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

Chronic inflammatory skin conditions significantly impact sex and intimacy, particularly in female patients or those with genital involvement. Studies on the impacts of intimacy have focused on adult populations and specific conditions, or have used single questions on sexual impact. There are limited data on young people, a group that is learning to navigate social and intimate relationships, and known to be vulnerable to mental health challenges.

To understand the impact of common chronic inflammatory skin conditions on sexual health, dating and intimacy in young people in the UK.

This was a quantitative and qualitative study (NCT06397664) of young people aged 17-25 years (inclusive) with common chronic skin conditions. Comparisons of Patient Health Questionnaire-9, General Anxiety Disorder-7, Teenager's Quality of Life Index, and International Index of Erectile Function and Female Sexual Function Index scores were made between conditions. A thematic analysis of 17 semi-structured interviews with participants was conducted to provide further depth and patient perspectives on how clinicians can help.

Patients with skin conditions, regardless of genital involvement, experienced significant burdens when navigating romantic and intimate relationships. However, standardized metrics did not reflect patient-reported impacts on the psychosexual toll of chronic skin conditions. Of the 73 young people included, 52% (n = 38) reported skin-related intimacy concerns. Three key challenges highlighted were (i) reduced confidence in pursuing romantic or intimate relationships; (ii) symptomatic manifestations impeding intimacy; and (iii) participants feeling supported but still struggling. Importantly, 78% (n = 57) of participants reported that their clinicians did not adequately enquire about intimacy concerns, and only 32% (n = 23) reported feeling comfortable discussing their concerns. Skin improvement reduced perceived negative impacts on intimacy. Participants suggested specific approaches to communication tailored to young people, including providing a conducive environment to share their intimacy concerns, as well as offering resources around intimacy, or psychosexual counselling in specific cases.

Given the impact that this topic has on patients' wellbeing, this research highlights the importance of creating an environment where, if appropriate, sex and intimacy can be acknowledged or discussed more openly in consultations.