Sexual Issues w/ Psoriasis

Psoriasis can not only affect one's appearance, but it can also have a significant effect on one's quality of life, especially sexual function.

In a study published in the International Journal of Dermatology, 40 percent of participants reported that their sex life worsened after the symptoms of psoriasis began. Part of this worsening can be explained by the emotional factors that accompany psoriasis, such as depression and embarrassment. Physical symptoms such as pain and irritation also may inhibit sexuality, especially if psoriasis affects the genital area.

Indeed, it is not unusual to have genital psoriasis, and the condition can be extremely distressing. Genital psoriasis usually appears as reddened skin with little itching or scaling. The condition can affect the skin above the genitals or near the anus, the upper thighs, groin, the genitalia themselves and the crease between the buttocks. And since physical examinations don't always include fully undressing, be sure to tell your doctor if you have psoriasis in any of these areas. Untreated genital psoriasis can cause cracking, bleeding and infections. It usually responds well to topical therapy, such as creams and lotions, but caution must be taken because the skin in this area is very sensitive.

Steroids have the potential to thin the skin, so only low-strength steroid creams should be used in the genital area. Steroid-free lotions such as tacrolimus (Protopic) and pimecrolimus (Elidel) are sometimes used because they reduce skin inflammation without causing thinning of the skin the way steroids can.

Vitamin D compounds, such as calcipotriene (Dovonex), and retinoids, such as tarazotene (Tazorac), are rarely used for genital psoriasis because they can cause irritation. However, some doctors recommend calipotriene mixed with petroleum jelly or alternated with a low-dose steroid to minimize irritation. Sometimes doctors recommend tazarotene gel in very low doses with special care taken when used in skin folds.

Ultraviolet light treatments are sometimes used to treat genital psoriasis, but the doses must be reduced because the skin on the genitalia is thin and can burn easily. Men should not have ultraviolet light therapy on the penis or scrotum because of the potential risk of skin cancer, but areas such as the groin can respond well to this treatment.

If you use topical mediations to treat genital psoriasis, be sure to wash them off before intercourse in order to avoid transferring them to your partner. Using a condom may also be beneficial for reducing irritation. After sexual activity, you'll need to clean the area and reapply your medication.

Overcoming the problems of psoriasis often involves treating both emotional and medical factors. If you have psoriasis and you're feeling depressed, be sure to speak to a doctor—depression is a serious but treatable condition. If you're embarrassed by your condition, remind yourself that having psoriasis is not your fault. You may find that it helps to write down any negative thoughts you have, consider how realistic they are, and recognize that reality is unlikely to match up to your worst-case scenario. Make a point of sharing your concerns with your partner, so that he or she can offer emotional support. Listen to your partner's concerns as well; some people are afraid that psoriasis may be contagious, and it never is. You also may benefit from joining a support group or participating in an online discussion group for people with psoriasis.

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