The first signs of psoriasis often occur at a young age. From children to teens to young adults, such a visible illness can be a stressful and traumatic one to deal with, and often an isolating one. It is therefore crucial for those around young people, parents in particular, to provide the support that helps them through this emotional time. The question is: How can you do so?
Understand Psoriasis Yourself
The more knowledge you arm yourself with, the better prepared you are to offer support and answer difficult questions that may arise.
What Is Psoriasis, and What Causes It?
On the surface, psoriasis is a skin condition. While this is true, research is uncovering ever more details about the disease and its underlying causes.
It is now widely believed to be an autoimmune disease, like multiple sclerosis and rheumatoid arthritis.
Basically, it means something (as yet unknown) causes the immune system to behave abnormally. In the case of psoriasis, it results in the rapid generation of skin cells.
The excess cells lead to the plaques and rashes that psoriasis is known for.
One of the fundamental characteristics of psoriasis is inflammation. In recent years, links have been made between the mechanisms of psoriasis and other diseases, suggesting those with psoriasis may be at greater risk of developing comorbidities. You can read more about the conditions linked to psoriasis here:
Types of Psoriasis
It is also worth understanding that psoriasis is not just one disease.
In fact, there are five variations of the disease. They are:
- Plaque psoriasis
- Guttate psoriasis
- Inverse psoriasis
- Pustular psoriasis
- Erythrodermic psoriasis
Plaque psoriasis is by far the most common, accounting for eight or nine out of every 10 cases. The plaques from which the name is derived are patches of inflamed, raised skin with silvery-white scales.
Guttate is the second most common form. It is characterized by small, red spots that often occur on the arms, legs, stomach, and chest.
The other three forms are much rarer. If you would like to learn about them in more detail, take a look at our comprehensive guide:
It is possible for one individual to live with different forms of psoriasis. Between 20% and 30% of people living with psoriasis will develop psoriatic arthritis. You can read more about psoriatic arthritis in the above blog post.
How to Support a Young Person with Psoriasis
For advice on supporting a young person who is living with psoriasis, who better to listen to than someone who has been through it themselves?
John Redfern was diagnosed with psoriasis at the age of 14. It forced him to quit his passion, Gaelic football, and he struggled to come to terms with his condition well into his adult years. He now keeps a blog, Smart Psoriasis Diet, and has previously shared his story with us, which you can read here:
In it, he gave some tips to parents of young people living with psoriasis, which we will look at in greater detail here.
Top 5 Tips for Parents of Young People Living with Psoriasis
1. Avoid Unnecessary Emotional Trauma
“Never expose your children to morbid situations even if it breaks with traditional values or rituals.”
This may seem like a rather odd tip to begin with, but there is a point to it. When John was 14 years old his uncle, of whom he was extremely fond, suddenly passed away.
John was exposed to the body at the funeral.
“This, I believe, was the traumatic experience that kick-started my psoriasis,” John wrote in his guest post.
This confirms the widely held belief that emotional factors can trigger psoriasis flare-ups.
Find out which apps we think are perfect for living with psoriasis:
As previously mentioned, psoriasis is believed to be an autoimmune disease. There is evidence that emotions, such as stress and anxiety, trigger a hormonal response that can affect the behaviour of the immune system.
Such emotions have also been linked to the release of molecules, called cytokines, that may amplify inflammation associated with psoriasis.
As such, there is an intrinsic link between your emotions, your nervous system, and the immune system.
Of course, John would have had psoriasis regardless, as the trauma did not cause the disease.
However, it is possible that the emotional distress triggered his first flare-up, which subsequently led to more stress, and began a vicious cycle many people living with psoriasis will be familiar with.
While John’s family did not realize he had psoriasis at the time, his advice remains the same: do not expose your child to traumatic experiences unnecessarily.
The emotional impact can last a lifetime, and triggering psoriasis is one of the ways it may manifest itself physically.
2. Take Sign of Mental Health Issues Seriously
“If they are showing signs of depression, do not brush it under the carpet. Schedule a talk with a therapist, as they may not want to open up entirely to you. This could be a huge help.”
Like John, Howard Chang contributed a guest post on this blog:
In it he wrote about his struggles with mental health and shared a passage from his university journal:
“I first was diagnosed with psoriasis when I was about 7.
“I have had psoriasis for over 12 years now and now it is about as bad as it has ever been. I have taken just about every medication known to the world, but they have not helped me in the least bit… Is there no end to psoriasis? Even at this very moment I can barely sit still. It just gets me on edge!!
“The problem is that it will never go away. I need a break.”
The link between psoriasis and mental health conditions is a strong one. Such a visible illness can lead to depression, anxiety, and social isolation.
The figures make for solemn reading. It has been estimated that people living with chronic diseases experience depression and anxiety at twice the rate of the general population, and those between the ages of 15 and 30 are three times likelier to attempt suicide.
Regarding psoriasis specifically, the latest results from PsoHappy – an app with which over 120,000 people complete surveys about their happiness – found that people with psoriasis rated their subjective happiness 30% lower than the general population.
Similarly, it has been estimated that 84% of people living with psoriasis have a psychiatric comorbidity, compared to 32% of people who do not live with it.
You can read more about the link between psoriasis and mental health here:
As both John and Howard can testify, these mental health issues can manifest at a young age and continue well into adulthood.
Sleep disorders, sexual dysfunction, personality disorders, anxiety, adjustment disorders, depression, and substance-related and addictive disorders have all been identified as being prevalent in people living with psoriasis
John’s advice, therefore, is to take any sign of depression in young people seriously. While it is a tough topic to deal with, addressing it at an early age can have significant long-term benefits.
3. Consider All Treatment Options
“Support your child by talking about psoriasis openly, exploring all options, both conventional and complementary.”
There are seemingly endless treatment options for psoriasis. Topical treatments, such as creams and ointments, are often the first port-of-call, especially for mild psoriasis.
Beyond that, there are various forms of light therapy, oral or injected medications, and alternative treatments. Complementary treatments, such as herbal remedies and yoga, may provide benefits in addition to regular treatment.
Of course, all of this must be discussed with your child’s doctor. Nonetheless, it is worth taking the time to perform your own research, so you can discuss all the options openly with your child.
It can also help you explain difficult situations to your child.
“My mom drove me an hour three times weekly each way to one of the only clinics in the San Francisco Bay Area that provided ultraviolet treatments,” recalls Howard.
“In the phototherapy unit the nurse instructed me to wear green goggles without explaining why. No one told me why I needed to stand in it with my clothes off, or for how long.
“Sometimes the light treatments burned my skin with the same sunlight wavelengths that people buy sun protection to block.”
Such experiences can take their emotional toll on anybody, not least a young person who does not understand what is happening or why.
John’s tip, therefore, is similar to the opening point about learning as much as possible about psoriasis. Doing likewise for the possible treatment option will help you when speaking to both your child and their doctor.
4. Take Time to Find a Suitable Diet
“Keep an eye on their diet as the flare-ups may be related to some food intolerances, such as wheat, gluten, nightshades, etc. Try an elimination diet to see if their psoriasis improves.”
Along with elements such as stress and weather, diet is commonly cited as a trigger for psoriatic flare-ups.
A recent survey of over 1,200 National Psoriasis Foundation members unlocked a wealth of information regarding the relationship between dietary habits and patient-reported outcomes.
It represented a wide range of demographics and differing levels of psoriasis severity.
The most commonly quoted triggers for flare-ups included sugar, gluten, and nightshades (which include tomatoes, potatoes, eggplant, and peppers).
Conversely, fish oil/omega-3 polyunsaturated fatty acids (PUFAs), fruits and vegetables, and probiotics were shown to have a positive effect on symptoms of psoriasis.
While it is not always clear why certain foods have a positive or negative effect on psoriatic symptoms, the results are supported by other studies.
Nonetheless, the report is keen to stress that each case of psoriasis is unique to the individual, and there is no one-size-fits-all diet.
As such, finding what works for your child may involve a certain level of trial-and-error.
John’s advice, therefore, is to pay close attention to your child’s diet. Keeping a food diary may help you identify patterns you can act upon.
The information may prove extremely useful to your child’s doctor or nutritionist, who may be able to use it to help tailor a specific diet. Similarly, they may recommend an elimination diet to confirm or disprove suspicions you may have.
That usually involves completely removing certain food groups, such as the ones mentioned above, before re-introducing them one at a time.
Elimination diets are often used to pinpoint food intolerances. They can be equally effective in detecting which foods trigger psoriasis flare-ups and which help ease the symptoms.
Diet is a part of what John calls “Beating Psoriasis Trifecta,” along with sun and stress. It may be the trickiest of the three to get right given the huge number of variables, but taking the time to do so could hugely benefit your child’s condition.
5. Check for Vitamin D Deficiency
“Get your child’s vitamin D levels checked. If you are from a country where the only sun you get is in the summer, then more than likely they will be vitamin D deficient. The immune system will always underperform if this essential hormone is not at its optimal levels.”
In recent years, the role of vitamin D – ‘the sunshine vitamin’ – in the body has been subject to a great deal of research. It is believed to interact with and influence over 200 genes in the human body.
One key area that has been explored is its connection to autoimmune diseases.
There is an ever-growing body of evidence that vitamin D deficiency is more common in people with MS, rheumatoid arthritis, lupus, and other autoimmune diseases.
It has also been linked to psoriasis. The exact nature of the link remains unclear and is a subject of much debate within the medical community.
However, a recent study found a correlation between vitamin D deficiency and psoriasis.
Dr. Suzanne Olbricht, an associate professor of dermatology at Harvard Medical School, doesn’t believe vitamin D deficiency causes psoriasis, “but it may impair the body’s ability to keep skin healthy.”
The link could go some way in explaining why many people living with psoriasis experience more severe symptoms in winter than summer.
Treatments such as supplements or light therapy can be used to raise vitamin D levels.
Maintaining healthy vitamin D levels is believed to reduce the possibility of developing comorbid autoimmune disease, such as those listed above, later in life. It may also help prevent the development of cardiovascular diseases, type 2 diabetes and cancer, as well as other diseases linked to vitamin D deficiency.
Will it also help ease the symptoms of psoriasis? Possibly. It is still a topic of contention, but there is evidence to suggest it helps when used in conjunction with other treatments.
The picture may become clearer in the coming years as more research is performed. As a parent, John’s tip is to get your child’s vitamin D levels checked, so your doctor is able to recommend the best course of action.
On top of that, keeping up to date with the latest research – and speaking regularly to your child’s doctor – will help ensure you are able to provide the most effective treatment for your child.
Find What Works for You & Your Child
Supporting your child with psoriasis is a difficult and highly personal topic. While there is no right or wrong way of doing so, hopefully these tips can offer some guidance to anyone seeking it.
If you would like your story featured on the MyTherapy blog, contact Dan here.
While we hope the information in this blog post is useful, please do not use it as a replacement for professional advice. Please consult a doctor or healthcare professional before making any changes to your child’s treatment or diet.