PA04 Chronic inflammatory skin conditions in adolescents and their impact on intimate relationships

Abstract Chronic inflammatory skin conditions significantly impact sex and intimacy, with increased risk among female patients and those with genital involvement. Studies have largely focused on the impacts of specific conditions and employed single questions on sexual impact, and few have examined the British cohort. There are minimal data on how inflammatory skin conditions impact adolescents, who are particularly vulnerable to mental health challenges and are learning to navigate social and intimate relationships. Our objective was to understand the impact of common chronic inflammatory skin conditions on adolescent sexual health, dating and intimacy in the UK. This is a quantitative and qualitative study of adolescents with common chronic skin conditions aged 17–25 years (inclusive). The trial was registered with ClinicalTrials.gov (NCT06397664). Comparisons of Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), Teenager’s Quality of Life Index (T-QoL), International Index of Erectile Function (IIEF) and Female Sexual Function Index (FSFI) scores were made between conditions (n = 73). A thematic analysis of 17 semistructured interviews with participants provided further depth and patient perspectives on how clinicians can help. Participants experienced significant burdens when navigating romantic and intimate relationships. Of the 73 young adults, 52% (n = 38) reported skin-related intimacy concerns. Three key challenges highlighted were (i) diminished confidence in pursuing romantic or intimate relationships, (ii) symptomatic manifestations (e.g. itch or pain) impeding intimacy and (iii) daily challenges in intimacy despite supportive partners. There was no significant impact on sexual function compared with controls or between conditions. Importantly, 55% (n = 40) of participants reported that their clinicians did not enquire about intimacy concerns, while 32% (n = 23) were hesitant to discuss this with their clinicians. Participants suggested specific approaches to communication tailored to young adults, including active listening and providing a conducive environment to share their intimacy concerns. Open-access counselling or group therapies also emerged as the preferred support offered. Challenges in romantic life and intimacy are present in young adults with chronic inflammatory skin conditions but there is currently an unmet need in addressing concerns. Clinicians should consider adaptations to communication tailored to young adults and offer access to psychosexual counselling.