Psoriasis is a chronic disease in which the immune system becomes too active. Due to this, skin cells start multiplying quickly. When this happens, patches of skin, mostly on the scalp, knees or genital area, become scaly and inflamed. People with psoriasis have to deal with dry and cracked skin that itches or even bleeds. These symptoms of psoriasis tend to affect sleep, and thereby one’s sex life. Find out how psoriasis affects sex life, and how to deal with it.

What is psoriasis?

Psoriasis is a skin problem that leads to itchy, scaly patches on body parts like the scalp, knees, elbows, and trunk. It is a common, long-lasting issue without permanent cure although it can be well controlled, says dermatologist Dr Pawan Singh. It can be painful, so it can disturb sleep, and make it tough to focus. Psoriasis tends to come and go, flaring up for a few weeks or months, then getting better for a bit.

Psoriasis happens when skin cells grow faster than usual. Normally, our body makes new skin cells deep within our skin, and they slowly move up through the different layers of skin. They keep moving till they reach the surface, where they die and then fall off. This cycle usually takes about 3 to 4 weeks. But in people with psoriasis, this process speeds up to just 3 to 7 days, says the expert. So, skin cells build up quickly on the surface, leading to flaky, crusty patches covered with scales.

What are the symptoms of psoriasis?

Common signs and symptoms of psoriasis include:

• Patches of rash ranging from small dandruff-like flakes to larger outbreaks covering a major portion of the body.
• Rashes can have different colours, like shades of purple with gray scales, and pink or red with silver scales.
• Small spots with scales.
• Dry, and cracked skin that might bleed.
• Itching
• Burning
• Feeling sore

How does psoriasis affect sex life?

Psoriasis can affect intimacy in several ways, causing anxiety about the body, discomfort during sex, and reducing romantic desire. People with psoriasis may have low self-esteem and may face stigmatisation and discrimination, which can make it hard for them to be in a romantic relationship and date. Having sex can be challenging because friction can irritate the skin or worsen symptoms, especially if psoriasis affects the genitals or surrounding skin.

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Some medications used to treat psoriasis might affect libido and sexual function. For instance, Rheumatrex (methotrexate) is a powerful medication often prescribed for moderate to severe psoriasis. It works by suppressing the overactive immune system responsible for psoriasis, says the expert. Methotrexate may cause loss of libido, as per a research published in the Sexual Medicine journal in 2020.

During a 2022 study, published in the Medicina journal, it was found that more than 90 percent of the participants felt slightly unattractive due to psoriasis. Researchers also found that psoriasis occasionally affected the sex life of almost 80 percent of those participants, and over 50 percent of them avoided sexual contact. The location of psoriasis, especially in the genital area, on the face, and hands, also had a significant impact on the level of sexual problems of those participants.

How can people with psoriasis enjoy their sex life?

Psoriasis should not interfere with having a healthy and fulfilling love life. Here are some tips:

1. Discuss with your partner

Discuss your concerns with your partner openly and well in advance to ease worries and enjoy sex without distraction. Be upfront about your psoriasis, clarifying that it is not contagious and doesn’t spread through physical contact, says the expert. If necessary, invite your partner to accompany you to a doctor’s appointment for more information.

2. Set the mood

Choose comfortable undergarments made from natural fabrics so that you don’t feel irritation or discomfort. Opt for light-coloured bedding to conceal flakes, and try to relaxing by playing soothing music.

3. Take care of your skin

After sex, gently cleanse and moisturise your skin, applying psoriasis medication as needed. Use fragrance-free moisturisers and natural oils to keep your skin hydrated and healthy, suggests the expert.

4. Take care of yourself

During a 2018 analysis, published in the International Journal of Dermatology, in 31 to 88 percent of cases, people reported stress as being a trigger for psoriasis. Since stress is linked with psoriasis, address it through counseling or therapy, and prioritise regular exercise to boost mood and energy levels. Practice self-acceptance and focus on building confidence, knowing that true intimacy involves acceptance of all aspects of yourself.

Gradually build trust and intimacy, allowing yourself to feel comfortable and confident with your partner before having sex.