Sexual Health

Chronic inflammatory skin conditions in young people and their impact on intimate relationships: a quantitative and qualitative study.

TL;DR

Young people with chronic inflammatory skin conditions experience significant burdens navigating romantic and intimate relationships, yet 78% reported their clinicians did not adequately enquire about intimacy concerns and standardized metrics failed to capture these psychosexual impacts.

Key Findings

Over half of young people with chronic inflammatory skin conditions reported skin-related intimacy concerns.

  • Study included 73 young people aged 17-25 years (inclusive) with common chronic skin conditions in the UK (NCT06397664)
  • 52% (n=38) of participants reported skin-related intimacy concerns
  • Conditions studied were common chronic inflammatory skin conditions regardless of genital involvement
  • Both quantitative questionnaires and qualitative semi-structured interviews (n=17) were used

The majority of participants reported that their clinicians did not adequately enquire about intimacy concerns.

  • 78% (n=57) of participants reported that their clinicians did not adequately enquire about intimacy concerns
  • Only 32% (n=23) reported feeling comfortable discussing their intimacy concerns with clinicians
  • This gap was identified across the full sample of 73 young people
  • Participants specifically requested communication approaches tailored to young people

Three key psychosexual challenges were identified through thematic analysis of semi-structured interviews.

  • Challenge one: reduced confidence in pursuing romantic or intimate relationships
  • Challenge two: symptomatic manifestations impeding intimacy
  • Challenge three: participants feeling supported (by partners or clinicians) but still struggling
  • These themes emerged from thematic analysis of 17 semi-structured interviews with participants
  • These challenges were present regardless of whether the skin condition involved genital areas

Standardized psychosexual and quality-of-life metrics did not reflect patient-reported impacts on the psychosexual toll of chronic skin conditions.

  • Measures used included Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), Teenager's Quality of Life Index, International Index of Erectile Function (IIEF), and Female Sexual Function Index (FSFI)
  • Comparisons of these scores were made between conditions
  • Despite 52% of participants reporting intimacy concerns, standardized metrics failed to capture these impacts
  • This discrepancy highlights a limitation of current measurement tools for assessing psychosexual burden in this population

Improvement in skin condition reduced the perceived negative impact on intimacy.

  • Participants reported that skin improvement led to reduced perceived negative impacts on intimacy
  • This finding was identified through qualitative interviews with 17 participants
  • This suggests that effective dermatological treatment may have downstream benefits for intimate relationships and wellbeing

Participants suggested specific communication approaches and resources to help clinicians better address intimacy concerns in young people.

  • Suggested approaches included providing a conducive environment for sharing intimacy concerns and active listening
  • Participants recommended offering resources around intimacy or psychosexual counselling in specific cases
  • Group therapy was also mentioned as a potentially helpful resource
  • Communication approaches were requested to be specifically tailored to young people rather than adult-focused models

Prior research on intimacy impacts of chronic skin conditions has focused on adult populations, specific conditions, or used single-item sexual impact questions, leaving young people understudied.

  • Existing studies have focused on adult populations in the USA and the Netherlands
  • Previous studies used single questions on sexual impact rather than comprehensive mixed-methods approaches
  • Young people are described as 'a group that is learning to navigate social and intimate relationships, and known to be vulnerable to mental health challenges'
  • Limited data existed specifically for UK young people aged 17-25 with chronic skin conditions prior to this study

What This Means

This research suggests that chronic skin conditions—such as eczema, psoriasis, or acne—have a meaningful negative effect on the romantic and sexual lives of young people aged 17 to 25 in the UK. More than half of the 73 participants surveyed reported that their skin condition had affected their intimate relationships. Qualitative interviews revealed three main ways this happened: young people felt less confident pursuing relationships, physical symptoms directly got in the way of intimacy, and many felt they were still struggling even when they had supportive partners or healthcare providers. Notably, these impacts were present whether or not the skin condition affected genital areas. A particularly striking finding is that standard clinical questionnaires used to measure mental health, quality of life, and sexual function failed to capture the intimacy-related burden that patients described in their own words. This suggests that current tools may underestimate the true psychosexual impact of skin conditions in young people. At the same time, most participants (78%) said their doctors did not adequately ask about intimacy concerns, and fewer than one in three felt comfortable raising the topic themselves—indicating a significant communication gap in clinical care. This research suggests that dermatologists and other clinicians caring for young people with chronic skin conditions should consider proactively creating space to discuss intimacy and relationships in a non-judgmental way. Participants in the study indicated that improving the skin condition itself helped reduce intimacy-related distress, and they called for age-appropriate communication, access to sexual health resources, and in some cases psychosexual counselling or group therapy. The findings point to a need for healthcare settings to better address the emotional and relational dimensions of living with a visible chronic condition during a formative period of life.

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Citation

Tan J, Marlow L, Phillips C, McPherson T. (2025). Chronic inflammatory skin conditions in young people and their impact on intimate relationships: a quantitative and qualitative study.. The British journal of dermatology. https://doi.org/10.1093/bjd/ljaf228