Summary

There is a large unmet need for psychological support in children with visible, chronic and often severe skin disease which impacts greatly on children, young people (CYP) and families. Many national treatment guidelines advocate psychological support but there is little funding or access to appropriate help. The St John’s Institute of Dermatology service at St Thomas’ Hospital treats CYP throughout the UK with disorders such as genetic skin disease, severe infammatory disease, scarring disorders and diseases which cause visible diference. These can impact children’s self-confdence and quality of life, causing anxiety, low moods, and depression. The paediatric dermatology department, served by ten paediatric dermatologists and eight paediatric tertiary specialist clinics, has seen an unprecedented growth in patient volume and complexity of clinical cases. A national paediatric psychodermatology service has been set up for CYP whose skin disease causes psychological impact, and those with skin conditions caused by psychological/psychiatric/ neurodevelopmental comorbidities. This service has had excellent feedback from CYP/families, lowered CYP distress and reduced follow-up in general clinics/GP attendance.