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Psoriasis in Men: Severity, Infertility, and More

Medically reviewed by Steven Devos, M.D., Ph.D.
Written by Sarah Winfrey
Posted on March 1, 2024

Psoriasis seems to have no boundaries — it can affect anyone, regardless of their location, race, and even their gender. However, although this skin condition develops in men and women equally, according to the National Psoriasis Foundation, it sometimes affects them differently.

This article focuses on key facts about how psoriasis affects men. Note that the details and statistics discussed here are for people who are biologically male, including trans women who have not undergone hormone therapy.

Similarities Between Men and Women With Psoriasis

Many of the basics of psoriasis are the same for men and women.

Causes and Risk Factors

No one knows exactly what causes psoriasis in either men or women. In both, the immune system is dysregulated, causing skin cells to duplicate faster than normal. This causes the buildup of silvery scales and other symptoms, like itching and burning.

In both men and women, a range of factors can trigger psoriasis flare-ups. Examples of possible triggers include:

Some of these individual triggers may be behaviors that are more common among men than women. One study showed, for instance, that among people with psoriasis, males with psoriasis were more likely than females to have used alcohol and tobacco. However, the researchers didn’t determine whether these were triggers for psoriasis in the people studied.

Symptoms

Psoriasis symptoms also tend to be the same for both men and women. While your specific symptoms depend on your type of psoriasis, they may include:

  • Silvery scales
  • Itching
  • Burning
  • Nail symptoms
  • Pus-filled bumps covering the body
  • Small, raised, discolored bumps of skin

There’s no research that addresses whether certain symptoms are more common in men or women.

Treatment Options

In general, the same treatments are available for men and women. They include:

  • Topical treatments, including corticosteroids and vitamin D
  • Phototherapy
  • Retinoids
  • Medications that suppress the immune system
  • Biologic medications that target specific parts of the immune system

Differences in Psoriasis Between Men and Women

Although many of the basics are the same, there are also some important differences in how psoriasis affects men and women.

Severity

Psoriasis tends to be more severe in men than in women. One study showed that males tend to have more of their body affected by psoriasis. Another showed that psoriasis tends to be more severe for men on every affected area of the body, except the head. The researchers described the data as persistent and significant but could not find an explanation for the increased severity.

Treatment Plans

The same treatment options may be available and effective for everyone, but men and women often differ in what’s chosen. One study showed that men are more likely to use systemic treatments, like immunosuppressants or biologics, while women are more likely to use topical treatments. This may be related to the differences in disease severity. Also, men are more likely than women to see a dermatologist. Women tend to treat themselves or see their regular doctor for psoriasis treatment.

Many dermatologists find that for all skin diseases, men generally prefer receiving oral treatments or injections rather than regularly applying creams. However, women don’t tend to mind applying topical treatments on a daily basis.

Fertility

Psoriasis and psoriasis medications can affect fertility but may do so differently in men versus women. Most studies on psoriasis and fertility have been done on women because their psoriasis can be affected by regular hormonal fluctuations. However, there’s some good information available for men, too.

Untreated psoriasis in men can affect fertility by reducing sperm quality, including a lower sperm count and less sperm motility (movement).

Male infertility or lowered fertility may be related to systemic (bodywide) inflammation associated with psoriasis. Systemic inflammation can affect sex hormone production and glands related to sexual function. Men with psoriasis may experience erectile dysfunction, but researchers don’t know yet if this occurs because of a physical cause, like inflammation, or for psychological reasons.

Certain medications aren’t recommended for men who are trying to have children. For example, you should avoid or get off methotrexate, a common immunosuppressant used to treat psoriasis, if your partner is trying to conceive. Methotrexate can cause serious birth defects in a child who’s conceived while the father is taking it. Talk to your doctor about how family planning may affect your treatments.

Comorbidities

A comorbidity is a condition that occurs with another condition and may or may not cause it or be caused by it. For example, people diagnosed with psoriasis are more likely to have heart problems compared with the general population. However, these heart conditions may not occur as often or as severely in men with psoriasis: They were less likely than women with psoriasis to have cardiovascular comorbidities in one large study.

Depression, another comorbidity of psoriasis, is also less likely to affect men despite their generally more severe psoriasis symptoms. It’s unknown if the origins of depression associated with psoriasis are biological or caused by something else.

Speak With a Dermatologist for Help

If you are a man living with psoriasis and have questions about how it affects you, talk to your doctor. They can help you find the solutions that are right for you. They can also help you treat any related infertility or erectile dysfunction, and they can make sure you get the treatment you need if your psoriasis is severe.

Find Your Team

MyPsoriasisTeam is the social network for people with psoriasis and their loved ones. On MyPsoriasisTeam, more than 126,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis.

Are you a man living with psoriasis? Share your experience in the comments below, or start a conversation by posting on your Activities page.

Posted on March 1, 2024
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Steven Devos, M.D., Ph.D. received his medical degree and completed residency training in dermatology at the University of Ghent, Belgium. Learn more about him here.
Sarah Winfrey is a writer at MyHealthTeam. Learn more about her here.

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