Men are more likely to use biologic or systemic medications for psoriasis and their psoriasis is often more severe than in women, according to a study completed in Sweden and published in the American Journal of Clinical Dermatology in 2017.
Previous studies have speculated that men have more severe psoriasis symptoms, according to the researchers. They pointed to a small study completed in 1945 in Sweden. The study only had 55 participants, however, the results showed that men had significantly more treatment and speculated it was because of the severity of symptoms.
Today, topical treatments are usually used for mild to moderate symptoms, and severe psoriasis is treated with biologic or systemic treatments — men definitely receive treatments geared toward severe symptoms. Looking at the type of treatment does give a clue as to whether symptoms are more severe.
The researchers weren’t sure whether other reasons for treatment choice might also play a role, for example, they wondered if women in childbearing years shied away from biologic or systemic treatments. This wasn’t the case, however, as they found that women at any age had a much lower rate of receiving these treatments. Gender did not seem to be a decisive factor in the choice of treatment. Instead, physicians were guided by the severity of the disease.
This was determined by the Psoriasis Area Severity Index (PASI) scores for different areas of the body — the arms, legs, and head. The men’s scores indicated more severity than women on the arms and legs, but both genders scored about the same for the head.
The scientists believe this could be explained because women’s hair length and styling would typically shield the scalp from sunlight, which helps reduce psoriasis symptoms. Without that extra benefit, the psoriasis on their heads was more severe.
The researchers also noted that studies in other countries have found similar results, based on the type of treatment. Some countries have registries of all people who take biologic and systemic medications.
- In Ireland, almost twice as many men as women used systemic treatments for psoriasis.
- In Japan, it was found that men developed more severe psoriasis and received significantly more systemic treatments.
Prevalence of psoriasis
The Global Report on Psoriasis by World Health Organization (WHO) from 2016 indicates that around the world, the prevalence ranges anywhere from .09 to 11.43 percent, however, in most developed countries it ranges between 1.5 and 5 percent. In the United States, the overall prevalence rate was 3.2 percent in 2014, according to a study published in the Journal of the American Academy of Dermatology.
While it is hard to find an exact prevalence rate, it is even more difficult to compare the prevalence in men and women. Typically, psoriasis is considered equally prevalent in both sexes, however some studies reported in the Global Report from the WHO found it is more common in men.
In the United States, approximately 7.5 million people have psoriasis and there are slightly more men than women with psoriasis. A study published in 2014 in the Journal of American Academy of Dermatology looked at medical records of 6,216 people and found an overall prevalence rate of 3.2, with women at 3.1 and men at 3.6.
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