Psoriasis, Depression and Sexual Dysfunction: What's the Link?


Sarah Handzel, BSN, RN

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About 1–3% of the population in developed countries is diagnosed with psoriasis, a common skin condition causing thick, silvery patches that can be dry, red, itchy, and painful. The extent of the patches can range from mild to severe, with some people reporting burning or bleeding near their patches. While the cause of psoriasis isn’t fully understood, stress seems to be a major factor in flare-ups.

Beyond the physical signs of psoriasis, many patients, maybe even you, have to deal with social stigmas because of the way their skin looks. It’s also common for people with psoriasis to report being depressed and anxious. Since psoriasis can have such a negative influence on your mental health and quality of life, you might also have developed some level of sexual dysfunction. If you’ve had this problem, it’s important for you to know you’re not alone, and you should try to feel comfortable discussing it with your doctor.

Sexual Dysfunction and Psoriasis

Many studies have shown a diagnosis of psoriasis commonly occurs along with psychological diagnoses, especially depression and anxiety. However, even if you don’t have depression, you might also notice a decrease in the quality of your sex life. It’s possible for sexual dysfunction to happen without any other kind of psychological influence.

Sexual dysfunction can be any kind of problem that occurs at any point during sexual activity. Unfortunately for many psoriasis patients, sexual dysfunction is a common, underreported problem. If you have psoriasis and are experiencing sexual dysfunction, it could be related to several factors:

  • Psychological effects of the condition. If you have psoriasis, you might also be depressed or anxious even if you don’t think you are.

  • Severity of the disease. The more severe the psoriasis outbreak, the more embarrassed or uncomfortable you might feel.

  • Sexual partner concerns. Your sexual partner might be worried about sexual activity, especially if you’re having a flare-up.

  • Side effects of treatment medications. Some medications used to treat psoriasis can cause unpleasant side effects that can affect your sex life.

Some research shows up to 40.8% of people had a decline in sexual activity after being diagnosed with psoriasis. This decline was shown to be related to the effect of psoriasis on patients’ appearance. Almost 15% of patients have reported their sexual partners expressed a decreased sex drive after their diagnosis. People with more moderate to severe forms of psoriasis tend to have a greater decline in sexual function.

Depression and Psoriasis

Since many people with psoriasis feel shame, depression and anxiety as a result of the way they look, the quality of relationships they have with other people can decline. This might mean  people with psoriasis become isolated socially, which can worsen depression and anxiety.

There’s new evidence that some of the chemical signals triggering psoriasis outbreaks in your body might also be tied to the depression you could be feeling. These chemical signals, called cytokines, have been shown to worsen psoriasis symptoms by activating certain cells involved in your immune system. This causes higher levels of inflammation in your body. Studies show people with depression have higher levels of these inflammatory cytokines in their bodies. This means, if you’re depressed, it could be causing more flare-ups of your psoriasis.

Stick With Your Treatment

Even though some of psoriasis treatment medications can cause sexual dysfunction, you should continue on your treatment plan prescribed by your doctor. Also, it’s important for your doctor to know if you think you might be depressed or anxious.  With new information suggesting a link between depression, psoriasis, and sexual dysfunction, making sure your doctor knows about your problems or concerns is especially important.

Psoriasis is a difficult skin condition to live with, but your doctor has your best interests in mind when creating a plan for managing your flare-ups. Part of managing your condition is assuring the best quality of life possible for you, which means addressing any psychological and interpersonal problems you might be having. If you’re having trouble sexually, it’s important to talk to your doctor about your concerns to make sure you get the help you need.