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‘Developmentally appropriate’ services needed to better address chronic skin diseases in teens

Teens and young adults often lack access to developmentally appropriate specialist dermatology clinics with embedded psychological support, and an improvement in the delivery of transition care is essential to address unmet needs in this population, according to a review published in Clinical and Experimental Dermatology.

“Services need to be developmentally appropriate and address the needs of young adults with skin problems,” Tess McPherson, MA, MBBS, MD, FRCP, a consultant dermatologist with Oxford University Hospitals NHS Foundation Trust, told Healio Dermatology. “There are many challenges, both immediate and long term. Services need to recognize the impact skin problems have on young people and support them appropriately.”

In the review, McPherson and colleagues noted that the psychological impact of conspicuous skin conditions on adolescents is particularly high, often negatively affecting self-esteem and social engagement. Higher rates of anxiety and depression, the researchers noted, have been reported in patients with skin conditions, with lifelong, cumulative effects more severe among those who develop such conditions in adolescence.

“There is increasing recognition of the need for psychological support for all patients with chronic skin disease, with the 2013 National Institute for Health and Care Excellence

quality standard on psoriasis emphasizing the importance of a ‘holistic assessment’ addressing ‘psychological and social well-being,’” the researchers wrote. “However, despite

this political rhetoric, there are very few dedicated teenage and young adult skin clinics in the U.K. with appropriate psychosocial support for young people to deliver developmentally appropriate services.”

Additionally, the researchers noted that the Royal College of Physicians identified a training gap regarding the care of adolescent patients, with the majority of medical trainees

having no formal training or clinical experience in adolescent health.

“As a specialty that covers all ages, dermatology is well placed to offer seamless transitions between pediatric and adult services,” the researchers wrote.

The researchers wrote that a dedicated teen and young adult dermatology clinic with embedded specialist psychological support can optimize management of such patients and address unmet needs. A successful transition model, they wrote, should include three key features: appropriate parent involvement, promotion of health efficacy and meeting the adult team before transfer.

“The overwhelming evidence and clinical experience of managing adolescents with skin disease in our services highlights particular challenges in this cohort, including low self-esteem, anxiety, reduced social engagement and poor adherence to treatment,” the researchers wrote. “There are existing models for the successful delivery of appropriate support and dermatological services for young people across the U.K..” – by Regina Schaffer

Disclosures: The authors report no relevant financial disclosures.