Genital psoriasis and sex

Living with genital psoriasis can be uncomfortable, with symptoms like itching, stinging, burning, pain, and scaling occurring in some of the most sensitive areas of the body. But genital psoriasis doesn’t just affect a person physically. It can also influence a person’s relationships, intimacy, self-esteem, and sexual health.

In studies, people with genital psoriasis report engaging in sex less often, avoiding sex more frequently, and having a decreased desire for sex because of the condition. They describe feeling embarrassed, unattractive, and stigmatized because of symptoms. Some worry that their symptoms will be perceived as a sexually transmitted disease or a contagious condition. Many report that having sex is painful and uncomfortable, and that it can make symptoms worse.

What you can do about genital psoriasis

Often, people with genital psoriasis avoid discussing their symptoms with a healthcare provider (HCP). But if you, a friend, a loved one, or a partner has the condition, it’s important to seek an HCP. Genital psoriasis is more common than many people realize, and treatment is available.

Treating psoriasis on the genitals can be different than treating psoriasis on other parts of the body. The skin is thinner, more sensitive, and more prone to irritation. As a result, certain treatments—such as UV light therapy—that are safe for elbows, knees, and other areas may not be safe for the genital area. If they are used, they need to be carefully controlled.

Medications are also used to treat genital psoriasis. These include corticosteroids, prescription ointments and creams, disease-modifying antirheumatic drugs (DMARDs), and biologics. Your HCP can review whether these options may be a good fit for you.

Steps for better sex with genital psoriasis

Having genital psoriasis does not mean you must abstain from sex. Many people with genital psoriasis have healthy sex lives, and there are several steps you can take to help make sex a more enjoyable experience.

• Rinse off. Clean the affected skin before and after sex. Doing this before helps remove topical medications and avoid transferring them to your partner, and doing it afterward may help reduce irritation. You don’t have to do this part alone—ask your partner to join you in the bath or shower.
• Use a condom and lubricant. Using a condom and a generous amount of lubricant can help reduce friction that can lead to pain and other symptoms. Men with genital psoriasis should apply a lubricant inside the condom as well as outside. However, do not use oil-based lubricants with latex condoms, since they can cause latex to break.
• Postpone when necessary. When skin is particularly irritated and psoriasis is flaring, sex may need to wait. Put sex off until symptoms calm down.
• Experiment. Humans are capable of a wide variety of sexual acts. When psoriasis is making one impractical, try to find another.

Perhaps more important than anything else is communicating with your partner. Explain how psoriasis makes you feel physically and emotionally, answer your partner’s questions about the condition, and openly discuss any concerns that either of you have.

Many patients also seek counseling and support groups to help manage the many emotions that accompany a condition like genital psoriasis.