What Is Psoriasis?

Psoriasis is a chronic (long-lasting) skin condition. People with psoriasis have a skin rash and, sometimes, joint problems or nail changes.

There's no cure for psoriasis, but treatment can help most people who have it control its symptoms.

What Are the Signs & Symptoms of Psoriasis?

The main symptom of psoriasis (seh-RYE-eh-siss) is red, thickened patches of skin called plaques. These can burn, itch, or feel sore. Often, silvery scales cover the plaques.

Plaques can happen anywhere. In children, they're most common on the:

• face
• scalp
• areas where skin touches skin (such as where the arm bends or in the armpit)
• diaper area (in babies)

Other symptoms of psoriasis include:

• dry, cracked skin that may bleed at times
• thick, pitted nails
• arthritis (painful, stiff, swollen joints)

What Are the Types of Psoriasis?

In children, common types of psoriasis include:

Plaque psoriasis. This is the most common type of psoriasis. It causes plaques and silvery scales, usually on the knees, elbows, lower back, and scalp. They can be itchy and painful and may crack and bleed.

Guttate (GUT-ate) psoriasis. This type often shows up after an illness, especially strep throat. It causes small red spots, usually on the trunk, arms, and legs. Spots also can appear on the face, scalp, and ears.

Inverse psoriasis. This causes smooth, raw-looking patches of red skin that feel sore. The patches develop in places where skin touches skin, such as the armpits, buttocks, upper eyelids, groin and genitals, or under a woman's breasts.

Face, scalp, diaper area psoriasis. These areas of psoriasis rash are more common in children. Diaper area psoriasis can clear up after a child is toilet trained and no longer wears diapers.

What Causes Psoriasis?

The exact cause of psoriasis isn't known. But experts do know that the body's immune system, which fights germs and diseases, is involved. Overactive immune system cells make skin cells grow faster than the body can shed them, so they pile up as plaques on the skin.

Some genes have been linked to psoriasis. About 40% of people with psoriasis have a family member who has it.

Anyone can get psoriasis and it may begin at any age. It can't spread from person to person.

What Are Psoriasis Flare-Ups?

Symptoms of psoriasis can go away completely, then suddenly come back. When the symptoms are worse, it's called an "outbreak" or "flare-up." Symptoms of psoriasis can be brought on or made worse by:

• infections such as strep throat and colds
• some medicines, such as lithium and beta-blockers
• stress
• skin irritations
• cold weather
• drinking alcohol
• smoking

How Is Psoriasis Diagnosed?

Doctors usually diagnose psoriasis by examining the skin, scalp, and nails. They'll also ask whether someone else in the family has psoriasis and if the child recently had an illness or started taking a new medicine.

Rarely, doctors might take a skin sample (a biopsy) to check more closely. A biopsy can tell the doctor whether it's psoriasis or another condition with similar symptoms.

How Is Psoriasis Treated?

Psoriasis is usually treated by a dermatologist (skin doctor). A rheumatologist (a doctor who treats immune problems) may also help with treatment. Treatments can include:

• ultraviolet (UV) light from the sun or from home or office treatments. But in some children, sunlight can make psoriasis worse.
• creams, lotions, ointments, and shampoos such as moisturizers, corticosteroids, vitamin D creams, and shampoos made with salicylic acid or coal tar
• medicines taken by mouth or injected medicines

A doctor might try one therapy and then switch to another, or recommend combining treatments. It's not always easy to find a therapy that works, and sometimes what works for a time stops helping after a while.

How Can Parents Help?

For some children, psoriasis is just a minor inconvenience. For others, it is a difficult medical condition.

To manage symptoms and make outbreaks less likely, your child should:

• Wash hands well and often and stay away from people who are sick to prevent infections.
• Manage stress through exercise, yoga, or meditation.
• Not smoke or drink alcohol.
• Keep a healthy weight. People who are overweight tend to have more severe psoriasis symptoms.

Kids and teens with psoriasis may feel uncomfortable with the way their skin looks. Help your child understand that psoriasis is common and treatments can help.

Whether your child's psoriasis is mild or severe, learn about the condition together. Offer to help find a therapist or join a support group if that might help. Talk to your doctor or check websites like:

• National Psoriasis Foundation
• TalkPsoriasis