Taboo Talk: Psoriasis and Intimacy
Psoriasis is an embarrassing disease, and when you add the subject of intimacy into the mix, the awkwardness can skyrocket. When my wife and I started dating, she was very upfront with me that she was saving herself for marriage. Unlike most teenage guys, I was A-OK with that; it meant I had more time to keep my skin hidden. We didn’t talk much about my disease that first year of dating. When she met me she thought I was having an allergic reaction, and that is why my face was so “blotchy”. After I told her what it was, she didn’t think much of it and that was that. I realize now after hearing from so many other sufferers how lucky I am. She truly was never bothered by my disease, even when it covered 85% of my body, and that hasn’t changed 12 years later.
This isn’t to say we haven’t encountered hurdles in our intimate relationship because of my psoriasis. In fact, on our wedding night, I instinctively did everything I could to not be seen in the buff. We also soon found out as newlyweds that we couldn’t “live in bed” as most couples did. If we attempted intimacy more than a few times a week, the friction left my skin irritated and out of commission. This was frustrating to both of us at first, but we learned from it and have adopted ways to make touch an enjoyable experience.
Friction is the enemy when it comes to psoriasis. This is true when picking out clothing, and it is also true in intimate relationships. Even if you don’t have genital psoriasis, taking precautions is a big importance since psoriasis is associated with the Koebner phenomenon. This means that some people with psoriasis can develop symptoms in new areas where the skin is injured or broken. So, if rubbing produces a breakdown of sensitive skin, it is possible to see plaques develop in that area.
The best way to combat this is by being prepared with lubricants, lubricated condoms, and lotions. Choose a lubricant* that is as pure as possible. Heated or flavored products may seem exciting, but they can irritate the skin, especially where plaques are present. Also, be cautious of sensitizing/desensitizing products, as they may have ingredients that could cause discomfort.
It is important to protect the genital region, but the rest of your body can benefit from moisturizing as well. This can soften plaques and even make it more fun for your partner and you. Instead of seeing it as an obligation, have your partner help and turn it into a nice massage. Again, find a lotion or cream that is free of additives and scents; coconut oil* is also a great choice!
After being intimate, be sure to care for your skin. Nothing feels as good as a hot shower, and this is a great way to keep your psoriasis happy too. Wash with a mild cleanser to remove any lotions or lubricants. Then, if you are using any topical medications, reapply them to your affected areas. This is also a great time to check your skin and make sure no injury has taken place. If you do notice any problem areas, medicate or moisturize, and consider choosing loose fitting clothes while your skin heals.
Don’t ignore dysfunction
One recent study found that in men, sexual impotence and erectile dysfunction was related to psoriasis1. If you are experiencing this yourself, don’t ignore it. It is perfectly normal to be embarrassed, but try to not let that keep you from seeking the advice of a physician. Erectile dysfunction can be a marker of cardiovascular disease, and if it is recognized early, the risk of future issues can be decreased2. Since cardiovascular disease is also a comorbidity of psoriasis, this is an issue to especially be aware of. Even if you are not having impotence now, be sure to find a doctor that you feel comfortable talking with in case the issue arises in the future.
Communicate, communicate, communicate
Sometimes there will be times when your disease will get in the way of being intimate with your partner . This could be due to a flare, fatigue, or even emotional barriers. Be honest with your partner about your condition. Don’t make excuses or avoid him/her. This will only cause confusion or hurt. If it is a new relationship, think about having the discussion before the issue arises. When you feel ready, explain to your partner more about your condition and how it may affect your relationship.
There are always non-physical and gentle ways to be intimate. Busy schedules make it hard for my wife and I to have time to sit and talk like we used to when we were dating, so using the time we normally would to be intimate for emotional bonding is sometimes just as satisfying. Sending flirty text messages, holding hands, or playing footsie under the table can often bridge the gap until my body is ready for more contact. Finding what works for both people will keep you prepared and ready for whatever your disease may throw your way.
*Editorial Note: If you are using condoms for STD or pregnancy prevention, you should not use any oil-based lotion or lubricant on the skin in the genital area, or on the condoms when you are having sex. Oil found in lotions and lubricants can degrade the condoms, causing small holes or tears that you can not see, but will defeat the protection otherwise provided the condom.