< See All Articles In Psoriasis

Sex is complicated – and so is explaining your psoriasis to your partner

Bringing up the ‘S’ word with the ‘P’ word can be tough. Here are some ways to talk through sex and your psoriasis

The ‘firsts’ of a relationship are exciting – the first date, the first kiss, the first time you sit in and watch The Notebook on the couch. These are the experiences you ground your relationship on, and the moments you’ll (hopefully) look back on with fondness. For those living with psoriasis, however, there is one ‘first’ that always feels (at least a bit) uncomfortable – the first time you and your partner get intimate. We’re not being coy here, we do mean the first time you have sex!

When it comes to psoriasis and relationships, there is no right way to handle things. There are some people who immediately open up about their condition to their partners, discussing in detail all of their symptoms, well before that intimate “will they/won’t they” moment. And there are plenty of people who are more reserved, mentioning it only briefly or even avoiding the subject all together. Regardless of how you’ve approached your psoriasis previously, everyone knows that feeling of anxiousness or dread, when the moment strikes and your partner gets an up close and personal look at the patches of thickened, red, scaling skin on your body.1 It can be scary for some, and it’s complicated!

Let’s back up a second: sex is also complicated. Being intimate is different for everyone, and if you live with a skin condition, it may feel especially tough. You’re already so self-conscious about your skin throughout your regular day, interacting with coworkers, friends, and strangers that when it is time to ditch the clothes and jump into bed with your partner, it can be especially nerve-wrecking. While you should be enjoying this time, you may be concerned with your counterpart is thinking: Is he/she afraid to touch me? Do they think it is contagious? The questions go on and on, removing you from the moment.

At some point, you’re going to want to talk about it. While it may be best to open up about your psoriasis before the lights go out and the clothes come off, it doesn’t always happen that way. So, regardless of when you talk to your partner, we’ve outlined some talking points to help answer those sticky sex psoriasis questions you may get in the heat of the moment:

Hey babe, what’s that patch on your skin?

If you’ve gotten this question, you know it can be complicated to answer. You know the medical jargon - psoriasis is a skin disease that causes patches of raised, red skin with scaling and inflammation.2 These patches can be itchy and sore, but you already know that. And no part of that explanation is as sexy as you want it to be.

“Well babe, my skin just can’t control itself – you’re too good looking and it’s freaking out.” Ok, probably not the best joke to make at a time of intimacy. Sometimes it’s just easier to break it down honestly. So let’s break the psoriasis ice. Explain to your partner where you usually get your patches, and any other symptoms you may have when they flare up. Are they worse depending on the weather outside, or your stress level? Let your partner know that too.

Um, is this like an STD or something?

Ahhh! Not the question you want to get in the “moment.” You don’t have to put on your lab coat and go full scientist here, but it’s a nice reminder to your partner (and to you), that you didn’t “catch” psoriasis by anything that you did, it just happened to you. Usually, skin cells grow within deep layers of the skin and then move to the surface about once a month.3 When you have psoriasis, your immune system mistakenly attacks the healthy skin cells, causing them to rise too fast after forming and then pile up on the skin’s surface4.

So there’s nothing wrong on the inside right?  

You’re not damaged goods, but we all know that psoriasis is more than skin deep – so make sure your partner knows that too. Discuss how the symptoms such as pain and burning sensations of the skin regularly limit your ability to undertake daily activities5, and in this case, nightly activities too. You may endure even greater physical disability if you get patches in areas like your hands, feet and nails5.  But really, some days you may feel unattractive, which leads to not looking forward to any type of sexual encounter. So be sure to talk to your partner about how you’re feeling – if you’re not feeling it, you’re not feeling it, and that’s ok!

Hold on, can I catch this??

This is probably the biggest question looming in your partner’s mind right before getting intimate so put them at ease. Let them know that it is not an infection, but an autoimmune/inflammatory disease so it is not contagious. We now know that psoriasis is caused by a combination of genetic factors and environmental triggers – none of which can be passed on through contact with the affected skin6.

Ultimately, psoriasis may impact your relationship but it doesn't need to control it.  Be sure to have an open dialogue with your partner, and let them know whenever you’re not feeling your best. Remember, if you’re dating someone who values you for who you are, instead of what you look like, then your condition should not be a big deal to your partner even when you let your guard down and take off your clothes. So go ahead and cue the soft music after your cuddle session on the couch – you got this.

  1. Zachariae H. Am J Clin Dermatol 2003; 4(7):441-47. Reference location: http://www.skintolivein.com/psoriasis/psoriasis-a-distressing-problem/
  2. Website “National Psoriasis Foundation” – About psoriasis. https://www.psoriasis.org/about-psoriasis
  3. Schön MP, Boehncke WH. N Engl J Med 2005; 352(18):1899-1912. Reference location: http://www.skintolivein.com/psoriasis/psoriasis-a-distressing-problem/
  4. Website “National Institute of Arthritis and Musculoskeletal and Skin Diseases” – What is Psoriasis? Last accessed: 12.28.15 http://www.niams.nih.gov/Health_Info/Psoriasis/psoriasis_ff.asp
  5. Rapp SR et al. J Am Acad Dermatol 1999; 41(3 Pt 1):401-07. Reference location: http://www.skintolivein.com/psoriasis/psoriasis-more-than-skin-deep/
  6. Website “Mayo Clinic” – Causes. Last accessed: 09.10.15 http://www.mayoclinic.org/diseases-conditions/psoriasis/basics/causes/con-20030838

Related articles