of psoriasis include:

Learn more about psoriasis.

Generally, plaque psoriasis can appear anywhere on the body, but it most often affects the:

For children with the condition, psoriasis tends to appear on the scalp before anywhere else. It may also affect the nails.

It may also appear on the face or in skin folds. In addition, the plaques may be thinner and smaller than those in adults.

Babies with psoriasis may develop what looks like a diaper rash that does not respond to typical treatments.

Most children develop plaque psoriasis. Guttate psoriasis may also occur in children because it tends to appear after a child has an infection like strep throat. But it can also appear without a trigger infection. Other types of psoriasis are less common in children.

Additional symptoms that may indicate psoriasis in a child include:

  • raised patches of skin that are red and covered with silvery-white scale
  • dry, cracked skin that can bleed
  • itchiness, soreness, or a burning sensation in and around the affected areas
  • red areas in skin folds
  • various nail changes, including:

Here you will find examples of what psoriasis may look like in children.

While no one knows exactly what causes psoriasis, several triggers may make a flare-up more likely. These include:

  • infection
  • skin irritation
  • stress
  • obesity
  • cold weather
  • certain medications, such as lithium

Avoiding triggers or finding ways to manage them can help reduce the frequency or severity of psoriasis outbreaks.

Psoriasis flare-ups

Psoriasis is a chronic condition that cycles through periods of increased and decreased activity.

During active times, or flare-ups, your child will have more symptoms. The symptoms may improve or even disappear within a few weeks or months.

Flare-ups often occur following an illness. However, it’s difficult to predict how severe the symptoms will be once a cycle begins.

Psoriasis is common in children. According to the National Psoriasis Foundation (NPF), an estimated 20,000 children under 10 years old are diagnosed in the United States each year.

Most people experience their first psoriasis symptoms between ages 15 and 35, but psoriasis can develop in children much younger and adults much older. Research shows that about 30% to 50% of adults with psoriasis developed the condition before the age of 20.

For some children, psoriasis symptoms may become less severe and less frequent as they grow older. Others may consistently experience symptoms that may worsen over time.

Healthcare professionals can typically tell whether a child has psoriasis by looking at their skin. During a physical examination, a healthcare professional might ask:

  • which symptoms a child is experiencing
  • whether they’re having joint pain, which could indicate juvenile psoriatic arthritis
  • which medications a child is taking
  • whether there’s a family history of psoriasis
  • whether a child has been exposed to any of the common triggers of psoriasis

Diagnostic tests are not usually necessary, but in some cases, a doctor may order a biopsy. A healthcare professional can use the biopsy results to help them distinguish between psoriasis and similar-looking conditions, like eczema.

Currently, there’s no cure for psoriasis. Treatment focuses on easing symptoms when they occur and helping prevent or reduce the severity of flare-ups.

Topical treatments

Topical treatments are more commonly prescribed than other types of treatments. They can help reduce symptoms of mild to moderate psoriasis and include medicated options and moisturizers. Topical treatments come in various forms, including:

  • ointments
  • lotions
  • creams
  • solutions
  • foams

Topical treatments that the Food and Drug Administration (FDA) has approved for use in children as young as 12 years old include:

  • corticosteroids
  • vitamin D analogs like calcipotriene (Sorilux)
  • treatments that combine the two

Sorilux is safe to use in children over age 4 years.

Topical treatments can be very effective and may cause fewer side effects than other treatments. But it’s important to know that these treatments can be messy, and your child may need to apply them more than once a day.

Consider helping your child remember to apply the treatment by setting electronic reminders or scheduling doses around certain daily activities, such as right before bed and right after waking up. For younger children, try to keep the medications out of reach when not in use and supervise children during their application.

Light therapy

Both natural and artificial light can help ease symptoms of psoriasis. Several newer options include lasers and medications activated by special lights.

Consult your child’s doctor before starting treatment with light therapy. Exposure to too much light could actually make symptoms worse.

If a doctor recommends natural sunlight, consider taking a walk together or playing outdoors after school. However, you should try to cover any exposed areas of skin not affected by psoriasis with sunscreen.

Learn about light therapy for psoriasis.

Oral or injected medications

A doctor may prescribe pills, injections, or intravenous (IV) medications for moderate to severe cases of psoriasis in children.

Some of these medications can cause serious side effects, so it’s important to understand the risks before starting treatment. Due to the possible serious side effects, these treatments may be reserved for older children or only used for short periods of time.

Injection medications that the FDA has approved for use in children include:

  • etanercept (Enbrel)
  • ixekizumab (Taltz)
  • ustekinumab (Stelara)

Taltz and Stelara are safe to use starting at age 6 years. Enbrel is safe to use starting at age 4 years.

Lifestyle changes

Working with your child’s doctor to create a treatment plan to manage triggers can be one of your child’s best defenses against psoriasis. Certain lifestyle habits may also reduce their likelihood of flare-ups. These include:

Anti-inflammatory foods to consider incorporating into a child’s diet include:

  • fatty fish, such as tuna and sardines
  • nuts, such as almonds
  • leafy green vegetables, such as spinach
  • fruits, such as strawberries, cherries, and oranges

Foods that may trigger inflammation and should be avoided or minimized include:

  • processed foods, including ones high in added sugar
  • foods high in saturated fat, such as red meat and full-fat dairy products

Health-promoting activities can strengthen your body. They may also help reduce the number of active periods of psoriasis activity and their severity. In addition, teaching your child about keeping their skin clean and moisturized can help reduce skin irritation and psoriasis flare-ups.

If you need ideas on promoting healthy habits at home, consider starting a friendly competition among the household members. Depending on your goals, you could keep a tally of things like daily steps, time spent being active, or the number of nutritious meals consumed.

Or, you might have a collective brainstorming session in which everyone comes up with ideas for health-promoting activities or meals.

Growing evidence suggests that having psoriasis in childhood can increase your risk of developing other health issues. These include:

Having psoriasis may be linked with a greater likelihood of developing psychiatric conditions or mood disorders. For example, research from 2019, involving a small group of children, showed that children living with psoriasis have about a nine times greater risk of anxiety than children without the condition.

For children, having psoriasis can be distressing. It can be particularly distressing for children with large skin areas covered by plaques or plaques that develop in sensitive areas, such as on the face or around the genitals.

While the scope of a psoriasis outbreak may be relatively small, its impact on a child’s self-esteem may be large. And it may contribute to feelings of depression, isolation, or anxiety.

Seeking professional help

It’s important to work with your child’s doctor to create a treatment and support plan to help address any negative emotional and psychological effects that psoriasis may cause. Not addressing them can have a lasting effect on their overall well-being.

You might consider asking your child’s doctor to talk with your child about their skin appearance.

Having their doctor acknowledge and explain psoriasis can further help your child understand that adults care about their well-being.

As a parent, you can offer support as well. For example, talking with your child about specific responses to questions and comments from their peers can help prepare them for conversations and interactions outside of the home.

You may also want to speak with your child’s doctor about working with a therapist or joining a support group for additional assistance.

Early detection and diagnosis of psoriasis are crucial for children. As soon as you notice symptoms that could be caused by psoriasis, make an appointment with a doctor.

Early intervention, treatment, and general support can also help reduce the stigma of psoriasis and improve any self-esteem issues that may arise because of it.