Genital Psoriasis and Sex

Genital psoriasis can make sex painful, and sex can make genital psoriasis worse. Here’s what you can do about it.

Medically reviewed in November 2021

In addition to the day-to-day discomfort of living with genital psoriasis—which includes symptoms like itching, stinging, burning, pain and scaling in some of the most sensitive areas of the body—genital psoriasis can have a significant negative effect on a person’s relationships, intimacy, self-esteem and sexual health.

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 also describe feeling embarrassed, unattractive and stigmatized because of symptoms—and some worry that their symptoms will be perceived as a sexually transmitted disease or a contagious condition. Many people also reports that sex is painful and uncomfortable as a result of genital psoriasis, and that sex can make symptoms worse.

What you can do about genital psoriasis
If you, a friend, a loved one or a partner has genital psoriasis, it is important to seek treatment from a healthcare provider. While genital psoriasis is more common than most people realize, many people with the condition do not discuss these symptoms with a healthcare provider, which is unfortunate because genital psoriasis is treatable.

Treating psoriasis on the genitals is different than treating psoriasis on other areas of the body—the skin is thinner, more sensitive and more prone to irritation—and treatment requires several additional considerations. Psoriasis treatments that are safe to use on elbows, knees and other parts of the body—such as corticosteroids and UV light therapy—may not be safe to use on or around the genitals, and will need to be used in lower, carefully controlled doses.

If you’re already working with a dermatologist, but the treatments you’ve used haven’t worked to control genital psoriasis, ask what other treatment options are available.

One clinical trial looked into the potential of treating genital psoriasis with a biologic drug. Biologics are a category of drug typically prescribed to patients with moderate-to-severe psoriasis when other treatments haven’t been successful. They are typically taken by injection or infusion and work by suppressing certain parts of the immune system. Participants in the clinical study reported genital psoriasis had significantly less impact on sexual activity when being treated with a biologic drug that blocks a pro-inflammatory protein called interleukin-17. They also reported that the treatment lessened itching, which is cited as one of the most distressing symptoms of genital psoriasis.

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 that can help make sex a more enjoyable experience.

  • Rinse off. Cleanse 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. And 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 cause pain and irritate 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, which can cause latex to break.
  • Postpone when you have to. Unfortunately, when skin is particularly irritated and psoriasis is flaring, sex may need to wait. Postpone sex 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 on the list above 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 utilize counseling and support groups to help manage the many emotions that accompany a condition like genital psoriasis.

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