In the latest issue of Contemporary Pediatrics®, the dermatology section features articles^1,2 on the mental health issues children with dermatological disorders encounter often daily.

As pediatric nurse practitioners (PNPs), pediatric-focused family nurse practitioners (FNPs), and advanced practice registered nurses (APRNs) who specialize in various aspects of pediatric health care, we must be sensitive to the child’s personal feelings about a dermatological disorder while asking questions that enable the child/adolescent to express their inner thoughts.

Taking the time to sit with the child/adolescent, demonstrate active listening while talking with the child, showing respect for their feelings, and together creating an achievable individualized plan to help the child in their day-to-day interactions with others who do not understand dermatological conditions that also affects their mental health.

Guiding mental health ‘growth and development’ for children and adolescents

We all know that children can be cruel to each other, but most likely do not understand the harm that their behaviors inflict on a child with a dermatologic disorder, such as vitiligo.

I vividly recall the conversation I had with a 13-year-old female, many years ago, who had a diagnosis of vitiligo on 1 half of her face. The child was devasted from in-school experiences and comments made by other children and adults. She was excluded from activities on the playground, and after school activities, and felt ugly.

At that time, medications were not available and information on how to care children with vitiligo was limited. I invited a cosmetologist to come to the clinic to determine what make-up would be helpful for this child and going forward, possibly helping all the children with a vitiligo diagnosis in our practice.

Once the cosmetologist met the child, she was confident that she could be helpful. The child was shown how to apply make-up and then demonstrated her new skill. The child was smiling for the first time when leaving clinic appointment.

Make-up as part of the routine treatment plan may positively impact mental health

In the dermatology article by Drs. Havele and Cohen, their conclusion mentions camouflage make-up as being helpful during treatment. In my experiences, I never thought of using the word camouflage. We talked about wearing make-up, as most teens have an interest in make-up. For children and adolescent with vitiligo, it is extremely important to help the children and adolescents learn the best ways to apply make-up.

In my opinion, it should be a part of the treatment plan, whether it is on the face, or any other exposed part of the body. Arms and legs are exposed during gym class at school and make-up helps solve the problem. Placing mental health first on our list of anticipatory guidance not only for vitiligo and other dermatological disorders, but for every primary care encounter, may be the first step in creating meaningful change in the current state of behavioral and mental health disorders for children and adolescents.

References:

1. Havele SA, & Cohen BA. Exploring the treatment landscape for pediatric vitiligo. Contemporary Pediatrics. 2024;40(7):31-32.

2. Fitch, J. Stigmatization of chronic pediatrics skin disorders impacts quality of life. Contemporary Pediatric. 2024;40(7)34.