If you have genital psoriasis, you might feel like there’s an unwelcome stranger in your bedroom. Genital psoriasis can cause pain and discomfort during sex, and even create stress for you and your partner.
A study published in March in the Journal of the American Academy of Dermatology found that almost half of people with genital psoriasis experienced pain during sex, and had sex less often because of their disease. According to the findings, more than a third of patients also experienced worsening of their psoriasis after intercourse.
“It’s a terribly stigmatizing part of the disease for some people,” says Caitriona Ryan, M.D., a dermatologist at Baylor University and the lead author of the study. And to make matters worse, treatment options for genital psoriasis can be limited. Few clinical trials have tested treatments for genital psoriasis specifically, Ryan says, and information on systemic and biologic therapies is particularly scarce.
But despite these challenges, patients can start taking steps now to treat their disease and limit its impact on their relationships. Communication is the key, according to Ryan, both with your doctor and with your partner.
Here are five tips for living with genital psoriasis.
1. Tell your doctor if you notice any plaques in your genital area -- even if you don’t think it’s psoriasis.
One of the toughest parts of treating someone with genital psoriasis, Ryan says, is knowing that they have the disease in the first place. Often, the patient doesn’t bring it up.
“It’s not until I ask that they tell me,” Ryan says.
Use whatever language you’re comfortable with when you’re talking to your doctor, Ryan says -- just be sure to mention if you have something that might be psoriasis in your genital or groin area. And even if you don’t think it’s psoriasis, you should tell your doctor anyway.
“I see a lot of males who have a little bit of scalp psoriasis, and then the only other place that’s affected is the genitals,” Ryan says. “They didn’t realize that the genital disease was anything linked to their scalp psoriasis.” A doctor can help you make the connection, and start the right treatment.
2. Don’t wait for your doctor to ask about genital psoriasis.
Many dermatologists don’t ask patients if they’re experiencing symptoms of psoriasis in the genital area, Ryan says.
“A lot of patients that I ask will tell me, ‘nobody’s ever asked me before,’” Ryan says.
She hopes that studies like hers will draw attention to the issue, and encourage doctors to check in with their patients about genital psoriasis. But until then, it may be up to the patients.
3. Check with your doctor to see if you can use your topical treatment on your genital area.
According to Ryan, one of the most important reasons to let your doctor know if you have genital psoriasis is to make sure you’re using the right treatment. Just because your doctor prescribed a cream for you to use on your elbow, for example, doesn’t mean you can also use it on your genitals. Some treatments can lead to side effects such as peeling of the skin, she says.
4. Tell your doctor if your treatment isn’t working.
Because genital psoriasis can be tough to treat, the first topical you try may not do the trick. Patients should let their doctor know if they’re not seeing results, says Ryan.
“If their genital disease isn’t responding, they need to go back to their dermatologist,” says Ryan. “There could be another problem there.”
For example, patients may develop a yeast infection in the same place as their genital psoriasis, or they could develop an allergy to their topical, Ryan explained. If that’s the case, their dermatologist can help them find a different treatment option.
5. Be open with your partner, and tackle the problem together.
Just as important as speaking with your doctor about your genital symptoms, Ryan says, is speaking with your partner.
“We’ve seen that the partners can be equally affected by the patients having genital involvement because it creates stress within the relationship,” she says.
If your partner knows what’s going on, they may be able to make sex more comfortable for you both. For instance, using a lubricant can make sex less painful, and may also cut down on some of the friction during intercourse that can lead to new disease flares, Ryan says.
Learn more helpful tips when dealing with genital psoriasis
Looking on the best way to manage your genital psoriasis? Get more treatment tips and advice in our free Genital Psoriasis Guide from NPF's Patient Navigation Center.
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