Do You Avoid Touch with Psoriatic Arthritis? What You Should Know
Psoriatic disease, which includes psoriasis and psoriatic arthritis (PsA), causes physical symptoms that involve the skin and joints. It can also have psychological and emotional effects.
A 2017 study suggests that a significant percentage of people who have psoriasis or PsA avoid touch because of physical pain, anxiety, embarrassment, and other reasons. This is referred to as touch aversion or touch avoidance.
Touch aversion can make it harder to experience intimacy in relationships. It can also affect a person’s quality of life. If you have a psoriatic condition, there are ways to cope with touch avoidance. This may include communicating with your partner, following your treatment plan, and reaching out to others living with psoriatic conditions.
Some people have touch aversion, or a reluctance to experience touch from someone. Because people may experience this differently, there are a couple of scientific ways to measure it. The touch avoidance questionnaire (TAQ) and the touch avoidance measure (TAM) are two examples.
There are many different reasons why people vary in how much they enjoy or want to experience touch. Some cultures or communities tend to engage in physical expression more often, according to a 2020 study . Researchers also note that younger people tend to want more touch.
Medical conditions such as chronic pain and depression can make someone less likely to invite or welcome touch. If you live with psoriasis or PsA, you are not alone if you sometimes experience touch avoidance.
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Haphephobia
Some people with touch avoidance may also have haphephobia.
Haphephobia is a specific phobia that involves feeling anxious at the idea of touch or the expectation of touch.
As with other anxiety disorders , if you have haphephobia, you may actively avoid touch. The idea of being touched may cause you a great deal of worry. You may experience anxiety attack symptoms, such as a pounding heart, sweating, and feeling unable to manage.
You can get help for haphephobia through a mental health provider. This can be an option you explore alongside your treatment plan for psoriasis or PsA. Some treatment strategies for haphephobia include cognitive behavioral therapy, medications, and exposure therapy.
Many people with psoriasis experience touch avoidance.
A 2017 study based on an online survey conducted by the National Psoriasis Foundation (NPF) found that 48.2% of 1,109 respondents avoided touch or had touch avoidance.
Participants were asked whether in the previous 2 weeks, they had avoided touching someone or if someone had avoided touching them because of the look and feel of their skin.
Participants ranged across age groups, from age 18 to over 65, but most participants identified as white (89.5%) and female (70.1%).
Touch avoidance may also be experienced by people who have PsA.
Research has found that the symptoms of PsA have an emotional effect. Those feelings can lead to changes in intimate relationships, including changes in sexual function or a willingness to experience intimate touch.
A 2019 study of 439 people with PsA found that joint and skin symptoms could negatively affect a person’s quality of life. People in the study said that PsA symptoms affected how they thought of themselves and how others viewed them.
The authors of a 2020 study found a higher risk for erectile dysfunction (ED) among men with PsA. They noted earlier research about the psychological impacts of PsA but did not draw a conclusive link between the emotional effects of PsA and ED.
In a smaller 2019 study of women with PsA, 67% of 33 participants experienced sexual challenges.
Because people with PsA and psoriasis are all different and experience their conditions differently, there are many reasons why someone may experience touch avoidance.
People with PsA and psoriasis can experience a range of emotional and physical symptoms that lead to touch avoidance. Pain and embarrassment are just two examples.
Pain and physical sensitivity
People may avoid touch when they have physical discomfort from psoriasis. The 2017 study mentioned earlier found that touch avoidance was higher in people with more severe itching. Even if you don’t have severe itching, it may make you uncomfortable to experience touch during a psoriasis flare.
In intimate relationships, people may experience touch avoidance because of psoriasis on or around the groin area and genitals.
In addition, intercourse or other sexual activity may cause physical pain, which can affect the emotional aspect of a relationship, too.
Shame, embarrassment, or anxiety
The emotions of shame or embarrassment can also lead to touch aversion. Researchers in the 2017 study found that touch avoidance was higher among people who had psoriasis on visible areas of the skin like the face, neck, hands, and scalp.
If you’re starting a new relationship or experiencing worsening psoriasis symptoms while already in a relationship, you may worry about being rejected. This fear is usually unfounded, but it can still cause many people great distress, suggesting there’s a psychological aspect to psoriasis as well.
A number of strategies may help you overcome touch avoidance. This can, in turn, reduce anxiety in relationships and in daily life.
- Talk with your partner: You can tell them you have psoriasis and talk about how it affects you both physically and mentally. Share information (articles, studies) on psoriasis with them if they are unfamiliar with the condition. This communication may help you feel more comfortable the first time you are intimate with a new person.
- Take steps to reduce pain: Topical medications made for intimate areas may help reduce painful intercourse. Your doctor or pharmacist can recommend safe and effective treatments.
- Prepare to answer questions about psoriasis: Sometimes close friends or family members may have questions but are reluctant to ask or simply don’t know where to begin. You can share what you’ve learned, including the fact that the condition is not contagious.
- Treat the psoriasis or PsA: Sticking to a treatment plan can help reduce the frequency and severity of psoriasis or PsA flares. Newer medications may help. A 2022 study found that treatment with ixekizumab improved moderate-to-severe genital psoriasis and reduced touch avoidance.
- Join a support group: Talking about touch avoidance with others in the PsA community can help lessen feelings of isolation. You may also discover new ways to cope.
- Work with amental health professional: A counselor or therapist can help you learn techniques for managing any emotions that come with psoriasis and PsA.
Touch avoidance is often experienced by people with psoriasis or PsA. This can affect intimate relationships and emotional well-being. You can find support by reaching out to others with psoriatic disease, consulting with a mental health professional, and following a psoriasis treatment plan.
Last medically reviewed on March 14, 2023
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- Anxiety disorders. (2022).
nimh.nih.gov/health/topics/anxiety-disorders - Armstrong A, et al. (2017). Association of touch avoidance with disease severity and quality of life in psoriasis patients.
researchgate.net/publication/320190892_Association_of_Touch_Avoidance_with_Disease_Severity_and_Quality_of_Life_in_Psoriasis_Patients - Boone D, et al. (2019). Comparison of Female Sexual Function Index in patients with psoriatic and rheumatoid arthritis and healthy controls.
pubmed.ncbi.nlm.nih.gov/31219665/ - Casetta L, et al. (2020). Italian validation of the touch avoidance measure and the touch avoidance questionnaire.
ncbi.nlm.nih.gov/pmc/articles/PMC7390897/ - Merola JF, et al. (2019). Patient perspective on the burden of skin and joint symptoms of psoriatic arthritis: Results of a multi-national patient survey.
ncbi.nlm.nih.gov/pmc/articles/PMC6393265/ - Nahar S, et al. (2022). Haphephobia: A rare specific phobia of being touched.
ncbi.nlm.nih.gov/pmc/articles/PMC9564330/ - Psychological aspects of psoriasis. (n.d.).
papaa.org/learn-about-psoriasis-and-psoriatic-arthritis/further-resources/psychological-aspects-of-psoriasis/ - Soung, J, et al. (2022). Improvement in touch avoidance in patients with genital psoriasis treated with ixekizumab: 52-week results of a phase 3 clinical trial in patients with moderate-to-severe genital psoriasis (IXORA-Q).
jaad.org/article/S0190-9622(22)01357-3/fulltext - Wilton, KM, et al. (2020). Erectile dysfunction in men with psoriatic arthritis: A population-based cohort study.
ncbi.nlm.nih.gov/pmc/articles/PMC8046843/
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