Love Notes: Staying Intimate While Living with Psoriasis

When your psoriasis is flaring up, feeling sexy can be a challenge. You may want to hide your skin from your spouse or significant other, but taking a time-out from your relationship isn't realistic. And letting your partner in on what you're going through may increase your intimacy and strengthen your bond. "To maintain a good relationship, sharing your thoughts and experiences about psoriasis is important," says Renee Garfinkel, Ph.D., a clinical psychologist in private practice in Washington, D.C., who is affiliated with George Washington University. "You don't have to dwell on it, but share your feelings as you would about anything important to you." Here, she offers some tips:

Start with a reality check. Come to terms with your feelings about your condition, and try to get some perspective on how bad it is. "Your psoriasis may make you feel ugly. Okay, but lots of women feel unattractive at times," says Garfinkel. "Realize that your psoriasis is only one small part of who you are. You are not your psoriasis."

Share your experience, but avoid TMI. You don't have to share too much information, unless your spouse wants to hear every detail. "Most loved ones just want to know that you're going to get better and what they can do to help," says Garfinkel. "Saying something like, 'If I'm acting a little standoffish, it's because I'm having a flare; it's nothing personal,' lets your spouse know that you still care about him or her and opens the door for him or her to offer to help."

Let your spouse help you. Be specific about what you want your spouse to help with, whether it's applying cool compresses to your skin, giving you more time in the bathroom in the morning to get ready for work or whatever else you'd like him or her to do to help you deal with a flare-up.

Play up your positives. Find clothing that enhances your best features—maybe a long, pretty negligee that covers the psoriasis on your knees, or an emerald blouse that highlights the green in your eyes. "We all have body parts that we want to de-emphasize," says Garfinkel. "It's no different than wearing a cute cover-up at the beach to conceal cellulite."

Talk the talk. When you can't have sex because of pain or discomfort, you can still talk about it. "Say something like, 'I miss having sex with you. I can't wait until this flare-up passes and we can be together again.' It'll let your spouse know that you still feel desire for them. It can be very arousing to talk about what you would like to do with each other without actually doing it, sort of like phone sex," says Garfinkel. "Or, do what you can. If your face isn't affected, you could kiss like you did as teenagers, then laugh about how it reminds you of when you couldn't go any further because your parents were in the next room."

Recognize signs that you need help. "If you're anxious or thinking obsessively about your condition to the point that you have trouble concentrating on anything else, a few sessions with a therapist can break that unhealthy pattern of thinking and set you on a new path," says Garfinkel.

Say thank you. Show your gratitude when your spouse does something to help you. If he does the dishes because the psoriasis on your hands is flaring, take over one of his chores, like paying bills. "You're avoiding that dynamic in which you're the one with the problem and your spouse is always helping you," says Garfinkel. "Instead, you help and appreciate each other."

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