Tips for Dealing with Parents as a Clinician in Dermatology, with Lisa Swanson, MD

During the Dermatology Education Foundation (DERM) 2025 NP/PA CME Conference in Las Vegas, Lisa A. Swanson, MD—a dual-board-certified dermatologist and pediatric dermatologist at Ada West Dermatology—discussed the challenges of dealing with parents of pediatric patients, emphasizing the need for adaptability and understanding parental priorities.

Swanson touched on this topic as part of a discussion of her presentation at the conference on speaking with parents. During her interview with HCPLive, Swanson advocated for a technique called "gentle persistent persuasion," gradually introducing and discussing treatments like isotretinoin or dupilumab to parents who are initially hesitant.

“If I have a patient who has scarring acne, but the parents aren't ready to consider isotretinoin, I will, at each visit, talk about it, discuss it, answer questions about it, gently encourage, bring up points that I think are valid,” Swanson explained. “I hope that over time, eventually, they become more amenable to the therapy. The same could be said for the kiddo with severe atopic dermatitis, where I think dupilumab would be a nice fit, but the family's not ready for it yet. Understandable. We take it one day at a time, one visit at a time.”

The importance of empathy was highlighted by Swanson, especially when parents express opinions different from the physician’s advice, to avoid defensiveness and maintain a collaborative relationship. In cases of disagreement between parents and teenagers, finding a compromise is suggested to address both parties' concerns effectively.

“Sometimes, particularly in the teenage age group, you will encounter a situation where you've presented a list of options to a patient and their family, and the teenager vocalizes that they want to go one way, and the parent vocalizes very strongly that they would want to go another way,” Swanson said. “In these situations, I try to find a point of compromise. I try to agree with both sides. I'll say to the teen, ‘Of course, you are troubled by your acne. I understand that it poses a daily problem for you as you try to go to school, and you're feeling less confident and self-conscious about your acne. I completely understand that, and I think that can be a good reason to perhaps pursue a more aggressive choice like isotretinoin...I might say, ‘I also see your side’ [to the parents].

In many circumstances, Swanson pointed out, parents and their children have not tried a prescription medication yet and may be afraid that switching straight to isotretinoin is too abrupt. She emphasized that a good compromise would be to go with the parents' choice at first, but to decide later if the teen should be given their own choice in the matter after results are observed.

For more about the topics covered in Swanson’s session at the conference, view her full interview video above. To find out more from DERM 2025, view our latest conference coverage.

The quotes contained in this interview summary were edited for clarity.

Swanson has served as a speaker and/or consultant for Abbvie, Almirall, Alphyn, Arcutis, Boehringer Ingelheim, Castle, Dermavant, Galderma, Incyte, Johnson & Johnson, Leo, Lilly, Novan, Pfizer, Sanofi-Regeneron, and Verrica.