A Guy’s Guide to Psoriasis

Psoriasis is a skin condition marked by dry, thick, raised patches of itchy, flaky skin. It affects approximately 3 percent of men and women in the United States, which equals about 7.5 million adults.

For most people, psoriasis is a lifelong condition with periods of symptom flares and remission. Many experience psoriasis symptoms after a period of clear skin, in some cases worse than before.

Although comprehensive reviews have found inconclusive data about the relationship between gender and psoriasis, smaller studies have found that biological sex may impact the psoriasis experience.

Men may have more severe psoriasis

A 2017 study found that, on average, men had significantly higher Psoriasis Area and Severity Index (PASI) scores than women. The study reported that women had a median PASI score of 5.4 versus 7.3 for men. A score from 5 to 10 is considered moderate disease.

Psoriasis treatment response may vary among sexes

A 2021 study analyzing 9 years of data found that women tend to respond better to biologic and nonbiologic psoriasis treatment options than men. The study measured outcomes at 3, 6, and 12 months and found that women had statistically significant better outcomes at each stage.

The emotional toll of psoriasis

For people of all genders, living with psoriasis has an emotional impact.

Psoriasis blogger Howard Chang told Healthline that between managing doctor’s appointments, medical care, and his daily skin care routine, the condition is always present in his life.

“It can take an emotional toll, especially when my psoriasis is worsening,” he said. “A day doesn’t go by when I don’t think about psoriasis. When it’s bad, an hour doesn’t pass without feeling anxious about whether it will get even worse or if it will get better.”

There’s an established link between psoriasis and an increased risk of depression or anxiety. It often becomes cyclical, where psoriasis can bring on depression and anxiety, and this in turn can lead to behaviors that make psoriasis worse.

Red, itchy, flaky psoriasis plaques can crop up just about anywhere on the body. Psoriasis can manifest in ways that impact men in particular, though.

Hair loss

For people of all genders, scalp psoriasis can result in hair loss. The American Academy of Dermatology recommends a few strategies to reduce hair loss from scalp psoriasis:

• Brush gently when removing scale. Hard or rough combing can increase the chances of hair loss.
• Try not to pick or scratch the scale. This can make psoriasis worse and lead to hair loss.
• Let your hair air dry so you avoid over-drying your scalp from blow drying.
• Apply medication directly to your scalp. Direct application maximizes the effectiveness of the treatment.
• Alternate between medicated and nonmedicated shampoos. Medicated shampoos dry out the hair. Dry hair is more likely to break and fall out. Use conditioner after every shampoo to reduce dryness.

A dermatologist can also help you find the right kind of psoriasis treatment to apply to the scalp.

Beard itch and maintenance

People with beards may also have to take particular care with facial hair and skin maintenance. This will help you avoid cuts or dryness that can trigger flares or exacerbate psoriasis.

Follow these tips:

• Use a gentle cleanser to remove dirt without irritating skin.
• Use beard conditioner, oil, and comb to detangle and groom longer beards.
• Use shaving oil or cream before trimming with an electric razor, or use scissors for longer beards.

Check with a dermatologist about the specific ingredients in any shaving cream or oil to help determine if it may irritate your skin.

Genital psoriasis

Though it may be embarrassing, genital psoriasis affects people of all genders.

It’s not contagious. Your sexual partners cannot catch psoriasis if you have psoriasis.

It’s usually safe to engage in sexual intimacy even when you’re experiencing a genital psoriasis flare. Avoid sex if the skin is raw, though.

Otherwise, take these precautions:

• Clean the affected area before and after sex.
• Use a lubrication.

Genital psoriasis may require special treatment. Tell your dermatologist if you have a flare up in this area so you can work together on figuring out next steps.

Taking steps to identify triggers and adopt a healthy lifestyle can help anyone living with psoriasis, including men, manage the condition.

Identifying triggers

Certain triggers can cause psoriasis to worsen or flare up. These can include:

• stress
• smoking
• illness or injury
• weather
• certain medications

Tracking your psoriasis over time can help you identify and avoid your individual triggers.

For entrepreneur Thomas Fultz, founder of Coffeeble, stress-reducing techniques have been helpful on the psoriasis journey.

“I’ve taken on meditation, deep breathing exercises, and night walks,” he told Healthline. “All have helped tremendously with my stress. Mindset is key.”

Lifestyle tips

Making certain lifestyle changes can also help improve psoriasis management. This may include:

• eating a balanced diet
• exercising regularly
• maintaining a healthy weight for you
• quitting smoking, if you smoke
• limiting alcohol, if you drink
• maintaining overall health

Chang tells Healthline that taking these steps helps him control his psoriasis.

“I’m realizing that my lifestyle impacts my overall health, and hence my psoriasis,” he said. “Minimizing psoriasis triggers and keeping up a healthy lifestyle is part of my holistic approach to managing psoriasis.”

A variety of treatment options are available for people with psoriasis.

Talk with your dermatologist if you have specific concerns about treating psoriasis on your scalp, genitals, or beard area in particular. Sometimes these specific areas require targeted treatment strategies.

Treatment options

Treating psoriasis usually involves one or a combination of approaches. This may include:

• topical ointments, creams, or lotions
• light therapy
• systemic treatments, such as oral medications or injectable biologics
• laser treatments

Talk with your dermatologist about your individual symptoms to come up with the best treatment strategy to try.

Finding the right treatment

Treating psoriasis often involves working with a dermatologist to experiment with various options before finding the treatment or combination of treatments that works best for you

Even after finding success with a given treatment regimen, you may require a change in treatment over time.

Jon Quigley, a product development expert, has had a long road to finding solutions for psoriasis. He described his psoriasis experience to Healthline as severe.

“In the worst of circumstances, I can’t tie my shoes, as my fingers have tears in them,” he said.

Quigley was prescribed a combination of oral medication and UV light therapy. Although it worked on his psoriasis, the medication made him feel ill. He tried topical steroids and ointments, but they were ineffective.

He has found success with natural sun exposure to help control symptoms.

Fultz relied on topical steroid creams, which were challenging to apply. He has had positive experiences with photobiomodulation, a form of light therapy. He gains access to this treatment option through a local spa.

Chang has also experimented with a variety of therapies. He currently takes a biologic and uses a topical steroid, which has resulted in some success, although his skin is not yet completely clear of psoriasis.

Before switching or stopping any psoriasis treatment, first talk with your dermatologist. Some treatments might have to be tapered, or gradually reduced, before stopping completely.

Your dermatologist can recommend the best next steps.

Men may experience psoriasis differently than women.

Work with a dermatologist to identify specific areas of concern, pinpoint personal triggers, make necessary lifestyle changes, and find the right treatment or combination of treatments to help you manage your psoriasis.