As your child grows older and develops physically and emotionally, they will want to become more involved in different activities and relationships beyond the family.
They may also want to become more independent in managing their own psoriasis and psoriatic arthritis care.
Every child is different
Transitioning care of your child’s psoriasis or psoriatic arthritis can be dependent upon multiple factors.
How independent is your child? A child’s age does not always mean they are ready to handle the tasks necessary for managing their psoriatic disease. As a guide, ask yourself, “How responsible is my child with other key tasks?”
What psoriasis or psoriatic arthritis treatment does your child use? Is it a cream, lotion, or shampoo? Or perhaps a pill or injection? The type of treatment will be a factor as to when your child begins to take care of managing their disease.
Help prepare your child for the transition
A child needs to be ready to take on responsibility and understand what is expected of them as you transition responsibilities. As a parent, you might need to coach your child to help them learn how, when, and why they use treatment for their psoriatic disease. Start early by talking about what treatment will do and why you may be applying a cream or lotion or why they receive phototherapy or an injection. Click the relevant box below for an example of what you can say to your child.
For younger children
“When we use this medication it’s helping to slow your skin cells down because they grow too fast. That’s what causes these plaques or spots to grow. In time, this medication should help you feel better. You won’t itch as much and will sleep better. You'll be able to do more of the things you want to do. If it doesn’t work we’ll try another. Someday you’ll be able to do this on your own when you’re ready. For now, we’ll do this together.”
For teens
“When we use this medication it’s to help your immune system counter the inflammation that causes your skin cells to grow too fast, creating plaques on your skin. In time, this treatment will help you feel better by controlling your skin cell growth. It'll itch less, be less visible, and you'll be able to do more of what you want to do without thinking about your skin. Plus you'll reduce the chances of developing other conditions, like heart disease. I’ll show you how to use this treatment for now, but someday soon you’ll be able to do this on your own when you feel you’re ready.”
Work to establish a routine and use treatment as directed by a health care provider. The treatment should become part of a routine that fits into your child’s life. Try matching the timing of using the medication with something else your child does already. For example when your child brushes their teeth.
At what age should your child take responsibility?
This depends on the developmental age of your child and their ability to act independently. With parental supervision, some children at age 5 can begin to start moisturizing their skin using pump dispensing bottles. Some younger teens may have issues self-administering a biologic injection due to their level of maturity, but older teens might want to do it themselves. Some teens ages 16 and up may do better using a pen device, however, a parent should always be in the home and available to help in case of complications. Oral medications such as methotrexate or cyclosporine require parental monitoring until age 16 or 17 because it is an immunosuppressive treatment with risks of taking too much at once. [1]
Remember, every child is different, and what they are able to do will change as they grow older. As a parent, you can coach your child and offer help when needed using positive reinforcement when care tasks are completed effectively. Tasks might not work as well in the beginning, so speak calmly and try not to get frustrated if mistakes are made. Getting frustrated can lead to resentment and negative feelings towards having psoriatic disease. Positive reinforcement is more likely to lead to more desirable outcomes.
Encourage your child to be involved with their health care team
Part of transitioning care is having your child become more involved in appointments with their health care team. Let your child do as much talking during medical visits as their abilities, age, and preferences allow. It is important for you as a parent to encourage your child to be engaged in their medical decisions. This empowers your child and gives them a voice in decisions that impact their body. Tips to help promote independence in their care include:
Encourage your child to use a symptom tracker or journal to document flare triggers and treatment outcomes, as well as note any new symptoms, such as pain in the joints or psoriasis in skin folds. Your child can use the sample fillable symptom tracker as a discussion guide with their dermatologist and other health care providers.
Have a pre-visit discussion with your child. Ask what questions they would like to ask about their treatment and write them down. Here are some questions to consider: • Does your child have concerns about side effects or other ways the medication could change their way of life? • If this medication does not work, what other options are available as a treatment choice? • When do I use this treatment? How often do I use it? How much do I use? When exploring new treatments, it is important to know the timing, amount (dosage), and frequency.
Help your child learn what the most appropriate questions are to ask and what information he or she should provide to their health care provider(s) at their appointment.
Let them speak up during their visits. Based on maturity level, let them have a say in what treatment they would like to receive. As long as they are informed, engaged in asking questions, and know what to expect, they can actively participate in choosing their treatment. They are the expert on their body.
As your child grows older, encourage them to schedule their own health care provider appointments while standing by in case they need assistance regarding the coordination of schedules. Encourage them to place appointment reminders on their phone.
It is important for your child to learn to be independent to help build a relationship built on trust and open communication with their health care providers.
Being forgetful happens
While you may transition care to your child, just like adults your child may forget things like taking their medication. Recognize that your child just wants to be normal, likes their freedom, and does not want to be different.
Other factors that can impact transitioning care
• Poor communication which includes communication within the family, as well as communication between your child and their health care provider.
• Family stress.
• Lack of education about the disease.
• Depression. This impedes the ability to take care of one’s medical care.
• A complex treatment routine. If your child is struggling to keep up with their treatments, then something needs to change. You and your child should be open with your child’s doctor and work to find a treatment plan that your child can adhere to.
• Time management. Juggling school, sports, and social activities with home life can be overwhelming. Help your child learn how to balance all activities including the use of treatment.
If your child seems to be forgetting their treatment, stay calm and try open-ended conversations such as, “How about we talk about your psoriasis treatment schedule? I’m wondering how it’s working for you and if we need to make some changes.” Focus on the treatment schedule instead of the missed dosage. Gently remind your child that sticking with treatment leads to better health outcomes where they can enjoy life.
An open-ended approach that engages your child in conversation may be better than “Did you take your medication today?”, which could cause your child to become defensive and uncomfortable. Poor adherence to treatment eventually leads to poorer health outcomes.
Tips to help your child maintain their treatment routine
• Keep medications in a public place where it is easy to see and gives your child a visual reminder to take their medication without verbal reminders.
• Start early in your child’s life to create a routine that includes the use of their medication.
• Encourage your child to set alarms on their phones or use apps that send text reminders to take or use their medication.
• Plan ahead for weekend trips and vacations. Create a plan that allows your child to meet their medication needs while enjoying time away from home.
• Find ways to check in without micromanaging your child’s care. You want to keep communication open as much as possible.
• Look for opportunities to educate your child about their disease if it does not occur through their provider. Check out our resources developed with teens for teens.
Throughout the transitioning of care reinforce that you will always be there for your child and be part of their team. There may be bumps along the way, but by working together, your child can learn how to manage their psoriatic disease on their own and live a long and healthy life.
Additional Resources
Transitions in Care for Youth with Psoriasis
Join pediatric dermatologist Dr. Adelaide Hebert as she addresses transitions in care, changes in responsibilities, and tips for making such changes occur.
Visit the Centers for Disease Control and Prevention (CDC) to learn what skills your child can achieve at different stages of development as well as positive parenting tips to help ensure the health of your child from infant to teen.
We use cookies to offer you a better experience and analyze our site traffic. By continuing to use this website, you consent to the use of cookies in accordance with our Privacy Policy.
