Dermatologist specialising in paediatric, young adult and teenage dermatology: Professor Tess McPherson

All dermatologists have training in managing skin of all ages including children and young people. A consultant dermatologist who specialises in paediatric dermatology will generally have spent extra time training and managing skin conditions in paediatrics and may have had training in general paediatrics. They will have more detailed knowledge of how skin conditions present in the skin and are likely to do clinics in a children’s hospital and work closely with paediatricians in other specialties. 

Children and young people can be referred to dermatology through a number of different pathways if specialist input is thought helpful or necessary. This can include from Primary care (GP or advanced nurse practitioner), from paediatric team or from another dermatologist.

A consultation will include asking about the skin condition, the impact, background physical and mental health. Examining the skin and then discussing likely diagnosis, how we will approach managing and what extra support and resources may be necessary. I work with a specialist nurse who can help advise on practical management. In the clinic we run for young people we also work with a psychologist who will further address mental health aspects of skin condition. All of the team see addressing the emotional impact of skin condition as of vital importance.

Yes, skin conditions can be associated with mental health in many ways and for many reasons including the lived experience of the symptoms and managing a skin condition and on self-esteem. These can lead to significant mental health issues and impact psycho-social functioning which, if not managed and supported, can have huge effects on life.

I find people like to be asked and will be open about the impact and have reported that this makes them feel more understood and supported. This is something I now feel more comfortable having managed young people for some years. When we have looked at qualitative data from the healthtalk.org site young people consistently would like health workers to address the emotional impact of skin condition alongside discussions regarding management and treatments (2 top asks from health workers were to give more information and to address the emotional impact- article in BMJ open) and this was highlighted in work we have been doing in BSPAD writing recommendations for guidance to best  support children and young peoples with the psychological impact of living with skin conditions.

Think about what are the main issues for you. Is it to get a firm diagnosis? Is it to find what treatments have been proven to be effective? Is it to know what to expect in the future? Is it to understand more about the condition? Is there anything you are not doing because of your skin that you would really like to? Is it to talk about how this is making you feel? It can be useful to write a list of questions you have before the appointment.

No – this will be highly individual

Yes – the impact will vary across individuals but there are particular times of life and development – for example adolescence. Being a teenager can feel hard and the social pressures on how you should look and present can be particularly intense at this time.

This will depend of course in what way and how. I would say be kind to yourself and don’t judge yourself by your skin. Despite what you see in social media there is no such thing as ‘perfect skin’ and striving for this is not possible and will not make anyone happier. Skin conditions are very common and although it is very normal for them to affect how you feel they should not define who you are, what you do or how others judge and treat you.

Parents and carers can play a critical role in how children accept their skin and build resilience. It is very normal to want to take any problem from your child and we know parents can blame themselves and, in some cases, actually struggle more than their child. Many parents of young children may also understandably worry about how others will treat their child. Stigma and Bullying can sadly be experienced by children with skin and hair conditions. However, it’s important to note that parents tend to expect this when it may not happen and while this can occur its not typically caused by the condition itself but rather how others perceive or react to it and how the child feels about themselves and reacts to negative comments. I would suggest helping with treatments and ensure a focus on positive characteristics rather than appearance and try to avoid negative judgement or clear demonstration of upset. Parents may need their own support to manage this.