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Living well with psoriasis

Psoriasis and intimacy

Nearly one-third of people with psoriasis and psoriatic arthritis say their disease interferes with their love life, according to a National Psoriasis Foundation study. Psoriasis can make sex and dating a little more complicated than picking out fancy cologne, but it doesn’t have to.

Many of the patients who come to see Madelyn Petrow-Cohen, a clinical social worker and psychologist with offices in Maplewood, N.J. and New York City, are anxious about sexual relationships. Her patients sometimes even are reluctant to get involved in a relationship for fear that it could become sexual.

Learn to love yourself

Petrow-Cohen advises people with psoriasis or psoriatic arthritis to work on becoming comfortable in their own skin and to accept that they have a chronic illness that needs to be managed for life. People struggling with intimacy can do that by framing life with psoriasis in a different light. "There’s a certain amount of acceptance that there’s uncertainty involved in psoriasis," she said. "If energy is going toward resisting what is, you don’t have energy left over going toward transforming the challenges ahead."

Open communication

When is the right time to tell a potential partner you have psoriasis or psoriatic arthritis? There is no single answer to that question, Petrow-Cohen said. Some people feel comfortable revealing that right away. Others have that conversation after the relationship is more established. In either case, psoriatic diseases can be handled in a similar fashion to other chronic diseases—by establishing a supportive and trusting relationship with another person and by both understanding that there may have to be modifications to intimate activities when, for example, a person is having a flare.

Psoriatic advantage?

There can be a benefit to all this self-introspection and open communication: a stronger relationship. "It does push things to a deeper level because it’s real …," Petrow-Cohen said. "I find that when people do finally pair up, they pair up with very kind and sympathetic people."

Tips for managing psoriasis in an intimate relationship

  • Follow your physician’s advice carefully.
  • Use corticosteroids exactly as prescribed.
  • Do not apply high-concentration coal tar ointments to the penis, scrotum or vulva, or to areas with cracked skin. They can cause irritation.
  • Use mild cleansers without scrubs or perfumes.
  • Keep the area clean.
  • Cleanse the area and reapply our medications after being intimate.
  • Let your partner know that psoriasis is not contagious.
  • Acknowledge how genital psoriasis affects your daily activities and make sure your partner is aware of it.
  • Understand that genital psoriasis generally does not cause sexual dysfunction.
  • Men may find it helpful to wear a lubricated condom during intercourse, which can keep skin from becoming more inflamed.
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