Information for parents: Treatments for children
Treatments for psoriasis | Treatments for psoriatic arthritis
Treatments for psoriasis
Currently, there is no cure for psoriasis. However, researchers around the world are seeking better treatments with fewer side effects and control that is more lasting. Until then, many people with psoriasis can manage the symptoms of their disease with one or a combination of many medically recognized treatments and countless home remedies.
Although psoriasis in children is similar to that in adults, there are some real differences, especially regarding treatments. Many treatments used for adults may not be appropriate for children dues to possible long term or delayed side effects. Physicians decide which treatments to use according tot the type and severity of the psoriasis, the areas of the skin affected and the patient’s age and past medical history.
Infants: Treatment is very conservative. Moisturizers can be a good first step. Oatmeal baths and anti-itch creams can help relieve the itching. Consult a physician before starting any treatment with an infant.
Children: For mild psoriasis, sunlight may be helpful. For moderate cases, regular broad-band or narrow-band ultraviolet light B (UVB) therapy can help clear the lesions. Strep infection can trigger an outbreak, so antibiotics may help clear the bacteria that could have triggered the psoriasis.
Teens: Ultraviolet light B (UVB) therapy can help clear the psoriasis. Oral medications may have different side effects for teens, and potent topical steroids need to be applied with caution because they can be absorbed too quickly.
Types of psoriasis treatment
Topical treatments: Creams and ointments are used directly on psoriasis plaques. Most people with psoriasis begin medical treatment with topicals because they pose the least risk of long-term side effects. Learn more about topical treatments for psoriasis »
- Steroids: Doctors commonly prescribe topical steroids for teenagers. They may prescribe very weak steroids for younger children. Side effects can occur from using topical steroids over a long period, it is important to follow directions closely.
- Calcipotriene: Calcipotriene is a derivative of vitamin D3, sold under the brand name Dovonex. It has few side effects when used as directed. It is not approved for children under 12 years of age, but a physician may prescribe it. The prescription topical medication is not the same as the Vitamin D dietary supplement, which is not effective in treating psoriasis.
- Tazarotene: A topical retinoid that is a derivative of vitamin A, sold under the brand name Tazorac. Although it has not been studied for use with young people, a doctor may prescribe it for a limited time.
- Coal tar: Tar treatments work best for people with lesions limited to areas such as the knees, elbows, scalp and shin. Few side effects are associated with coal tar, and it is often combined with ultraviolet light therapy.
- Anthralin: A synthetic derivative of an ingredient found in Goa powder from the bark of the araroba tree of South America. Anthralin has no known side effects, but can be messy and stain hair or unaffected skin.
- Salicylic acid: Salicylic acid removed built-up scale so medications can penetrate the lesions and slow the excessive skin cell production. It is often used with tar and steroid medications.
Light therapy: Ultraviolet light A or B (UVA, UVB) work by exposing the skin to light waves. Learn more about light therapy for psoriasis »
- Sunlight: Frequent sunbathing can control some cases of psoriasis. It is essential to use sunscreen on unaffected skin, avoid sunburn and have skin checked frequently for cancer if sunbathing is used as a therapy for psoriasis.
- Ultraviolet light B: UVB treatments can be administered in a doctor’s office, clinic, or at home with a home phototherapy device. The main potential side effect of UVB is a burn resembling sunburn.
- PUVA: PUVA combines a psoralen drug with UVA light. Psoralen makes the body very sensitive to the UVA rays. It can be used on a short-term basis to bring a severe or disabling case of psoriasis under control. The main long-term risk of PUVA is the increased risk of cancer, which a doctor can monitor. Never use psoralen drugs with sunbathing or tanning salons because of the risk of severe, even life-threatening, burns.
- Lasers: Excimer and pulsed dye lasers can be used to treat chronic, localized plaque lesions.
Systemic medications: Doctors do not usually prescribe systemic medications for children and teenagers. However, they might if a young person has a severe case of psoriasis. Methotrexate, acitretin, cyclosporine and some biologics are drugs that may be prescribed. Sometimes topical medications are used with these potent drugs to help speed clearing and make the person more comfortable. Learn more about systemic treatments for psoriasis »
Once you, your child and a physician settle on a treatment plan, follow through with it. Half of all patients do not adhere to the treatment plan prescribed by their doctors. This makes it seem like the treatment isn’t working, when the reality is that the individual didn't use it the correct way or give it enough time to be effective.
Treatments for psoriatic arthritis
Your child's rheumatologist, weighing your opinion or preference, will prescribe the most appropriate course of treatment based on your child's overall health, medical history, the extent of the condition, and the expected course of the disease.
Treatments for juvenile psoriatic arthritis include:
Nonsteroidal anti-inflammatory medications (NSAIDs): NSAIDs include over-the-counter medications such as aspirin, ibuprofen and naprosyn, as well as prescription-strength products. NSAIDs help control swelling, pain and morning stiffness and help improve range of motion in joints. They can help reduce the limitations to daily activities often caused by arthritis.
Disease-modifying antirheumatic drugs (DMARDs): DMARDs may relieve more severe symptoms and attempt to slow or stop joint/tissue damage and the progression of psoriatic arthritis and include drugs such as methotrexate and cyclosporine.
Biologics: Biologics are highly selective agents that target specific parts of the immune system; some of these parts are involved in the development of psoriasis and psoriatic arthritis. Enbrel (etanercept) and Humira (adalimumab) are indicated for moderate to severe polyarticular juvenile idiopathic arthritis (JIA), of which psoriatic arthritis is a sub-type.
Other treatments for juvenile psoriatic arthritis may include physical therapy to improve and maintain muscle and joint function and regular eye exams to catch eye inflammation, which can occur in some children.