(LifeWire) - When reading through the personal stories posted on the National Psoriasis Foundation online message board, it is immediately clear that the rashes and scales associated with psoriasis are not just skin deep. For teenagers and young adults, especially, psoriasis can hamper romance and impair self-esteem.
"I was constantly afraid of letting her get too close, for fear that she would be repulsed by my skin," one forum participant wrote about his relationship with a girlfriend.
Another wrote about being sent home from school during a flare up, even though psoriasis, which is a chronic disease of the auto-immune system, is not contagious.
"The nurse felt that I was 'frightening the other students' because they didn't want to catch whatever it was I had. It's days like that you just don't want to get out of bed or look into a mirror."
Psoriasis affects as many as 7.5 million Americans of all ages, according to the National Institutes of Health. However, three quarters of these individuals are under the age of 46 -- in the midst of establishing their identities, forming relationships, and launching careers. As a result, the effect psoriasis has on emotional well-being is gaining as much attention as its effect on physical health.
Psoriasis and Depression
One study of 5,000 Italian psoriasis patients found that 63% of women and 61% of men had symptoms of depression associated with the disease. Depression, which can be linked to body image and self-esteem issues, can be further exacerbated by the fatigue associated with psoriasis. Experts say that building a support system is key to handling psoriasis-related depression.
Sharing information and feelings with friends and family, reaching out to other individuals with psoriasis, attending conferences, and chatting online are all important ways to build a healthy support system. On the National Psoriasis Foundation message board, for example, young people express anger and hope, share coping methods, and promote the idea that psoriasis can become just one small part of life.
If emotional issues remain unresolved, talk to a trusted physician about psychotherapy and, if necessary, medications for anxiety and depression.
Psoriasis and Dating
For those with psoriasis, sharing the diagnosis with a significant other can be a challenging experience.
Mentioning an upcoming appointment with a doctor or a therapeutic activity like sunbathing are easy ways to broach the subject. Experts also recommend setting aside enough time to have a meaningful discussion about the condition. After a diagnosis of psoriasis has been disclosed, both the patient and the partner may have difficulty engaging in physical intimacy.
In a Dutch study involving approximately 90 individuals, some with psoriasis and others without, patients with psoriasis reported more social fears about sexuality than their unaffected peers. Experts recommend talking with potential partners about anxiety and working through the problem together. Keep in mind that psoriasis cannot be passed through sexual contact.
If the psoriasis affects the genitals, sexual contact can be painful. Experts recommend using lubrication or wearing a condom to limit skin-to-skin contact. A lubricant may also be beneficial because friction can actually cause a flareup.
Before any sexual contact, remember to wash off any topical medications as they can be absorbed through the skin of your partner.
Minimizing Flares
Adopting a conscientious care routine can keep psoriasis flares to a minimum. Keep track of personal triggers, including foods, fabrics and skin products, and try to avoid them. Some people with psoriasis say their symptoms resolve themselves with a wheat-free diet -- however the supporting medical evidence is controversial, at best. Finally, avoid peer pressure and stay away from cigarette smoke and alcohol, as studies have shown that both can aggravate psoriasis.
For more information about psoriasis, the National Psoriasis Foundation has compiled a list of informational links.
Additional resources include:
The American Academy of Dermatology
Mayo Clinic's Psoriasis Information
Psoriasis Genetics Lab at the University of Michigan
Sources:
Esposito, Maria, et. al.. "An Italian Study on Psoriasis and Depression." Dermatology. 212. 2. 2006. 123-127. 21 Apr. 2008. <http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowAbstract&ArtikelNr=90652&Ausgabe=231609&ProduktNr=224164>.
"Forum Pages." Psoriasis.org. 2008. National Psoriasis Foundation. 21 Apr. 2008. <http://www.psoriasis.org/forum/>
"Genital Psoriasis and Intimacy." 2004. Psoriasis.org. 21 Apr. 2008. <http://www.psoriasis.org/about/psoriasis/genital/intimacy.php>.
"Minimizing Flare-ups." PsoriasisNet. 17 Apr. 2008. American Academy of Dermatology. 21 Apr. 2008. <http://www.skincarephysicians.com/psoriasisnet/flare_ups.html>.
"Psoriasis and Dating." Psoriasis.org. 2008. National Psoriasis Foundation. 21 Apr. 2008. <http://www.psoriasis.org/about/youth/teens/relationships.php>.
"Psychological Aspects of Psoriasis." PsoriasisNet. 17 Apr. 2008. American Academy of Dermatology. 21 Apr. 2008. <http://www.skincarephysicians.com/psoriasisnet/psychological.html>.
Seikowski , K., M. Gelbrich and W. Harth. "Sexual Self-Reflection in Patients With Atopic Dermatitis and Psoriasis." The Dermatologist. 59. 4. Apr. 2008. 297-303. 21 Apr. 2008. <http://www.ncbi.nlm.nih.gov/pubmed/18340414?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum>.
"Support People." Psoriasis.org. 2008. National Psoriasis Foundation. 21 Apr. 2008 <http://www.psoriasis.org/about/living/support/>.
Traub, M. and K. Marshall. "Psoriasis--Pathophysiology, Conventional, and Alternative Approaches to Treatment." Alternative Medicine Review. 12. 4 Dec. 2007. 319-330. 21 Apr. 2008. <http:// www.ncbi.nlm.nih.gov/pubmed/18069901?ordinalpos=5&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum.>