The Impact of Pediatric Dermatologic Conditions on Mental Health in Underserved Communities in the United States: Barriers and Strategies for Their Mitigation

Pediatric dermatologic conditions are associated with significant psychosocial burden and disparities in access to care, particularly among underserved populations in the United States. Chronic skin diseases such as atopic dermatitis, acne, psoriasis, and alopecia areata may negatively affect emotional well-being, sleep, self-esteem, quality of life, and social functioning in affected children and caregivers. Structural inequities related to race, ethnicity, socioeconomic status, insurance coverage, transportation, and healthcare accessibility further contribute to differences in disease burden and treatment access. This narrative review examined the relationship between pediatric dermatologic conditions, mental health outcomes, healthcare disparities, and barriers to care in underserved pediatric populations. A structured search of PubMed, Web of Science, and PsycINFO identified peer-reviewed studies published between 2015 and 2025 involving pediatric patients aged 0-18 years. The reviewed literature demonstrated that underserved pediatric populations experience delayed dermatologic evaluation, reduced access to specialty care and advanced therapies, and increased emergency department utilization. Chronic pediatric skin disease was consistently associated with anxiety, depression, stigma, sleep disturbance, and impaired quality of life affecting both patients and caregivers. Teledermatology as an alternative care model may help improve specialty access and reduce barriers to care, although disparities in telehealth utilization remain. These findings highlight the complex relationship between pediatric dermatologic disease, psychosocial burden, and structural inequities affecting underserved children. Multidisciplinary, family-centered, and culturally responsive approaches may help improve both psychosocial outcomes and equitable access to pediatric dermatologic care.