Learn how psoriasis can affect adolescents and young adults, its emotional impact and the importance of timely treatment and clinical research when the disease develops early in life or requires advanced treatment.
Psoriasis in adolescents and young adults is much more than a skin disease. It can develop at a particularly sensitive stage of life, when identity, self-esteem and the relationship with one’s own body are still developing. When psoriasis appears during this period, its effects can be significant and may persist if the disease and its wider impact are not addressed appropriately.
Throughout my career as a dermatologist, psoriasis in adolescents and young adults has been an area of particular importance to me, not only medically but also because of the personal impact the disease can have. I have seen many young people live with a visible chronic disease while feeling that their symptoms, concerns or treatment needs were not fully understood.
Current evidence supports the importance of appropriate and timely treatment, particularly when psoriasis is having a significant physical or psychological impact. Nevertheless, some adolescents and young adults continue to live with inadequately controlled, undertreated or normalised symptoms.
The aim of this article is to explain why psoriasis at this stage of life deserves careful medical and psychological attention, and what treatment and research options may be available.
Psoriasis in adolescence: a disease that goes beyond the skin
Psoriasis is a chronic immune-mediated inflammatory disease that is not contagious and can begin at any age. One of the recognised peaks of onset occurs during adolescence and early adulthood, a period characterised by major physical, emotional and social changes.
Skin lesions, scaling, itching and involvement of visible areas such as the scalp, elbows, knees or face can become an important source of concern. In many cases, the real burden of the disease cannot be assessed solely according to the extent of the plaques. It is also important to consider how psoriasis affects everyday life.
In adolescents and young adults, psoriasis may affect:
- body image;
- social and personal relationships;
- participation in sport or leisure activities;
- self-confidence.
For this reason, caring for younger patients with psoriasis also means paying attention to mental health, emotional wellbeing and the support they may need.
Psychological impact of psoriasis in adolescents and young adults
Studies have shown that psoriasis can have a substantial psychological impact in adolescents and young adults. This impact does not necessarily correlate with the visible extent of the disease. Visible lesions, concerns about other people’s reactions and the social pressures associated with adolescence can contribute to avoidance behaviours or social withdrawal in some young people.
Psychological difficulties associated with psoriasis may include:
- anxiety;
- depressive symptoms;
- low self-esteem;
- social isolation;
- difficulties in intimate or personal relationships.
Many patients also report a relationship between emotional stress and psoriasis activity. However, this relationship is complex and varies considerably between individuals. Stress may coincide with worsening symptoms in some patients, while living with a visible and symptomatic chronic disease can itself increase psychological distress.
For this reason, treating psoriasis in adolescents should involve more than improving the skin alone. Assessment of mental health and quality of life can be an important part of comprehensive care.
Psoriasis in young people and mental health: what does the evidence tell us?
Research has reinforced the need to consider psoriasis within the broader health of the patient. In adolescents and young adults, this comprehensive approach is particularly relevant.
Evidence suggests that:
- adolescents with psoriasis have an increased prevalence of anxiety and depressive symptoms compared with unaffected peers;
- psychological burden does not always correlate with the visible severity or extent of psoriasis;
- inflammatory, psychological and social factors may all contribute to the overall burden of the disease;
- psoriasis beginning early in life can have a sustained effect on quality of life if disease activity or its psychological consequences are not adequately addressed.
These findings support an early, individualised and patient-centred approach that takes into account both physical symptoms and the young person’s emotional and social circumstances.
Why timely treatment matters
One of the important developments in modern psoriasis care is a greater emphasis on avoiding prolonged periods of inadequately controlled disease.
There is increasing interest in whether treating psoriasis earlier and achieving good disease control may have long-term benefits. However, it is important to distinguish what is established from what is still under investigation. Appropriate early treatment can:
- reduce current disease activity and symptoms;
- help prevent prolonged periods of poorly controlled inflammation;
- improve quality of life;
- reduce the burden of psoriasis on school, work, social activity and psychological wellbeing.
Research is also examining whether earlier control of psoriasis may influence longer-term disease trajectories and the development of complications such as psoriatic arthritis. At present, however, it should not be assumed that treating skin psoriasis early will necessarily prevent psoriatic arthritis or permanently alter the course of the disease in every patient. We now have a range of effective treatment options, including therapies approved for selected adolescent patients. The aim is no longer simply to manage individual flare-ups, but to achieve sustained disease control when this is clinically appropriate.
It is also important to remember that apparently limited psoriasis can still have a substantial psychological or functional impact, and this should be considered when treatment decisions are made.
Treatment of psoriasis in adolescents: current and personalised options
The treatment of psoriasis in adolescents and young adults should always be individualised. There is no single approach that is appropriate for every patient. Treatment should take into account age, type of psoriasis, disease severity, areas affected, impact on quality of life, previous treatment response, and comorbidities and individual circumstances.
Current treatment options may include:
- topical treatments;
- phototherapy in selected patients;
- conventional systemic therapies;
- advanced targeted therapies, including injectable treatments, when approved and clinically indicated for the patient’s age and disease profile.
Follow-up by a dermatologist with expertise in psoriasis is important for monitoring treatment response, adjusting therapy and identifying possible comorbidities.
The objective should not be simply to tolerate the disease, but to achieve the best possible level of control while supporting the young person’s overall health and quality of life.
Clinical research in psoriasis affecting adolescents: studies at ICMR
Clinical research is an important part of improving our understanding and treatment of psoriasis. At the International Center for Medical Research (ICMR), clinical studies in psoriasis may include adolescents and young people, depending on the specific study protocol, age criteria and characteristics of the disease.
Clinical research may:
- evaluate investigational psoriasis treatments before they become available in routine clinical practice;
- explore additional options for patients whose disease remains inadequately controlled despite approved treatment;
- contribute to scientific knowledge about psoriasis and its treatment;
- provide structured medical follow-up within a regulated research protocol.
Participation is always voluntary and assessed individually. It depends on whether the patient meets the inclusion and exclusion criteria for a particular study. Clinical trials are carried out under strict ethical, regulatory and safety requirements, and participation does not guarantee that the investigational treatment will provide clinical benefit. Research participation should not replace an approved treatment when this remains the most appropriate option. At ICMR, clinical trials in psoriasis may be open at different times, and each adolescent or young adult is assessed individually to determine whether participation could be appropriate.
You can view currently available psoriasis clinical trials here:
https://icmrresearch.com/ensayos-clinicos-psoriasis/
Making patients aware of clinical research can be useful when discussing the full range of available options, particularly when standard treatments have not provided adequate disease control.
Living with psoriasis from a young age: Jordi Roca’s experience
Talking openly about psoriasis can also help reduce stigma and increase understanding of the disease. In this context, Jordi Roca shared his personal experience at The Psoriasis Revolution III (2025 edition).
At The Psoriasis Revolution III (2025 edition), Jordi Roca, pastry chef at El Celler de Can Roca, spoke about living with psoriasis from a young age and spending a period of his life without adequate disease control.
His account illustrates some of the personal challenges, frustration and emotional impact that can accompany poorly controlled psoriasis over many years. He also described the improvement he experienced after receiving specialised dermatological care and advanced treatment.
Personal experiences such as his can help make the disease more visible and show that psoriasis can affect people in very different circumstances. His testimony highlights:
- the importance of greater awareness and understanding of psoriasis;
- the possibility of achieving substantially better disease control with appropriate treatment in many patients;
- the value of specialist assessment when psoriasis remains inadequately controlled.
Experiences such as Jordi’s also illustrate why prolonged periods of poorly controlled psoriasis should not automatically be accepted as inevitable.
Advice for adolescents and young adults with psoriasis
In addition to medical treatment, there are several issues that I regularly discuss with younger patients.
1. Do not minimise how psoriasis affects you
Psoriasis affects the skin, but it may also affect self-esteem, mood and social wellbeing. All of these aspects are relevant to your care.
2. Do not assume that poorly controlled psoriasis has to be accepted
If your psoriasis is not adequately controlled, it may be worth reviewing the treatment strategy. There may be additional options depending on your age, disease severity and previous treatments.
3. Seek care from a dermatologist with experience in psoriasis
Specialist assessment can be particularly valuable when the disease is difficult to control, affects high-impact areas or has a substantial effect on quality of life.
4. Take an active role in treatment decisions
Understanding your disease and the reasons behind different treatment options can help you participate meaningfully in decisions about your care.
5. Pay attention to your mental health
If psoriasis is affecting mood, self-esteem, social relationships or everyday life, psychological support may be helpful alongside dermatological treatment.
Psoriasis in young people: looking towards the future
Psoriasis in adolescents and young adults should not be minimised or regarded as something that simply has to be endured. We now have a better understanding of the disease, a wider range of approved treatments and ongoing clinical research aimed at improving future care.
Early recognition of an inadequate response and timely adjustment of treatment can help reduce the physical and psychological burden of psoriasis. The aim is to achieve good disease control while supporting the young person’s quality of life, mental health and long-term wellbeing.
If this article reaches an adolescent, a young adult or a family living with psoriasis, the key messages are:
- you should not have to accept persistent symptoms without reassessment;
- effective treatment options are available for many patients;
- specialist support can help determine the most appropriate approach for each individual case.
I invite you to share this article about psoriasis in adolescents and young adults with anyone who may find it useful.
References
1. Bronckers IMGJ, Paller AS, van Geel MJ, van de Kerkhof PCM, Seyger MMB.
Psoriasis in children and adolescents: diagnosis, management and comorbidities.
Paediatric Drugs.
2. Paller AS, Singh R, Cloutier M, et al.
Psoriasis in children and adolescents: update on diagnosis and management.
Journal of the American Academy of Dermatology (JAAD).
3. Beattie PE, Lewis-Jones MS.
A comparative study of impairment of quality of life in children with skin disease.
British Journal of Dermatology.
4. Kimball AB, Jacobson C, Weiss S, Vreeland MG, Wu Y. The psychosocial burden of psoriasis. American Journal of Clinical Dermatology.
5. Eichenfield LF, Tom WL, Chamlin SL, et al.
Guidelines of care for the management of psoriasis in pediatric patients.
Journal of the American Academy of Dermatology (JAAD).
