Psoriasis: what impact on sexuality?

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Psoriasis is a multifactorial inflammatory skin disease (dermatosis) that touches around 2% of the French population. This dermatological disease is characterized by red patches and scales (whitish lamellae) often accompanied by itching. Psoriasis manifests itself in flare-ups.

There is a genetic background to the development of psoriasis, with 10% of hereditary forms. Other factors such as immune dysfunction, medication or a strong emotion can trigger its appearance.

This pathology affects health, well-being and to a large extent sexuality.

Psoriasis increases sexual disorders and in particular erectile dysfunction

The sexual dysfunctions are quite common in men and women with psoriasis. Indeed, this inflammatory dermatosis causes plaques on the body can be unpleasant. Usually they appear on friction zones at the elbows, knees, forearms or extend over the entire surface of the body.

People with this condition tend to want to hide and avoid contact with others. So much so that this avoidance behavior generates anxiety, constant dissatisfaction, depression and loss of social contact. These secondary behaviors have a direct impact on libido and sexual desire.

According to studies, between 22% and 71% of patients (men and women) suffering from psoriasis are affected by sexual dysfunction.

A Brazilian study found that sexual desire is greatly altered in more than half of women with this dermatosis.

The erectile dysfunction are present in 55% of men with psoriasis.

Erectile dysfunction is in some cases accompanied by premature ejaculation, decreased libido or difficulty reachingorgasm. A 2009 study shows that in men:

  • 16% notice premature ejaculation;
  • 13% observed a decrease in libido;
  • 7.5% are prone to anorgasmia;

Psoriasis has a negative impact on the couple with an impact on the sexuality of the spouse

Psoriasis is a benign, non-contagious condition if it does not progress to a more serious form. The plaques present on the body depending on their locations and their importance can be perceived as a real handicap.

This is because while most psoriatic lesions are mild and get better over time, sometimes psoriasis can take on a more serious form, such as:

  • One erythrodermic psoriasis which is characterized by sunburn-like patches. This form is rare but serious and requires urgent hospitalization because the skin no longer performs its protective and thermoregulatory functions.
  • One pustular psoriasis which manifests itself by purulent phlyctenes and yellowish. This type of condition results in restriction in daily activities since the blisters appear mainly on the hands and the arch of the foot.

This disease therefore has an influence on the behavior of the person as well as on his mental health.

Thus, a 2018 study shows that :

Patients with psoriasis have avoidance behaviors. Indeed, 47% of them reduce their participation in social activities such as going out with friends or meeting new people and 39% feel social rejection.

Psoriasis greatly affects the intimacy and the couple. Lack of self-confidence, worry about showing off naked body or excessively hedging can lead to sexual tensions within a couple. The feeling of shame and the fear of the gaze of the other can induce a difficulty in the relationship and in the sex.

For the person suffering from psoriasis, the caresses are often difficult to bear. The physical discomfort is so great that many patients avoid intimate relationships. A study shows that 71% of patients abstained from having sex.

This behavior is not without consequences on the spouse, since disorders of desire, arousal or orgasm were observed in 40% of partners (47.9% of women and 35.3% of men) of people with psoriasis.

The particular case of genital psoriasis

Usually, the condition affects areas of friction such as the elbows, knees, scalp or lumbar area. However, psoriasis can spread throughout the body and affect the genital areas.

According to a study, 16.5% of patients notice damage to the private parts during their illnesses. There is a difficulty in estimating a correct percentage by the dermatologists.

It is not easy to show your genitals and many patients do not dare to consult. Genital psoriasis is characterized by shiny red patches and thick with clear and well defined contours. Unlike common psoriasis, there is no skin peeling. Partly because this area is humid.

The lesions reach the hairy areas, folds, mucous membranes, pubis and inner thighs. The plaques cause a burning sensation and itching. Itching leads to chronic scratching which in turn accentuates the plaques and promotes the development of psoriasis.

The lesions can be impressive and unsightly. Even though psoriasis is not contagious, it can be confused with other illnesses such as yeast infection, herpes or a sexually transmitted infection. There is some physical difficulty in maintaining a fulfilling sexuality.

According to a 2010 study :

  • 29% of patients experience discomfort in their body when psoriasis is placed on the genitals, with a higher risk of sexual dysfunction.
  • In men, erectile dysfunction is present at 48.3% and genital psoriasis negatively impacts their sexual experiences.
  • In women, desire, arousal and sexual satisfaction are markedly impaired.
  • Sex is less common in people with genital psoriasis since friction during frolics accentuate the plaques and itching.
  • In men, the condom is a source of discomfort

The Importance of a Caregiver Discussion About the Impact of Psoriasis on Sexuality

Sexual dysfunctions in men and women with psoriasis can be improved if this dimension is taken care of during medical follow-up. Sexual disorders are not of biological or mechanical origin. They are caused mainly by ill-being, deep discomfort and poor psychological condition. This is because most patients show signs of depression or anxiety. 62% of patients are subject to depressive symptoms and 45% to chronic anxiety.

It is recommended to wear clothes made of cotton, linen or silk, preferably fluid and not sticking to the skin. The plaques can be relieved with specific oils and creams based on cortisone and vitamin D.

Psychological suffering can be relieved by consulting a psychologist and a sexologist. The latter can assist you in the management of your sexual dysfunctions and advise you in the choice of underwear, contraceptives and lubricants to improve your comfort. The sex therapist can also help you change your outlook on your sexuality and find solutions to better cope with your affection.

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Psoriasis: what impact on sexuality?

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Catherine Coaches