Is Psoriasis Worse for Men?

Health Writer
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Are men more likely than women to have psoriasis, and with more severe symptoms? Researchers have long speculated that this is the case, with one of the earliest studies (a small one involving only 55 people) dating all the way back to 1945. Now there’s confirmation from a large study completed in Sweden and published in the American Journal of Clinical Dermatology in 2017.

After assessing 5,438 patients, the Swedish researchers found that men with psoriasis are more likely than women to receive biologic or systemic treatments, typically used for severe symptoms, rather than the topical treatments generally used for mild to moderate symptoms. Looking at the type of treatment does give a clue as to the severity of symptoms but 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 might shy 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.

Researchers assessed subjects using Psoriasis Area and Severity Index (PASI) scores for different parts of the body: the arms, legs, and head. The men had more severe psoriasis than women on the arms and legs but both sexes scored about the same for the head. The scientists believe this could be explained because women’s hair length and styling typically shield the scalp from sunlight, reducing scalp psoriasis symptoms.

  • The researchers noted that studies in other countries have found similar results. Some countries maintain registries of all psoriasis patients who take biologic and systemic medications. In Ireland, almost twice as many men as women use systemic treatments for psoriasis, while in Japan, men develop more severe psoriasis than women and receive significantly more systemic treatments.

Psoriasis around the world

A 2016 global report on psoriasis by the World Health Organization (WHO) indicated that prevalence ranges from .09 to 11.43 percent; in most developed countries it ranges between 1.5 and 5 percent. Some studies included in the report found psoriasis more common in men than women.

In the United States, approximately 7.5 million people have psoriasis. A study published in 2014 in the Journal of the American Academy of Dermatology looked at the medical records of 6,216 people and found an overall psoriasis prevalence rate of 3.2 percent, with women at 3.1 and men at 3.6.

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