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.

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.

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.

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.