Some people experience mild to severe psoriasis symptoms on the genitals. Although typically uncomfortable, these symptoms are manageable with medication.

Genital psoriasis often occurs alongside psoriasis of the skin. One study from 2018 estimated that 33–63% of people with psoriasis experience symptoms on the genitals at some point.

In this article, we discuss how to recognize and treat genital psoriasis.

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Genital psoriasis can cause ongoing discomfort due to heightened sensitivity in the area.

Inverse psoriasis is the most common type of psoriasis to affect the groin and genital area. Inverse psoriasis causes smooth, dry, discolored patches on the skin. The affected areas of the skin can feel sore and itchy.

Psoriasis patches may appear red or pink on light skin tones and violet, purple, or darker than the surrounding area on darker skin tones.

Psoriasis causes different symptoms in different areas of the pelvis and thighs, which include the:

  • pubis
  • upper thighs
  • creases between the thighs and groin
  • vulva
  • penis
  • anus and the surrounding area

Treating flare-ups of genital psoriasis can be challenging, and the condition is not curable. However, it typically responds well to remedies and soothing options. It might even resolve without treatment.

Topical corticosteroids

Doctors tend to prescribe low strength corticosteroids to soothe the symptoms of genital psoriasis. Overusing topical corticosteroids, however, may lead to permanently thin skin and stretch marks.

Calcineurin inhibitors

Tacrolimus and pimecrolimus can help treat genital psoriasis without thinning the skin. The Food and Drug Administration (FDA) only approves these treatments for use in eczema. However, they can also help with the symptoms of psoriasis.

In some cases, tacrolimus and pimecrolimus can cause an uncomfortable burning sensation and reactivate sexually transmitted infections (STIs) such as herpes or viral warts.

Vitamin D creams and ointments

Synthetic vitamin D creams and ointments, also known as vitamin D analogs, are safe and effective treatments for psoriasis.

While these medications are typically less effective than topical steroids, there is a lower risk of complications with topical vitamin D treatments. This makes them a good option when long-term treatment is necessary.

Emollients

These cover the skin with a protective layer and help prevent water loss. Emollients are available for purchase over the counter. Some topical creams and ointments that contain fragrances and perfumes might cause irritation.

Oral systemic medications

In cases of moderate to severe psoriasis, doctors might prescribe systemic oral medications, including:

  • methotrexate
  • acitretin
  • cyclosporine
  • apremilast

The effects of these medications can vary from reducing inflammation to slowing the growth of new skin cells. They are only available through prescription and may benefit people who do not respond to topical treatments.

Biologics

These disease-modifying therapies (DMT) are systemic medications that have an effect on the whole body.

Doctors administer biologics via infusion or injection. They work to reduce the autoimmune response and can often help treat the condition when other medications fail to do so.

For genital psoriasis, biologics are not a first-line treatment. However, they can be helpful for people who have genital psoriasis alongside other symptoms or those whose symptoms do not respond to other treatments.

The exact cause of psoriasis remains unknown, but anomalies in the immune system and genetic factors might play a role in its development.

People with psoriasis develop skin cells at an extremely fast rate, and these build up into scaly lesions or plaques.

Risk factors

It is unclear what causes psoriasis, but genetics appears to play an important role. Having a direct family member with psoriasis increases a person’s risk of also developing the condition.

Other possible risk factors or triggers of genital psoriasis include:

  • previous infections, such as strep throat or skin infections
  • injuries to the skin, such as a cut or scrape, bug bite, or severe sunburn
  • stress and other environmental factors
  • cold weather
  • smoking
  • drinking large amounts of alcohol
  • some medications, including high blood pressure medications and antimalarial drugs

Contact with certain irritants might cause a symptom flare-up. These irritants include:

  • urine
  • feces
  • tight-fitting clothes

When experiencing symptoms of psoriasis in the genital area or anywhere else, this resource from the American Academy of Dermatology can help people find a specialist near them.

Genital psoriasis can get worse due to the friction associated with sexual intercourse. Using a condom might help reduce potential discomfort. It also forms a barrier, preventing skin-to-skin and fluid-to-skin contact and further reducing irritation.

After intercourse, people with genital psoriasis should thoroughly cleanse the area and reapply any medications to assist recovery.

Genital psoriasis may cause the area to look different, and a person may experience some discomfort during sexual intercourse. For this reason, people with genital psoriasis should consider communicating with their partners about the condition openly.

Although sexual intercourse can cause irritation, genital psoriasis is not transmissible and should not interfere with sexual activity.

Genital psoriasis causes red or purple patches of skin to develop in the genital area.

Treatment options include topical corticosteroids, topical calcineurin inhibitors, topical vitamin D analogs, oral medications, and biologics.

A person with genital psoriasis or related symptoms should always talk with a doctor. Not only can talking with a doctor ensure that treatment is safe and effective, but it also helps rule out other conditions, including STIs.