Psoriasis and Erectile Dysfunction: The Link
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Psoriasis and Erectile Dysfunction: Understanding the Connection
Published: 14 October 2026
Psoriasis and erectile dysfunction (ED) are more closely connected than many people realise. Research shows that men with psoriasis are at higher risk of developing erectile difficulties, with inflammation, reduced self-confidence, and certain psoriasis treatments all playing a role. Understanding this link can help you address both conditions more effectively and improve your quality of life.
At a glance
How psoriasis and erectile dysfunction are linked
Psoriasis is a chronic inflammatory skin condition that affects around 2–3% of the UK population. The same inflammatory processes that cause skin plaques can also damage blood vessels throughout the body, including those needed for healthy erections [1][2]. Chronic inflammation raises levels of certain proteins (cytokines) that interfere with the lining of blood vessels, reducing blood flow to the penis.
Men with moderate to severe psoriasis have been found to have a significantly higher risk of erectile dysfunction compared to men without the condition. The link is strongest in younger men and those with more widespread or severe psoriasis. Psoriatic arthritis, which affects some people with psoriasis, can add to the problem by limiting mobility and causing pain during sexual activity.
The psychological impact of psoriasis also matters. Visible skin plaques, itching, and concerns about appearance can reduce self-esteem and intimacy, making it harder to relax and enjoy sex. Stress and low mood—both common in people living with psoriasis—are well-known contributors to erectile difficulties [10].
The role of inflammation and blood vessel health
Erections depend on healthy blood vessels that can widen and fill the penis with blood. Psoriasis is not just a skin problem; it is a systemic inflammatory disease that affects the whole body. The same inflammation that causes red, scaly patches on the skin can also damage the endothelium—the inner lining of blood vessels—throughout the body [2].
This endothelial dysfunction reduces the ability of blood vessels to dilate properly, which is essential for achieving and maintaining an erection. Over time, chronic inflammation can contribute to atherosclerosis (hardening and narrowing of the arteries), further reducing blood flow. Men with psoriasis are also at higher risk of other cardiovascular conditions, such as high blood pressure, high cholesterol, and type 2 diabetes, all of which are independent risk factors for erectile dysfunction [1][10].
Addressing inflammation through effective psoriasis treatment, a healthy lifestyle, and cardiovascular risk management can help protect blood vessel health and may reduce the risk or severity of ED.
Psoriasis treatments and their impact on erectile function
Some treatments for psoriasis can affect sexual function, though the picture is complex. Systemic treatments such as methotrexate, ciclosporin, and acitretin are occasionally associated with sexual side effects, though these are not common. Biologic therapies (such as adalimumab, etanercept, or ustekinumab) target specific parts of the immune system and are generally not linked to erectile dysfunction; in fact, by reducing inflammation, they may improve overall vascular health.
Topical treatments (creams and ointments) applied to the skin are unlikely to cause ED. However, if psoriasis affects the genital area, the discomfort, sensitivity, or appearance concerns can understandably affect sexual confidence and function. It is important to discuss any concerns about sexual side effects with your dermatologist or GP, as switching to a different treatment or adjusting the dose may help.
Never stop or change a prescribed psoriasis treatment without medical advice. If you are starting a new systemic treatment and have concerns about ED, mention this during your consultation so your healthcare team can monitor and support you.
Discussing concerns with your healthcare team
Many men feel embarrassed to raise sexual health concerns, but your dermatologist, GP, and pharmacist are used to these conversations and can offer practical help. If you think your psoriasis treatment may be affecting your erections, or if ED is making it harder to cope with psoriasis, speak up. Adjustments to your treatment plan, referrals to specialists, or additional support for mental health can all make a real difference.
What you need to know
- Psoriasis increases the risk of erectile dysfunction through inflammation and blood vessel damage.
- Chronic inflammation from psoriasis can affect circulation needed for healthy erections.
- Most psoriasis treatments do not cause ED, but concerns should be discussed with your doctor.
- Lifestyle changes like weight loss, exercise, and stopping smoking help both conditions.
- PDE5 inhibitors are effective for ED in men with psoriasis after a clinical assessment.
How erectile dysfunction is assessed in men with psoriasis
If you are experiencing erectile difficulties and have psoriasis, your GP or pharmacist will take a full medical history, including details of your psoriasis, current treatments, other health conditions, and any medicines you take [2]. This helps identify whether inflammation, medication, cardiovascular risk factors, or psychological factors are contributing to your ED.
You may be asked about the severity and duration of your erection problems, your ability to achieve morning erections, and any changes in libido or mood. Blood tests may be arranged to check for diabetes, cholesterol, testosterone levels, and kidney or liver function, as these can all influence both psoriasis and erectile function [1][2].
Because psoriasis is associated with a higher risk of heart disease, your GP may also assess your cardiovascular health, including blood pressure and weight. Erectile dysfunction can be an early warning sign of cardiovascular problems, so it is important not to ignore it. Addressing ED may also prompt earlier detection and management of other health risks.
Online consultations at Cured Pharmacy
Cured Pharmacy offers a confidential online consultation service for erectile dysfunction, reviewed by UK-registered prescribers. During the consultation, you will be asked about your psoriasis, current treatments, and overall health to ensure any ED treatment is safe and suitable for you. Prescription medicines are only supplied after this clinical assessment.
Lifestyle measures to support erectile function with psoriasis
Lifestyle changes can improve both psoriasis and erectile function by reducing inflammation, supporting blood vessel health, and boosting mood. Maintaining a healthy weight is particularly important, as obesity worsens psoriasis and is a major risk factor for ED [1][10]. Even modest weight loss can improve symptoms of both conditions.
Regular physical activity helps reduce inflammation, improve circulation, lower blood pressure, and lift mood. Aim for at least 150 minutes of moderate exercise each week, such as brisk walking, cycling, or swimming. Exercise also helps manage stress, which is a common trigger for both psoriasis flare-ups and erectile difficulties.
A balanced diet rich in vegetables, fruits, whole grains, oily fish, and healthy fats (such as olive oil and nuts) supports cardiovascular and skin health. Limit processed foods, red meat, and sugary drinks. Smoking damages blood vessels and worsens both psoriasis and ED, so stopping smoking is one of the most effective steps you can take [1][2]. Reducing alcohol intake also helps, as heavy drinking can worsen erectile function and interfere with some psoriasis treatments.
When to get urgent help
- Erection lasting more than 4 hours (priapism) – call 999 or go to A&E immediately
- Sudden loss of vision or hearing after taking ED treatment – seek urgent medical help
- Chest pain during or after sexual activity – stop and call 999
- Severe dizziness, fainting, or very low blood pressure – seek same-day medical advice
- Allergic reaction (swelling of face, lips, or throat, difficulty breathing) – call 999
Call 999 or go to A&E in an emergency, or contact NHS 111 for urgent advice.
Treatment options for psoriasis and erectile dysfunction
Oral medicines called PDE5 inhibitors are the first-line treatment for erectile dysfunction in the UK. They work by increasing blood flow to the penis during sexual stimulation. The main options are sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra), and avanafil (Spedra) [1][2][3][4][5][6]. All require a prescription after a clinical assessment.
Sildenafil is taken about one hour before sex and works for around four hours. Tadalafil can be taken on-demand (at least 30 minutes before sex, with effects lasting up to 36 hours) or as a lower daily dose. Vardenafil works within 25–60 minutes, and avanafil is the fastest-acting, often effective within 15–30 minutes [3][4][5][6]. All need sexual arousal to work and should be taken at most once a day.
If you are taking medicines for psoriasis or other conditions, it is essential that your prescriber checks for interactions. PDE5 inhibitors must never be taken with nitrates (such as GTN spray), nicorandil, riociguat, or recreational drugs called poppers, as the combination can cause a dangerous drop in blood pressure [3][4][5][6]. Men taking alpha-blockers (for prostate or blood pressure) need to start on the lowest dose of a PDE5 inhibitor and be stable on the alpha-blocker first. Some medicines that affect liver enzymes (such as certain antifungals or HIV treatments) can alter PDE5 inhibitor levels, so dose adjustments may be needed [12].
Cured Pharmacy offers a range of ED treatments at transparent prices, from generic sildenafil at £0.45 per tablet (or £0.36 with first-order code Ednew) to branded options. All are supplied following an online consultation reviewed by a UK prescriber.
Other treatment options
If oral tablets are not suitable or effective, other options include Vitaros (alprostadil cream applied to the tip of the penis) or Caverject (alprostadil injection into the penis), both available on prescription [7]. Vacuum erection devices and penile implants are also available through specialist services. Your GP can refer you to a sexual health or urology clinic if needed.
Speak to your dermatologist
If you think your psoriasis treatment is affecting your erections, or if ED is impacting your quality of life, talk to your dermatologist or GP. Adjustments to your treatment plan or additional support can make a real difference.
Scientific References
- NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ [accessed 14 October 2026]
- National Institute for Health and Care Excellence. (n.d.). Erectile dysfunction. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/erectile-dysfunction/ [accessed 14 October 2026]
- Joint Formulary Committee. (n.d.). Sildenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/sildenafil/ [accessed 14 October 2026]
- Joint Formulary Committee. (n.d.). Tadalafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/tadalafil/ [accessed 14 October 2026]
- Joint Formulary Committee. (n.d.). Vardenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/vardenafil/ [accessed 14 October 2026]
- Joint Formulary Committee. (n.d.). Avanafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/avanafil/ [accessed 14 October 2026]
- Joint Formulary Committee. (n.d.). Alprostadil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/alprostadil/ [accessed 14 October 2026]
- Feldman, H. A., Goldstein, I., Hatzichristou, D. G., Krane, R. J., & McKinlay, J. B. (1994). Impotence and its medical and psychosocial correlates: Results of the Massachusetts Male Aging Study. Journal of Urology, 151(1), 54–61. https://pubmed.ncbi.nlm.nih.gov/8254833/ [accessed 14 October 2026]
- Electronic Medicines Compendium. (n.d.). Summaries of Product Characteristics and Patient Information Leaflets. https://www.medicines.org.uk/emc/ [accessed 14 October 2026]
Information on this page is for educational purposes only and is not medical advice. Prescription treatments require clinical assessment by a UK-registered prescriber. Always consult a qualified healthcare professional before starting or changing any medication.
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Start My Assessment Log in to Your AccountYour Questions Answered
Can psoriasis cause erectile dysfunction?
Yes, psoriasis is associated with a higher risk of erectile dysfunction due to chronic inflammation that can damage blood vessels, as well as psychological factors such as reduced self-esteem and stress.
Will treating my psoriasis improve my erectile function?
Effective psoriasis treatment that reduces inflammation may improve blood vessel health and overall wellbeing, which can help with erectile function, though ED often needs its own treatment as well.
Are ED tablets safe if I'm on psoriasis medication?
Most psoriasis treatments do not interact with PDE5 inhibitors, but your prescriber will check all your current medicines during the consultation to ensure safety. Never take ED tablets with nitrates, nicorandil, or certain other medicines.
Can methotrexate or biologics cause erectile dysfunction?
Sexual side effects with methotrexate are uncommon, and biologic therapies are not typically linked to ED. If you have concerns, discuss them with your dermatologist or GP.
How quickly do ED treatments work for men with psoriasis?
PDE5 inhibitors work in the same way for men with psoriasis as for other men. Sildenafil takes about an hour, tadalafil at least 30 minutes, vardenafil 25–60 minutes, and avanafil can work in 15–30 minutes.
Should I see my GP before trying ED treatment if I have psoriasis?
It is a good idea to see your GP if you have new erectile difficulties, as ED can be an early sign of cardiovascular problems. An online consultation with a prescriber can also assess your suitability for treatment.
Can losing weight help both my psoriasis and erectile dysfunction?
Yes, losing excess weight can reduce inflammation, improve psoriasis symptoms, support cardiovascular health, and improve erectile function.
What should I do if my erection lasts more than 4 hours?
Seek urgent medical help immediately (call 999 or go to A&E). A prolonged erection (priapism) is a medical emergency that requires prompt treatment to prevent permanent damage.
Medically reviewed by
Tarun Kumar, Superintendent Pharmacist (GPhC 2233073)