Skin disease is very common among children and young people. For example, up to 20% of young children develop eczema and the majority of young people develop some symptoms of acne temporarily during adolescence (McHenry et al., 1995; Smithard et al., 2001). However, there is surprisingly little research on the psychological impact of skin disease in childhood and the focus of most research in paediatric psychology has been on life-threatening conditions, such as cancer. Despite the lack of research, there is widespread acknowledgement of the impact of skin disease on the psychological well-being and quality of life of children, and increasing awareness of the importance of understanding the psychological impact of skin disorders on children and their families (Howlett, 1999).

This chapter will start by outlining some key issues in understanding the relationship between skin disorders and psychological factors for children. This includes the importance of considering both a developmental and systemic framework for childhood problems, and potential difficulties that may arise in communicating with a child about sensitive topics, such as how they feel about their appearance. The chapter will then describe current theoretical models of the psychological impact of physical disease on children and their families, and how these inform our understanding of the impact of skin disease. The next section will review research on the impact of skin conditions on the relationship between a mother and her baby or child, and the impact of skin conditions on the child's self-esteem.