Children with facial morphoea managing everyday life: a qualitative study

Summary Background Facial morphoea is a chronic inflammatory skin disorder, typically presenting in childhood and adolescence, which can be disfiguring, and which has been suggested to cause mild‐to‐moderate impairment in quality of life. Objectives To explore the everyday experiences of children with facial morphoea by examining the psychosocial impact of living with facial morphoea and how children and their families manage its impact. Methods We used a qualitative, social constructionist approach involving focus groups, in‐depth interviews and drawing activities with 10 children with facial morphoea aged 8–17 years and 13 parents. Interpretive thematic analysis was utilized to examine the data. Results Children and parents reported on the stress of living with facial morphoea, which was related to the lack of knowledge about facial morphoea and the extent to which they perceived themselves as different from others. Self‐perceptions were based on the visibility of the lesion, different phases of life transitions and the reactions of others (e.g. intrusive questioning and bullying). Medication routines, and side‐effects such as weight gain, added to the stress experienced by the participants. To manage the impact of facial morphoea, children and their parents used strategies to normalize the experience by hiding physical signs of the illness, constructing explanations about what ‘it’ is, and by connecting with their peers. Conclusions Understanding what it is like to live with facial morphoea from the perspectives of children and parents is important for devising ways to help children with the disorder achieve a better quality of life. Healthcare providers can help families access resources to manage anxiety, deal with bullying and construct adequate explanations of facial morphoea, in addition to providing opportunities for peer support. What's already known about this topic? Facial morphoea is a chronic inflammatory skin disorder that can be disfiguring, typically presenting in childhood and adolescence. Existing research using quantitative measures indicates that children with facial morphoea experience a mild‐to‐moderate impairment in quality of life. What does this study add? This is the first study to use qualitative methods to explore in depth the impact of facial morphoea on the lives of children and their parents. Children with facial morphoea experience significant psychosocial challenges, including perceptions of being different and negative re