We had both always wanted children. Lori, an only child, wanted four kids; I thought it would be great to have a son and a daughter. But our discussion about having children as a young couple extended beyond the number. Both of us have conditions that can be passed on genetically. Lori was born with spina bifida, a condition that affects the spine, and I developed psoriasis as an elementary school child. We agonized over whether our children would be healthy given our respective issues.
Does Psoriasis Run in Families?
Experts point to a genetic link in psoriasis while also noting the influence of environmental factors and the immune system. The American Academy of Dermatology notes that psoriasis runs in families and that if your parent, grandparent, or sibling has the condition, you are at a higher risk of developing it. That turned out to be the case for me, as both my parents were diagnosed with psoriasis while in their seventies. (The National Psoriasis Foundation says that psoriasis symptoms can start at any time in life, although they typically begin between ages 15 and 25.) A study titled “Genetic Epidemiology of Psoriasis,” published in the journal Current Dermatology Reports, provides statistics on the genetic basis of psoriasis. “According to family-based studies, an offspring of two affected parents has a 50 percent chance of developing psoriasis; this chance decreases to 16 percent if only one parent is affected,” the researchers state. “Also, if a child has psoriasis and neither parent has it, there is an 8 percent chance for that child’s sibling to develop psoriasis.” Moreover, the researchers say, twin studies show psoriasis is influenced by both genetics and environment. Environmental triggers such as infection, stress, medications, or excessive body weight have been shown to induce or worsen psoriasis symptoms. RELATED: Lessons From Life as a Teenager With Psoriasis
Anxiety Over My Children Getting Psoriasis
When Lori and I got married, in 1994, I don’t recall how much information I had on whether I might pass psoriasis to our children. I’d heard that psoriatic disease does cluster in families, but I couldn’t identify any relatives who had psoriasis. Lori and I were still considering the pros and cons of having children when we found out Lori was pregnant, two months after our wedding. We stared at a home pregnancy test — repeatedly checking the window on the stick to see if there really were two lines. A lab test at the clinic confirmed the results. Neither of us was ready for the anxiety that would follow. Lori underwent genetic counseling and testing that determined, to our immense relief, that the fetus didn’t have spina bifida. But there were no assurances our child wouldn’t get psoriasis sometime in her life. Genetics and statistics didn’t matter to me in those moments as I quietly worried. Lydia, our firstborn, arrived in 1995, and so far, she doesn’t have psoriasis. Fortunately, Tim, born in 1999, and our youngest, Aleta, born in 2001, weren’t born with spina bifida and don’t have psoriasis yet either. It’s possible that my children will develop psoriasis at some point, but what I know now is that everyone has their own unique set of genetic and environmental circumstances that ultimately affect what will or won’t happen.
A Personal Decision
My response to the social media follower who asked me about passing psoriasis to my children reflects my journey as a parent. I wrote that I suppose it’s a risk for anyone to have children not knowing the many unknown genetic predispositions we all have. But whatever my kids might have or deal with in life or with their health I want to be the best equipped to help them through it. The knowledge I’ve gained about the causes of psoriasis gives me tools to look out for my children. They are more skin aware living with a parent with a skin disease. My wife and I also pay more attention to their overall health, making sure they know they can come to us if they have any questions. Living with psoriasis has provided me with a vocabulary and lived experience to help my children through any of their concerns. Each of them has faced their own chronic or acute health issues, and I have helped them advocate for themselves, navigate the healthcare system, and find the best care possible. RELATED: My Son’s Weeklong Fever Turned Into a Rare Disease Still, I understand that the decision about whether or not to have children is a personal one. I know others living with health conditions, including psoriasis, who have decided not to have children. Others have had children with psoriatic disease. As a parent it’s important to keep the dialogue open with your partner and to also discuss any concerns with your healthcare professional. Lori and I are proud of our three young adult children who are working, attending college, and living full lives. As parents we are always there for them, knowing that along with any genetic tendencies we can also pass along to them our experience of enduring tough life and health challenges. You can read more about my experiences on my website, PsoHoward.
