About 7.5 million Americans have psoriasis, with around 20,000 new diagnoses in children younger than 10 years old each year. Psoriasis most commonly appears sometime between the ages of 15 and 35, although it can suddenly appear at any age.
Though most common in adults, this chronic skin condition can strike even a tiny newborn baby's delicate skin.
"It's more rare than in adults," says Adriana Brune, MD, a pediatric dermatologist in Corvallis, Ore. Somewhere between 2 and 6 percent of all cases of psoriasis affect children younger than age 2.
Infant psoriasis is generally diagnosed up to age 2. Older children who are diagnosed beyond that age (and without the characteristic diaper psoriasis) are considered to have childhood psoriasis, not infant psoriasis.
Causes of Infant Psoriasis
No one knows exactly what causes psoriasis in adults or in infants. Most experts agree that it is probably an autoimmune disease, and that the immune system makes a mistake and tries to attack skin cells, thinking that they're somehow foreign or harmful. The result is the inflamed patches of skin identified as psoriasis.
It's also thought that some people may be genetically predisposed to psoriasis — that they have some gene that they've inherited from other family members that causes them to develop it. A family history of psoriasis is common among babies with infantile psoriasis, says Dr. Brune.
In babies who develop psoriasis, the trigger is often an infection of the upper respiratory tract. "Psoriasis in children may be triggered by common infections, such as streptococcal or viral ones," says Brune.
Recognizing Infant Psoriasis Symptoms
This type of psoriasis very commonly strikes the diaper area, says Brune, but babies can still develop it without having any psoriasis symptoms under their diapers. Redness can also appear in the folds and creases of skin under the armpits, behind the knees, and in the groin area, where skin will look bright, shiny, and red. Infantile psoriasis may also affect the trunk, arms, legs, and even baby's scalp. Infant skin affected by psoriasis typically doesn't look as thick and scaly as it commonly does in adults, according to Brune.
If it does strike their tender little bottoms, it looks like a diaper rash that just won't heal despite treatment — even with anti-yeast medications your baby's pediatrician may prescribe — and "persists for months and months," says Brune.
Infant psoriasis may be itchy, particularly when it strikes the scalp, and babies who are old enough to scratch an itch may scratch at the red areas.
Infant Psoriasis Treatment
Psoriasis can't be cured, and treating infant psoriasis is more difficult than in adults because of the risk of side effects of psoriasis medications.
Topical steroids may be prescribed, says Brune, as well as a tar shampoo. Most of the time, infantile psoriasis tends to be mild and clears up with treatment. But if not, psoriasis treatment gets tricky — there aren't any other medications approved by the U.S. Food and Drug Administration for treating infant psoriasis, though other medications are used off-label at the doctor's discretion. Topical vitamin D analogues and calcineurin inhibitor medications, which work differently than cortisone-based steroid medications, may be prescribed. In some cases, a doctor may recommend the use of a topical corticosteroid cream or a drug called Dovonex (calcipotriene).
Infant psoriasis may also be treated with non-pharmaceutical therapies. Keeping the skin well-moisturized — regularly applying a rich lotion or cream — can help soothe dry, itchy skin caused by infant psoriasis, says Brune. Another home treatment to make baby more comfortable is a lukewarm bath with oatmeal.
Infant psoriasis should never be treated without a doctor's recommendations and supervision. Unfortunately, it's hard to predict whether infant psoriasis will simply disappear or will affect a baby into childhood. "Chronic, intermittent skin rash is common as the baby grows. In some it may disappear for many years, or even go away completely," says Brune. "In others, it may worsen with age."
Learn more in the Everyday Health Psoriasis Center.
Last Updated: 5/21/2013